Update: December 2018
Measles is an acute viral disease,
transmitted by airborne droplets. Especially vulnerable for this
diseases are considered children of the first year of life, which must be
protected by maternal antibodies, but today mothers
own immunity weakens and antibodies either completely absent or their
few. A vaccination against measles children do only after a year.
The disease affects the mucosa of the respiratory tract, oropharynx, eyes,
and the symptoms of measles in children are characterized by a rash and severe
intoxication. When a patient sneezes or coughs, it releases a virus
which is very contagious. The first manifestations of measles begin later.
9-10 days after infection.
The mechanism of measles development in children
The causative agent of measles is a virus that quickly
dies in open space when exposed to high
temperatures or ultraviolet rays. True, it is resistant to
antibiotics and live long at low temperatures.
You can only get measles by close contact with
infected person (the probability is 95%), and he
considered infectious only at the very end of the incubation period, at the peak
disease and the first four days after the onset of rash. After the lapse of
this time the carrier of the virus is safe.
This virus is very volatile, so it spreads easily in
indoors, it penetrates from the upper floor to the lower floor, through stairs and
corridors. About the first six months after birth, the child has
maternal immunity against measles, but by the year it is noticeable
weakens. However, if the mother of the child was not sick and did not receive
vaccine, then the baby has no innate immunity. As a rule, after
a person gets a typical measles virus, he gets
stable immunity to the disease until the end of life.
The incubation period for measles is 8-17 days, in rare cases
reaches 21 days. The typical course of the disease includes three
- prodromal (catarrhal)
- period of rash
- период pigmentation.
The prodromal period proceeds dynamically, the body temperature in
in some cases it rises to 39 degrees, a runny nose appears, dry
cough, redness of the eyelids, insomnia, loss of appetite.
Sometimes отмечается рвота, потеря сознания и кратковременные
The pathogen virus significantly reduces immunity and causes
allergies, and also violates the vitamin metabolism. Respectively,
favorable conditions for the occurrence of pathogenic
microflora, what caused the further development of related
Recently, there have been an increasing number of parents refusing vaccinations.
against measles, which leads to periodic outbreaks of the disease in
Russia. Measles is a disease that only people get sick of, infection
occurs only from person to person (see the refusal of Baptists from
measles vaccination led to an outbreak of the disease). Among the sick in
In recent years, about 80% of children have not been vaccinated, and 30% of
their failure was medically indicated. Among the sick inзрослых
70% were also not vaccinated.
No clinical signs of measles are observed during the incubation period.
arises. It proceeds without symptoms and manifestations. At that time
the virus does not make itself felt, but actively propagates in the mucous
shell of the upper and lower respiratory tract. After that, the virus with
blood is carried throughout the body, and from that moment begins
prodromal (catarrhal) period.
The prodromal period lasts about 3-4 days, and that’s when
начинают появляться первые симптомы кори у children:
- Onсморк, светобоязнь (ребенок испытывает боль при ярком свете),
redness, purulent discharge from the eyes (than to treat conjunctivitis in
- The behavior of the child changes noticeably, it becomes more
capricious, sluggish and drowsy, decreased appetite, the child loses in
- Spots become visible near the base of molars
Belsky-Filatov-Koplika – these changes in the mouth, characteristic
measles symptoms. They are caused by destruction and sloughing.
epithelial cells. This is the first and most important symptom
diseases allowing early diagnosis
disease and time to isolate the child from others. Stains look like
as white-gray dots surrounded by a red halo, and mucous
becomes edematous, uneven, rough, with traces
biting. With the appearance of a rash, these spots disappear.
- During the prodromal period, all signs and symptoms of measles
baby gradually strengthened: cough gets stronger
due to laryngotracheitis, the temperature can reach 38-39
On пике заболевания начинается его следующая стадия. Should
Remember that a child is contagious at this time for others (see symptoms
measles in adults).
- The period of rash develops on the background of increased temperature
(39-40) and dry barking cough in a child, stuffy nose and
- The child appears dry mouth, lips become
- The face of a sick child is puffy, puffy
- The eruption area gradually expands: the rash appears in
ear areas and on the face. The spots become red-burgundy and
even merge with each other, forming fairly large areas
redness protruding above the skin. Usually это папулы
up to 2 mm in diameter, surrounded by a large irregularly shaped spot.
Small hemorrhages can also form on the skin in severe
- Further spots spread to the body and arms.
Gradually catarrhal symptoms fade away: temperature
normal, appetite appears, cough weakens.
The duration of the period of rash is about 3-4
Затем он сменяется периодом pigmentation. Skin blood vessels
expand and fill with blood, resulting in
rash appears. Red blood cells are destroyed, and contained in them
iron is deposited in the tissue – hemosiderosis develops. Rash on
the body does not appear suddenly, but in stages, respectively
pigmentation also occurs gradually:
- At the very beginning, only the face and neck are subject to pigmentation,
then the body, part of the limbs and then the feet and shin.
- The affected areas acquire a bluish tint that is not
passes even when the skin is stretched or pressed.
- The baby sleeps well and eats, its body temperature comes in
norm, the state can be called satisfactory.
From 4 days after the start of the rash, the child’s condition begins
to normalize – the temperature drops, the conjunctivitis subsides,
cough weakens and runs cold, rashes turn pale. By
After 7-9 days from the onset of rash, all catarrhal phenomena
disappear. The duration of the skin cleansing period is 1-2.
weeks, but on the 5th day the child may well return to school or
to a kindergarten.
Measles – a serious infectious disease and occurrence
serious complications can cause a child to die. Should
understand that death is not caused by measles, but by
ею тяжелых complications.
As a rule, the diagnosis is made on the basis of typical clinical
pictures and lab results. The appearance of the patient
also matters: measles is characterized by swelling and swelling
eyelid, puffiness of the face, spots. Classic signs of measles
infections – recurrent rashes, pigmentation and a decrease in the number
leukocytes in the blood with a relative increase in neutrophils.
Differential diagnosis is used to distinguish measles from
аллергических rashes. In this situation, it is important to immediately draw
attention to the likely contact with the allergen. Allergy most often
accompanied by itching of the skin, but acute intoxication does not
is observed. Antiallergic drugs immediately give
For того, чтобы в лабораторных условиях подтвердить наличие
virus, conduct studies of rtha with measles antigen. Blood for him
taken twice. Method of enzyme immunoassay (ELISA)
used for the earliest detection of the disease. If in blood
protective antibodies are detected, this clearly indicates
the presence of measles.
Differentiation of the diagnosis is carried out with such diseases
which are also accompanied by catarrhal phenomena – rubella,
flu, whooping cough, enterovirus infection, herpetic, rhinovirus
infection, burns of the upper respiratory tract, etc.
The difference between measles and these diseases is the appearance of
2-3 день таких симптомов, как неспецифические энантемы на
soft and hard palate, as well as the spots of Velskiy — Filatov — Koplik,
development of scleritis, conjunctivitis, and symptoms of a common
If measles is uncomplicated, treatment includes the usual
hygiene procedures. The patient must lie warm, good
ventilated room and periodically take baths. Eyes
washed several times a day with a 2% solution of boric acid,
and the mouth should be constantly rinsed (see how and how to rinse
If measles is severely complicated by pneumonia, then
detoxification intravenous therapy and antibiotic treatment
penicillin series. If intolerance can be used
macrolides, or inhibitory penicillins, or cephalosporins 3
We must not forget about the healthy diet of the child. Children need
to give nutritious, wholesome, but easy food, such as
bread, broth, jelly and porridge. Young children need to
use milk and vitamin C.
When a child has a fever, he eats little, only drinks
water is normal. No need to force a child to forcibly take
food intoxication abundant food creates additional
the load on the entire body, liver, kidneys, gastrointestinal tract – preventing the removal
It is important to remember the indispensable daily cleansing of the oral cavity.
When a sick child is hard to look at a bright light, you need
darken the room. The room should be warm. Byсле того, как
the temperature returned to normal, and the cough and other symptoms disappeared,
the child can be let out for a walk on the street and allow him to communicate with
Врачи выделяют ранние и поздние complications этого заболевания.
Ранние complications, как правило, возникают на первых двух стадиях
the development of measles, and later – in the third period. All complications can
classified into three main groups depending on the zone
- disorders of the respiratory system;
- disorders of the central and peripheral nervous system;
- disorders of the gastrointestinal tract.
In direct proportion to the complication factor
subdivided into primary and secondary. Primary appear under
directly affected by the measles virus, and secondary due to
bacterial infection. Primary complications include:
- encephalitis (subacute sclerosing panencephalitis and
- measles multicellular pneumonia.
The respiratory system suffers greatly, and its defeat is expressed in
as a variety of laryngotracheitis, bronchitis, pneumonia, bronchiolitis and
pleurisy. Usually pneumonia affects children under two years of age.
age The probability of getting otitis media increases during the period
The functioning of the gastrointestinal tract is impaired:
colitis and enterocolitis occur, which is inflammation
intestine. They develop due to the layering of microbial flora, i.e.
are secondary complications.
The defeat of the nervous system is fraught with the occurrence of meningitis,
which flow hard enough and sometimes lead to death
There are several varieties of measles pneumonia in
- common localized pneumonia, on which organs and systems
the human body practically does not react;
- toxic pneumonia leading to work disorders
cardiovascular apparatus, central nervous system and
- toxic septic pneumonia characterized by septic
- septic pneumonia, characterized by a stronger manifestation
Also, pneumonia is usually divided into early and late. Early
pneumonia often accompanies measles in the first days after the onset
rash, late occurs 5 days later (in the period
pigmentation). Early pneumonia is more susceptible to children.
age, later – older.
Typical localized pneumonia can be recognized by
featured: mild dyspnea, cyanosis, dry, and later a wet cough
(see the first signs of pneumonia in a child). While listening
respiration is defined as bronchial, with slight wheezing. Usually
no serious adverse effects on the part of the respiratory
and cardiovascular system. Sometimes poorly marked
manifest fever and intoxication, loss of appetite and liquid
For the toxic form of measles pneumonia is characteristic response
body reaction and inflammation of the lung tissue. Especially acute
the nervous system reacts: there is some inhibition,
drowsiness, fatigue and decreased muscle tone. Sometimes
classic signs of meningitis, such as vomiting,
muscle stiffness, cramps and more.
Toxic-septic pneumonia is dangerous because
inflammatory changes are added purulent processes of mucous membranes
respiratory tract, oropharynx, pleura and lungs. Septic form
pneumonia differs in earlier emergence of purulent
Pneumonia can be purely measles (viral) or secondary
bacterial. Early occurring as bronchopneumonia.
Interstitial pneumonia often leads to severe respiratory
failure. May occur fusion of inflammatory foci
or abscessing (formation of ulcers) in the lung tissue. On
this background with severe intoxication
two years of immunocompromised concomitant anomalies in
cardiovascular or endocrine system) may die.
The first week after contact with a sick child can still
to attend children’s institutions, since only from the last 2 days
incubation period, the child may be contagious. For
Prevention of measles in preschool institutions needs to be limited
children with measles symptoms up to 5 days after the first
- It is very important to prevent measles.
preventive vaccinations in 1 year and 6 years.
- During the illness of the child in the room in which there is
sick, should be carried out daily wet cleaning and
- For детей, имевших контакт с больным человеком, для
prevention, it is recommended to introduce a specific immunoglobulin,
the resulting immunity is no different than the immune system
ill children, but persists for a month.
- Quarantine is made for children who were not ill until 17 years of age.
and not vaccinated against measles.