Measles: know the risks of the disease
Introduction to Measles
Measles, a highly contagious infectious disease, continues to pose a public health concern in various parts of the world despite significant advancements made possible by vaccination. Caused by the Morbillivirus, the disease manifests symptoms that can lead to severe complications, particularly affecting children under 5 years and adults over 20 years of age. Understanding the associated risks and available preventative measures is crucial to avoid outbreaks and ensure public health.
Historically, measles has been responsible for high morbidity and mortality rates among affected populations, with epidemic outbreaks marking critical periods in human history. The introduction of mass vaccination in the 1960s saw a drastic reduction in the number of measles cases and deaths. However, a decline in vaccination campaigns and the rise of anti-vaccine movements have contributed to the resurgence of the disease in regions where it had been controlled, highlighting the importance of maintaining high immunization rates in the population.
History and Prevalence of Measles
The Journey of Measles Through the Centuries
Measles has been a significant disease affecting humanity since antiquity, with descriptions dating back to the 9th century by Arabian physicians. Its capacity to cause rapid and extensive outbreaks was feared, especially among populations previously unexposed to the virus, resulting in high mortality rates. The development of the measles vaccine in the 20th century represented a public health milestone, enabling effective disease control in many countries worldwide.
Current Situation of Measles Worldwide and in Brazil
Today, the World Health Organization (WHO) recognizes measles as a highly contagious but preventable disease through vaccination. Despite global efforts to eradicate measles, outbreaks still occur, particularly in countries or regions with fragile health systems and insufficient vaccine coverage. In Brazil, after achieving certification as a measles-free country, there was a setback with the resurgence of cases, mainly due to vaccine hesitancy and the movement of people between outbreak areas.
Causes and Transmission of Measles
The Measles Virus and Its Contagion
The measles virus is highly contagious, transmitting from person to person through respiratory droplets expelled by coughing, sneezing, or even talking. Enclosed environments and crowds facilitate the spread of the virus, which can remain active in the air for up to two hours. Its high contagion rate means that up to 90% of non-immunized people who come into contact with the virus will develop the disease.
Risk Factors for Measles
Among the factors that increase the risk of contracting measles, lack of vaccination is at the forefront. Unvaccinated young children are particularly vulnerable, but adults and travelers to areas where measles is endemic or where there are current outbreaks also face an increased risk. Individuals with compromised immune systems, whether due to diseases or treatments that affect immunity, are also more susceptible to measles and its complications.
Symptoms of Measles
Initial Signs and Symptoms
The initial symptoms of measles, which appear about 10 to 14 days after exposure to the virus, are similar to those of a severe flu: high fever, persistent cough, runny nose, and conjunctivitis. These are followed by the appearance of small white spots inside the mouth, known as Koplik's spots, and a characteristic red rash that begins on the head and spreads to the rest of the body.
Potential Complications of Measles
Although many people recover without sequelae, measles can lead to serious complications, especially in children under 5 years, adults over 20 years, and immunocompromised individuals. These complications include pneumonia, one of the most common causes of death associated with measles, encephalitis (inflammation of the brain), and a rare but fatal condition known as subacute sclerosing panencephalitis, which can occur years after infection.
Diagnosis of Measles
Diagnostic Process
The suspicion of measles is usually based on the observation of characteristic clinical symptoms, especially if there is a history of exposure to the virus. To confirm the diagnosis, laboratory tests can detect the presence of the virus in the blood, urine, or respiratory secretions. The detection of specific antibodies against the measles virus can also help confirm past infection or immunity to the virus.
Importance of Early Diagnosis
Early diagnosis of measles is crucial for implementing control measures to prevent the spread of the disease, especially in enclosed spaces or communities. This includes isolating confirmed cases, notifying health authorities, and identifying and vaccinating non-immunized individuals in contact with the patient. A swift response also allows for the appropriate management of symptoms and the prevention of complications.
Treatment of Measles
Current Treatment Approaches
There is no specific antiviral treatment for measles. The management of the disease focuses on symptom relief and the prevention of complications. This may include the administration of antipyretics to control fever, adequate hydration to prevent dehydration, and, in some cases, vitamin A supplementation, which has been shown to reduce mortality in children with measles. Patients with severe complications may require hospitalization and intensive support.
Supportive Care and Recovery
During the recovery period, which can last several weeks, it's important to maintain a calm and comfortable environment for the patient, offering nutritious food and ensuring adequate hydration. Close observation for signs of complications, such as respiratory difficulty or changes in mental state, is essential for early and effective intervention. Recovery from measles usually results in lifelong immunity against the disease.
Prevention of Measles
Vaccination: The Best Prevention
Vaccination is the cornerstone of measles prevention. The MMR vaccine, which protects against measles, mumps, and rubella, is safe and effective, providing long-lasting immunity in most individuals. Two doses of the vaccine are recommended, with the first dose administered between 12 and 15 months of age and the second dose between 4 and 6 years. Maintaining high vaccine coverage rates in the population is essential to prevent outbreaks and advance towards the eradication of measles.
Additional Protective Measures
Besides vaccination, other measures can help prevent the spread of measles. Hygiene practices, such as frequent handwashing and using tissues when coughing or sneezing, are important to reduce the transmission of respiratory droplets. Avoiding close contact with infected individuals and maintaining well-ventilated environments are also useful recommendations. In the event of an outbreak, additional measures, such as quarantine or the temporary closure of schools and other gathering places, may be necessary.
Myths and Truths About Measles
Misinformation and myths about measles and vaccination against the disease have contributed to the resurgence of cases in some areas. One of the most damaging myths is the false association between the MMR vaccine and autism, a theory debunked by numerous scientific studies. It's crucial that individuals seek information from reliable, evidence-based sources to make informed health decisions. Raising awareness and educating about the benefits of vaccination and the real risks of measles are fundamental to combat these myths and protect public health.
The Role of Public Policies in Eradicating Measles
Public policies play a crucial role in the fight against measles. Well-organized vaccination campaigns, health education programs, and the implementation of laws that encourage or require vaccination are key to increasing
vaccine coverage rates. International collaboration and the sharing of resources and information are also essential to combat measles globally. Investing in strong and accessible healthcare systems for all, along with epidemiological surveillance, are key strategies for early outbreak detection and rapid response.
The Importance of Awareness and Health Education
Promoting awareness and health education about measles and its prevention is crucial to combat the disease. Informing the population about the associated risks, the importance of vaccination, and how the disease is transmitted can help reduce vaccine hesitancy and promote effective public health practices. Health education should be inclusive, addressing myths and concerns transparently and based on evidence, to build trust in vaccines and public health recommendations.
Conclusion
Measles is a serious but entirely preventable disease. The key to its eradication lies in maintaining high vaccination rates and educating the population about the risks of the disease and the importance of immunization. With coordinated and evidence-based efforts, we can protect our communities against measles and move towards a world free of this disease.
Frequently Asked Questions (FAQs)
Who should get the measles vaccine? The measles vaccine is recommended for all individuals, especially children starting at 12 months of age and adults who do not have immunity against the disease. People traveling to areas with active measles outbreaks should also ensure they are properly vaccinated.
What are the first warning signs of measles? The first signs of measles include high fever, cough, runny nose, conjunctivitis, and white spots in the mouth. The characteristic rash appears a few days after the first symptoms.
Can measles be contracted more than once? It is extremely rare to contract measles more than once. Natural infection with the measles virus generally confers lifelong immunity.
How can I protect my family against measles? The best way to protect your family is to ensure everyone is properly vaccinated against measles. Hygiene practices, such as frequent handwashing and avoiding close contact with sick individuals, are also important.
Are there side effects from the measles vaccine? Side effects from the measles vaccine are generally mild and can include low-grade fever and temporary rash. Serious reactions are very rare.