Measles is a disease caused by a virus, which is characterized by maculopapular reddish patches that are preceded by a fever of 38oC for more than 3 days and accompanied by symptoms of coughing, runny nose, red eyes, conjunctivitis.
Measles or morbili or rubeolav is a common infection in children and spreads through droplets. Morbili is one of the causes of death in children even though a vaccine against the measles virus has been found. This disease is characterized by prodromal symptoms such as fever, cough, runny nose, and conjunctivitis followed by a maculopapular rash
. Measles is caused by rubeola virus from the Paramyxovirus family with the genus Morbillivirus. This virus is an RNA virus known to have only one antigen. Measles is a serious and highly contagious acute viral infection. The rate of transmission is more than 90% of an infected person from 4 days before to 4 hours after the appearance of the rash. The incubation period for the disease is 7-18 days.
Symptoms of measles are characterized by: Fever with body temperature usually >380C for 3 days or more and will end after 4-7 days. High fever occurs after 10-12 days after contracting. There is also a cough, runny nose, red or watery eyes (3C: cough, coryza, conjunctivitis).
The typical sign (pathognomonic) is Koplik’s spot or a grayish white spot with a red base on the inner cheek. Symptoms on the body in the form of a maculopapular rash. The rash appears on the face and neck, starting behind the ears, then spreading over the body.
The rash persists for 3 days or more on the 4th to 7th day of the fever range. The rash appears when the fever is at its peak. The rash ends in 5 to 6 days, and becomes coppery or blackish in color.
Morbili has typical clinical symptoms which consist of 3 stages, each of which has special characteristics; as follows:
- The prodromal stage lasts approximately 4-5 days with symptoms of fever, malaise, cough, photophobia, conjunctivitis and coryza. At the end of the stage, sometimes Koplik’s spots (Koplik spots) appear on the mucosa of the cheeks / mouth area, but this characteristic symptom is not always found.
- Eruption stage which lasts 4-7 days after the prodromal stage is characterized by the appearance of Koplik spots and a rash that begins to appear from behind the ears spreading to the face, trunk, arms and legs.
- Convalence stage or the final stage is characterized by reduced eruptions (spots), leaving a brownish mark called hyperpigmentation, but over time it will disappear on its own. body heat decreases to normal if there are no complications.
Death can occur in morbili associated with complications that occur. About 30% of complications with a higher number occur in children under five years of age. Complications that can occur include pneumonia, ear infections, diarrhea and encephalitis. Measles vaccination in children can reduce the number of deaths. Measles vaccine is recommended to be given in two doses because about 15% of children fail to get immunity in the first dose.
Immunization with the measles vaccine is given to provide protection and the measles vaccine is in the form of a live virus. The live measles vaccine prevents measles infection and is recommended as the MMR vaccine for children aged 12-15 months and 4-6 years. The measles, mumps, rubella, and varicella (MMRV) vaccine, the MMR vaccine combined with the varicella vaccine, is an alternative vaccine that can be given to children aged 12 months – 12 years.
The second dose of MMR is not a booster dose but is intended to reduce the failure rate of the vaccine that has been given the first time, which is 5%.
The measles vaccine is an excellent vaccine with >90% efficiency with a booster given in the form of MMR. Although immunized patients get measles, it is usually mild, modified measles that heals very quickly and without serious complications.
Until now there is no specific antiviral drug for measles. Severe complications due to measles can be prevented through supportive measures by ensuring adequate nutrition and fluid intake, overcoming dehydration if it occurs.
Antibiotics are only given when a secondary bacterial infection is suspected, or there are complications such as middle ear inflammation and pneumonia. All children diagnosed with measles should receive 2 doses of vitamin A supplementation. Vitamin A
Therapyproven to reduce morbidity and mortality so that the World Health Organization (WHO) recommends giving vitamin A to all children with measles, where the main nutritional elements that cause morbili are not protein and calories but vitamin A. When vitamin A deficiency occurs in cases of morbili it will cause blindness and death. Therefore, vitamin A is given in high doses.