Bogomolets National Medical University
HONOR, MERCY, GLORY

PROFESSOR OLHA HOLUBOVSKA ABOUT DANGER OF MEASLES EPIDEMIC

11.01.2018

At present moment the measles epidemic threatens to Ukraine: there are already the severe cases of disease at children and adults, including lethal ones: Doctor of Medicine, head at department of infectious diseases at O.O. Bogomolets National Medical University, professor Olha Holubovska told about danger of disease and how to protect against measles”.

Measles is the infectious diseases of viral nature, only a human is ill with it as it is a source of infection. The measles as flu is transferred by air. The peculiarity of this virus is that it is very contagious: all, who contact with patient, being not vaccinated, fall ill, – tells the professor. The measles is spread at cough and sneezing, close personal contacts. It remains active and lives in the air and on infected surfaces during two hours. An infected human may transfer the virus for 4 days before and after appearance of eruption at it. According to the words by specialist, the virus is spread quicker at places of large accumulation of people but in fact it is impossible to say precisely that the infection took place namely at that very place. It is not worth binding the infection to any concrete places. This may be transport, street, everywhere, where there are infected people, of course it is spread quickly in closed space.

What are the peculiarities of measles infection?

The virus injures the nervous system, causes to strong immune depression. Besides, the disease is known with complications. The activation of endogenous infection up to tuberculosis is possible, as well as injury of the central or periphery nervous system, pneumonia, – tells Olha Holubovska. The doctor emphasizes that adults fall ill with measles much harder than children. The measles at children, aged less five years, may become the reason for ear infection (otitis), bronchitis, pneumonia, diarrhea, encephalitis.

The first clinical manifestation of disease is higher body temperature, often – at once to 39 degrees and more, possibly – cold, cough and some other non-specific symptoms, for example, nausea (as a result from injury of pancreas), earache, photophobia, etc. The duration of such period in average is approximately 4 days, sometimes – longer. Despite prevalence of non-specific symptoms, it is not difficult to set the true diagnosis in this case but – ONLY at careful examination of patient with compulsory examination of tunica mucosa of mouth across the permanent teeth: the only very characteristic symptoms – Koplik’s spots that are small whitish elements (1-3 mm) across permanent teeth and in other places of tunica mucosa of mouth – are localized namely there. They appear at ALL patients and their detection is in fact the clinical confirmation for diagnosis. The available various non-specific symptoms enforce to prescribe different symptomatic therapy. After some days for treatment the disease passes to the next period – eruptions when the so-called spotty popular eruption appears firstly on the face, which during 3 days stage-by-stage spread to the body and extremities. The eruption may tend to fusion, sometimes – haemorrhagic character, all that testify to the severe run of disease. When the eruption reaches the shins (usually on the third day since eruptions), only then the condition of patients starts improving, and the eruption on the face – paling. Such stage-by-stage approach is very characteristic to the measles and serves as an important diagnostic criterion. The disease is finished with gradual normalization of body temperature and development of pigmentation and peeling at the place of eruption.

What shall the doctors remembers when they for the first time come into contact with the patients?

The first and the most important thing is that the measles is the clinical diagnosis, we should not wait for confirmation, we do not even have the possibilities for approximate express diagnostics (as at flu), thus, for correct and TIMELY establishment of diagnosis it is necessary carefully to examine a patient, especially the mouth cavity, looking into the places for typical localization of Koplik’s spots. It is recommended to hospitalize the adult patients, taking into account for predicted severe, unforeseen run of disease at them, not to prescribe the antibiotics for prevention.

What shall the patients and potential patients remember?

THE FIRST AND THE MOST IMPORTANT THING – TIMELY TO ADDRESS TO THE DOCTOR AND NOT TO BE ENGAGED IN SELF-TREATMENT.

The potential patients should remember about vaccination. The adults, who were born until 1957, are considered to be immune to the measles. Those ones, who were born later, shall administer not less than one dose of vaccine at absence of medical contraindications, early infection in the anamnesis or immunity, confirmed by laboratory. The low level of vaccination and weak immunity are one of the main reasons for spread of disease. The children shall be vaccinated due to the age if the adults do not remember, whether they were ill or not, the blood test for titer of antibodies may be made at laboratory, they will show whether a human has the immunity to disease or not, – adds Olha Holubovska. The main strategy, accepted all over the world, against the measles is the vaccination of children against measles. The vaccine against measles is used for more than 50 years. The vaccine against measles is often combined with vaccines against scarlet fever and/or mumps in the countries, where these diseases are the problem. It is equally efficient both in the form of monovaccine and in combined form.

If a contact with ill person has already taken place, the vaccination is made during the first three days since contact to children, aged over 1 year, who were not ill with abovementioned infections and were not vaccinated. The vaccination is made to adults (aged up to 30 years), if they were not ill with abovementioned infections and did not receive the vaccination and re-vaccination against them. There are no means of specific therapy for treatment of the measles, all methods of treatment have the non-specific character and directed to avoid the complications – bed regime, plentiful drinking. It is necessary to add vitamin A to weak children in order to avoid the severe complications of the measles, – emphasized professor Olha Holubovska.

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