Rash, cough, runny nose are the first symptoms of measles in children. Be on the lookout! Measles in infants: symptoms, vaccination, treatment Care and special approach

Measles is an infectious disease that is transmitted by airborne droplets. A child who has not been vaccinated will get sick with a 100% probability if he comes into contact with an infected person. Such a percentage of susceptibility is not observed in almost any other diseases.

Measles in children occurs in an acute form, especially between the ages of 2 and 5 years. The disease virus enters the body through the respiratory tract and then spreads through the bloodstream. With this disease, the mucous membranes of the eyes, oral cavity and respiratory organs are mainly affected, a characteristic rash, conjunctivitis appears, and the temperature rises.

Causes of measles

The cause of the spread of infection is always the sick person. The virus enters the air through droplets of saliva released when coughing, sneezing or talking, and then “moves” into the respiratory tract of a nearby child. The patient is considered contagious during the last two days of the incubation period of the virus and up to the 4th day of the rash.

Measles is extremely rare in children under one year of age, because they still have little contact with the outside world and strangers. In addition, newborns are protected by maternal antibodies. In infants, the disease may not proceed quite normally and may be characterized by the following symptoms: lack of fever, slight runny nose, slight redness in the mouth.

At the same time, infants in the first year of life may experience complications that are more severe than measles itself and primarily affect the respiratory and cardiovascular systems.

Children who have recovered from the disease remain immune to the disease until the end of their lives. If the mother has had measles in the past, the child will be resistant to the disease until the age of 3 months. It is this period of time that maternal antibodies are contained in the child’s blood. Also, after vaccinations, immunity develops and the child will be protected from measles.

Symptoms and stages of the disease

Symptoms of measles: 1 and 4 - rash; 2 - Belsky-Filatov-Koplik symptom; 3 - enanthema in the prodromal period

Measles is an insidious disease that develops in stages. In the first days, the disease may not manifest itself at all, the children remain cheerful and playful. The virus spreading throughout the child’s body is still completely invisible to the sensitive eyes of parents. This is the insidiousness of the very first period of the disease, and there are four of them in total.

1. Incubation period

This is the time period that begins at the moment of infection and continues until the first signs of the disease appear. It is generally accepted that this period in children is 7-14 days. At this stage, the virus multiplies “quietly” in the body, there are no symptoms of measles, and the child is not bothered by anything at all. In this case, the baby becomes infectious to others only in the last 5 days of the incubation period.

2. Catarrhal period

During this period, the child develops symptoms that strongly resemble a cold:

general malaise, weakness, lack of appetite;
increase in body temperature up to 40°C;
headache;
dry cough;
runny nose and hoarse voice;
increased lacrimation, swelling and redness of the eyelids, conjunctivitis (drops and ointments for conjunctivitis);
abdominal pain and loose stools;
runny nose with purulent mucous discharge from the nose;
lacrimation, photophobia;
Infants may experience a decrease in body weight.

Documentary

The catarrhal period of the disease lasts no more than four days, during which all the symptoms of measles gradually turn into more severe forms. At the moment when all manifestations reach their highest levels, a rash begins to appear.

3. Period of rash

As already noted, the rash appears at the peak of all signs of the disease. Spots of a dark red hue appear primarily on the head. Gradually growing and merging with each other, they form large foci of rashes. It is for this reason that the child’s face swells, and the lips become dry and often crack.

On the second day of this period, the rash begins to appear on the arms and upper torso. The third day is characterized by the appearance of rashes all over the child’s body. The duration of the entire period is 4 days.

The period of rash is characterized by a decrease in body temperature, weakening of the cough and the appearance of appetite. The child becomes mobile and active. About a week after the onset of the rash, catarrhal symptoms disappear completely.

4. Pigmentation stage

The rash leaves behind pigment spots, the appearance of which occurs in the same sequence: first on the face, then throughout the body. These spots gradually begin to peel off and eventually disappear completely.

At the pigmentation stage, the child’s condition gradually returns to normal, sleep and appetite are completely restored, and body temperature does not exceed normal values.

Non-standard forms of measles

If a child gets measles, you will not always be able to notice the development of this disease. Measles may not occur as usual, but in a different form. Such forms of the disease are usually called atypical.

Mitigated form

Children who have been in contact with an infected child receive immunoglobulin for prevention. In such children, the overall picture of the disease becomes blurred:

the incubation period lasts 21 days;
in the catarrhal period there is a slight cough and runny nose;
all periods of the disease, except incubation, are reduced;
the rashes are not abundant and appear without observing stages;
there are no characteristic spots on the cheeks;
pigmentation is less dark.

Abortion measles

With such an atypical form, all signs of the disease appear according to the standard pattern. But after about 2-3 days, all symptoms of the disease suddenly disappear. The rash concentrates on the face and upper torso.

Erased form

This form of measles is very similar to mitigated measles. Here, catarrhal signs of the disease are also insignificant. However, unlike the mitigated form, the erased form is characterized by the absence of a rash. This factor greatly impedes making a correct diagnosis.

Reminder - Beware Measles!

Diagnosis of the disease

It is often difficult or even impossible to recognize a disease only by external manifestations. This is especially true for atypical forms of the disease. In addition, the first signs of measles strongly resemble a cold, which can mislead anyone.

To make a reliable diagnosis, your child must be sent for the following types of laboratory tests:

general blood analysis;
general urine analysis;
serology (detection of antibodies to the measles virus in the blood);
detection of measles virus in the blood.

Additionally, the child may be referred for a chest x-ray, and if there are complications from the nervous system, for electroencephalography.

In most cases, with the standard development of the disease, making a diagnosis does not cause difficulties and laboratory tests are simply unnecessary.

Treatment

There are no special treatments for measles; the body will cope with the infection on its own. Treatment here is symptomatic, which will alleviate the general condition of the sick child:

antipyretic drugs for elevated body temperature;
cough medicines depending on its type (different medicines are used for wet and dry);
remedies for runny nose and sore throat;
drink plenty of fluids and stay in bed.

During illness, it is also important to provide the child with the necessary vitamin complexes to maintain immunity, and to lubricate chapped lips with Vaseline.

Symptomatic treatment is carried out at home under the supervision of a pediatrician. The child is admitted to the hospital department if complications begin to develop. If there are complications, therapy is supplemented with antibacterial drugs.

Complications of the disease

Complications usually develop in children under 5 years of age or in adults over 20. The most common of them:

otitis;
laryngitis;
stomatitis;
encephalitis;
inflammation of the lymph nodes in the neck;
bronchopneumonia.

Complications that occur in young children can hardly be called a rare occurrence. That is why the baby needs to be treated under the strict supervision of a local pediatrician. Ideally, the doctor will visit your child at least once every three days.

Why do such consequences occur? Everything is very simple. The measles virus can suppress the immunity of a small patient, and this is an excellent circumstance for the bacteria surrounding the child. They are provided with “free entry” into the baby’s body, and they are not slow to take advantage of this. Depending on the type of bacteria that enters the child’s body, not only the complications listed above may occur. It is quite possible that there may be upset stool, conjunctivitis, and even problems with the central nervous system.

The baby’s immunity decreases at the rash stage and may not recover earlier than in a month. Therefore, during treatment, it is important to follow basic hygiene procedures, and continue to see a doctor even after recovery.

Prevention

The first step in preventing the disease is limiting contact with sick children. A child with signs of this infection should be isolated from other (not sick) children for the entire period when he is contagious. The patient's room should be regularly ventilated, and wet cleaning is also necessary.

Children who have been in contact with the patient are given a special immunoglobulin in the first 5 days after contact, which helps them not get sick. This measure is taken in relation to children who have not previously been vaccinated.

It is important to know! Immunoglobulin is administered only to children with weakened immune systems and under the age of three years.

But the most reliable assistant in preventing measles is vaccination.

Video: how to protect yourself and children from measles

Graft

We have already said that the vaccine is the most effective method in preventing measles. Vaccination is an artificial infection with a virus. But its concentration is so low that the child’s body copes with the infection on its own and at the same time produces protective antibodies.

After vaccination it is possible:

slight increase in temperature;
the appearance of conjunctivitis;
small rash on the body.

All this is completely safe and goes away in 2-3 days.

Note! The vaccine is contraindicated in children with weakened immune systems and those with blood or heart diseases. The vaccine is live measles bacteria. A child can be vaccinated only if there are no contraindications.

The first vaccination is carried out in children at the age of one year, revaccination - at 6 years. Then you can hope for a long-term effect, providing your child with protection from the virus for 15 years. Look vaccination calendar

Measles is not a pleasant disease. In addition, in young children it is often complicated by other unpleasant diseases that can cause much more harm than measles itself. At the same time, children who have had this disease once acquire lifelong immunity.

Measles vaccination is a reliable method of preventing the disease, but it is not a panacea. Before agreeing to vaccination, you must make sure that the child has strong immunity and there are no other contraindications.

We also read:

Jaundice of newborns

Common skin diseases in children

Other common childhood illnesses

When a baby develops measles, parents do not suspect it, since the incubation period of the disease is asymptomatic and lasts from 9 to 21 days. At this time, the baby feels well, but from the fifth day of infection it is considered infectious to others. The main cause of this infection is considered to be the lack of vaccination of the child.

Determining the symptoms of measles in infants at home

The first manifestations of measles in infants occur after the incubation period has expired. You can easily identify them at home using our photos. First of all, the baby experiences an increase in body temperature to peak levels, and a characteristic rash appears, which is initially localized on the head, and after a few days spreads lower down the body.

Note to moms! The measles virus in infants, entering the body, spreads through the bloodstream, so this disease may not manifest itself for a long time. Therefore, it is impossible to start quickly relieving symptoms.

Depending on the period, measles in infants is usually divided into several stages:

incubation, which occurs without any symptoms. The child feels well, there is no increase in temperature;
Catarrhal is characterized by the appearance of the first rash on the child’s skin. At this time, the baby begins to have an increase in body temperature, difficulty breathing, hoarseness, and a barking cough. All this is reminiscent of a cold or flu;
Depending on the degree of rash, measles in infants is divided into three types
The period of rash is characterized by the appearance of a rash in the form of semolina on the tonsils, palate and the inside of the baby’s cheeks. There is a general inflammation of the throat and redness of the mouth. Next, a rash appears on the head and after a few days begins to spread throughout the body, last of all affecting the legs.

Be sure to watch the video from Komarovsky, what he thinks about measles in infants.

You can study the signs of measles in a baby in more detail using the photo below. The nature of such rashes is quite difficult to confuse with other infections.

Important! If a baby develops measles, try not to look for the source of the disease (you will only waste time). They can be anyone, not necessarily a close or relative. The baby could have caught the virus in a store or other public place, since the disease is transmitted by airborne droplets.

Treatment of measles in infants: hospital or home?

Therapeutic therapy for measles in infants can be carried out both in the clinic and at home. It all depends on the severity of the disease. If doctors see the risks of complications and danger to the baby’s life, they must admit him to the hospital and conduct constant monitoring.

Children say! My son (4 years old) and my husband are walking through the market. We bought bags full of groceries. We are already approaching the exit. I turn to my husband:
- Before you leave, remember, we don’t need anything else?
And then my child shouts to the whole market: - Buy money!!! There is no money at home!

Vaccinations are given to prevent measles in infants.

Before starting treatment, measles is diagnosed in an infant based on the main symptoms, as well as by collecting blood and urine tests. Serology is also performed - it determines the presence of antibodies to the measles virus in the baby. If a complicated form of the disease is suspected, the child is prescribed an x-ray and a brain examination.

Treatment is mainly symptomatic, and the body fights the infection on its own; parents just need to help the baby cope with measles and alleviate the painful condition using the following methods:

give the baby antipyretics;
cough syrups as recommended by your doctor;
medicines for the common cold;
throat sprays;
Do not forget about drinking plenty of fluids and bed rest.

Note to moms! If your baby has conjunctivitis, perform proper eye hygiene, and if your lips are cracked and dry, you should lubricate them with Vaseline or special baby moisturizers.

Consequences of measles in children under one year of age

Symptoms of measles in infants first appear as a rash on the face

It is very likely that complications will develop due to improper treatment or advanced forms of measles in infants. The consequences are:

otitis;
laryngitis;
laryngotracheitis;
pneumonia, bronchitis;
encephalitis;
high mortality rate.

The risk of developing complications arises because the measles virus can negatively affect the function of the baby’s immune system. Therefore, the baby should be visited by a pediatrician during illness at least three times a week if the baby is being treated at home.

Children say! The grandson, having had lunch, fell asleep right in the high chair. The daughter unfolded the back of the chair, giving it a reclining position.
“Nastya, it’s better to take her to the crib,” I say. - Look how he lies crookedly, he’s uncomfortable!

Based on these risks, doctors are calling for newborns to be vaccinated against measles in order to develop immunity to the insidious disease.

A video about the treatment and daily routine of infants with measles will be useful.

Measles is a highly contagious infectious disease that is transmitted by airborne droplets and manifests itself in the form of a rash on the skin, as well as damage to the upper respiratory tract, eyes and is accompanied by symptoms of general intoxication of the body.

Measles most often affects children of preschool and school age, so this disease is classified as a childhood infectious disease.

Measles itself is not life-threatening for a child, but it often leads to complications such as pneumonia, purulent otitis media, meningitis or meningoencephalitis, which can be fatal if not treated promptly.

Therefore, we want to tell you in detail how measles manifests itself in children and adults and how to treat it, what effective methods exist to prevent this disease. In addition, we will look at the symptoms and treatment of measles in adults.

The causative agent of measles is a small spherical virus (120-230 nm) belonging to the Paramyxovirus family.

The measles virus consists of one strand of RNA and an envelope made of lipoproteins. The pathogen also has a set of antigens such as hemolysin, hemagglutinin, nucleocapsid and membrane protein. Hemolysin can cause hemolysis of red blood cells.

This paramyxovirus is not stable in the external environment, since it dies instantly when exposed to disinfectants, high temperatures and direct sunlight. But, at the same time, at room temperature the pathogen can exist for 1-2 days, and when frozen - 2 weeks.

The source of the measles virus is a sick person with an obvious or latent infection. The patient becomes contagious at the end of the incubation period, that is, 3 days before the rash appears, and remains contagious for 4-5 days after the rash.

The mechanism of transmission of measles is aerogenic (through the air), and direct infection occurs through airborne droplets.

To do this, it is necessary that particles of mucus that contain the virus, when coughing or sneezing, get onto the mucous membrane of the upper respiratory tract of a healthy person.

In addition to the aerogenic mechanism of spread of the measles virus, in rare cases there is a contact mechanism of transmission through household objects or children's toys.

The entry point for infection is the mucous membrane of the upper respiratory tract and eyes.

Outbreaks of measles are mainly recorded in the winter-spring season with a cycle of once every 2-4 years.

Since the measles virus is not prone to mutation, people who have recovered from the disease develop lasting immunity.

There is also an effective vaccine against measles, which is part of the complex vaccination - MMR (measles, rubella, mumps). Vaccination ensures active immunization of children, which has significantly reduced the incidence of measles.

Mechanism of disease development

The pathogen enters the mucous membrane of the upper respiratory tract and is sent through the lymph flow to the lymph nodes of the neck, where it begins to actively multiply. After this, the virus enters the blood and spreads throughout tissues and organs, forming small inflammatory compactions with multinucleated giant cells.

With the appearance of a rash, the number of viral bodies in the blood of a sick person begins to decrease.

On the fifth day from the appearance of the rash, the patient becomes harmless to others, since the virus is no longer in the body.

It is also known that the causative agent of measles has slight immunosuppressive activity, as a result of which bacterial complications are often observed.

The course of measles can be typical or atypical.

In the typical course of the disease, a sequence of periods is observed.

Atypical measles is typical for vaccinated children and adults. In turn, this form is subdivided along the flow into several types, namely:

abortive course. The onset of the disease is manifested by typical symptoms, but after 24-48 hours the patient’s condition improves sharply. The rashes on the body are minor, pale and disappear quickly;
a mitigated course is observed in contact children who were administered anti-measles gamma globulin. This type of measles is characterized by a mild course, with a small single rash that quickly passes;
the erased course differs from other types of measles by the presence of only individual symptoms of the disease;
Asymptomatic course of symptoms resembles a cold.

Despite the mild course of atypical forms of measles, patients also often develop complications, as with the typical course of the disease.

The clinical course of typical measles is divided into four stages. Let's look at them:

The initial stage of measles, or incubation period, is characterized by the absence of manifestations. At this stage of the infectious process, the virus actively multiplies in the lymph nodes of the neck. The duration of the initial stage is 1-2 weeks.
The catarrhal stage takes from 3 to 5 days. The first symptoms of measles appear acutely at the end of the incubation stage. Children develop catarrhal symptoms from the upper respiratory tract and eyes, as well as signs of intoxication of the body.

The pathognomic symptom of measles is considered to be enanthema (Filatov-Koplik-Belsky spots), which appears on the inner surface of the cheeks opposite the premolars and looks like semolina.

Characteristic symptoms of the catarrhal stage are:

general weakness;
headache;
moodiness and irritability;
decreased appetite;
sleep disturbance;
increased body temperature 38 ° C;
swelling of the nasal mucosa and runny nose;
dry cough;
noisy breathing;
hoarseness of voice;
hyperemia of the eye mucosa;
swelling of the eyelids;
the appearance of mucopurulent discharge from the palpebral fissure;
pain in the eyes in bright light;
facial swelling;
hyperemia of the throat mucosa;
lymphadenopathy (enlarged neck lymph nodes);
loose stool and others.

The rash stage lasts about five days and is characterized by an increase in symptoms of intoxication and catarrhal symptoms from the upper respiratory tract.

The recovery stage begins with the subsidence of the exanthema and the appearance of pigmentation. The rash first turns pale, and light brown pigment spots form in its place, which disappear within 7-8 days.

Measles rashes in children: photo

Measles is characterized by the appearance on the skin of the face, upper extremities, trunk and lower extremities of bright maculopapular rash elements that merge with each other.

Measles exanthema can be identified according to the following features:

pours out in stages - from top to bottom. First, pimples appear on the head, neck and upper chest, then on the back, abdomen, shoulders and forearms, and only then on the lower extremities and arms;
the rashes also subside gradually;
temporary pigmentation remains at the site of measles exanthema.

Measles in infants: features

Measles in children under one year of age is rare, since infants have antibodies against measles, which they received in their mother's milk. But this is only possible if the woman has been vaccinated against measles or has had it.

If the baby is fed artificial milk formula or the mother has not had measles, then, accordingly, the child does not receive protection against this infection and may become white even at such an early age.

In newborns and infants, measles is severe and is often accompanied by complications that can lead to the death of the patient.

How does measles start in vaccinated children?

Measles in vaccinated children begins 9-10 days after infection with the measles virus and is mild. Catarrhal and intoxication symptoms of the disease are not expressed, rashes are single in nature, which quickly fade and disappear.

Vaccinated children will most likely develop atypical measles, which we talked about earlier.

In adults, measles symptoms are more severe.

Patients may exhibit the following signs of the disease:

Strong headache;
severe general weakness;
high body temperature;
nausea, even vomiting;
insomnia;
the appearance of Belsky-Filatov-Koplik spots;
profuse skin rashes;
lymphadenopathy;
enlargement of the spleen and sometimes the liver.

Despite the severe course of measles, complications of the disease rarely occur in adults.

Complications of measles

As we said earlier, the measles virus slightly suppresses the patient’s immunity, as a result of which the risk of secondary bacterial flora increases.

Measles is characterized by the addition complications such as:

bacterial pneumonia;
bacterial laryngitis and laryngotracheobronchitis;
false croup;
stomatitis;
inflammation of the meninges;
inflammation of brain tissue;
purulent inflammation of the middle ear and others.

There is no etiotropic treatment for measles, so therapy for the disease is aimed at alleviating its symptoms.

Mild measles is treated mainly at home under the supervision of a local pediatrician.

Indications for hospitalization in an infectious diseases hospital are conditions such as:

moderate and severe measles;
presence of complications of measles;
the child living in a family where there are people with measles, infants and pregnant women.

When treating measles, they are guided by the following principles:

bed or semi-bed rest;
ventilation and wet cleaning of the room or ward where the patient with measles is located is carried out several times a day;
the windows of the patient’s ward or room should be covered with dark curtains;
a diet that should consist of easily digestible and hypoallergenic foods containing sufficient amounts of vitamins and microelements;
oral hydration to reduce symptoms of intoxication. For this, both ordinary water, compotes, juices, fruit drinks, and electrolyte solutions like Regidron are suitable;
the patient's eyes are washed with a warm, weak solution of Furacilin;
the patient’s lips are lubricated with petroleum jelly to avoid drying them out;
rinse the mouth with warm boiled water, weak solutions of potassium permanganate, Furacilin or soda, as well as decoctions of chamomile, string or oak bark;
prescribing antiallergic drugs such as Loratadine, Tavegil, Claritin, L-cet and others, which will reduce catarrhal symptoms and the severity of rashes;
prescription of antipyretic drugs (Nurofen, Efferalgan) at body temperature above 38.5 °C;
prescribing antiviral drugs in the first three days of the disease, which will increase the body's defenses and prevent the development of complications (human interferon, Viferon, Laferon and others);
prescribing broad-spectrum antibiotics to prevent purulent complications;
prescribing infusion therapy for severe cases with severe intoxication syndrome (saline sodium chloride solution, Disol, Reosorbilact and others);
prescribing hormonal drugs for measles complicated by meningitis or meningoencephalitis (Prednisolone, Dexamethasone) in combination with antibiotics.

Measles prevention methods

To prevent measles, children are routinely vaccinated twice with the introduction of the MMR vaccine (measles, rubella, mumps).

Vaccination is performed for healthy children at 12 months and 6 years of age, as well as for adults who have not been sick and have not been vaccinated before or do not have data on vaccinations, every 12 years until the age of 35.

All contacts who have not previously had measles are given anti-measles gamma globulin.

If you or your child exhibit symptoms characteristic of measles, we strongly recommend that you seek medical help in order to begin timely treatment and avoid serious complications. In addition, you should understand the importance of measles vaccination and not refuse it, since the disease in vaccinated individuals is much milder than in unvaccinated individuals.

It begins with a catarrhal period: malaise, tearfulness, loss of appetite, fever up to 38-39°C, headache, runny nose, dry cough. On the 2-3rd day, the temperature usually drops to low-grade levels, but catarrhal symptoms increase, serous runny nose, sneezing, dry hacking cough, a feeling of rawness in the nasopharynx, and sometimes hoarseness of the voice intensifies. At the same time, the cough becomes rough and hoarse. The patient's appearance is characteristic: the face is puffy, the eyelids are slightly hyperemic, swollen, conjunctivitis develops (conjunctival hyperemia, lacrimation, photophobia), serous discharge from the nose.

A typical early symptom of measles is the appearance 1-2 days before the rash (on the skin, on the mucous membrane of the mouth and soft palate) of measles enanthema - red and irregularly shaped spots the size of a pinhead to a lentil. Enanthema spots merge after 1-2 days and are lost against the general background of the hyperemic mucous membrane.

Almost simultaneously with enanthema, and sometimes even earlier, a typical initial symptom of measles appears - Velsky-Filatov-Koplik spots. They are found on the mucous membrane of the cheeks opposite the small molars, less often on the mucous membrane of the lips, gums, and sometimes on the conjunctiva. Each of the elements of the rash looks small, like a grain of semolina, a whitish lump on a small spot of redness. They are located in groups, sometimes in abundance, and are firmly held (not removed with a spatula). This symptom allows you to reliably diagnose measles before the typical rash appears. It persists for 2-3 days, but sometimes it can be detected even on the 1st or 2nd day of skin manifestations.
During the catarrhal period of measles, there may be another symptom - whitish deposits on the gums, as a result of necrosis and desquamation of the epithelium.

The catarrhal period lasts 3-4 days (occasionally it can be shortened or extended to 5-7 days) and is replaced by a period of rashes.

The period of rash begins with a new increase in temperature, which reaches a maximum on the 2-3rd day of the rash and returns to normal by the 5-7th day. At this time, manifestations of general malaise (lethargy, lethargy) increase, headaches intensify, appetite worsens, sleep is disturbed, sometimes anxiety and delirium appear at night, and catarrhal symptoms increase.

Measles rash (exanthema) appears against the background of an increase in temperature. The elements of the rash initially look like small (the size of a buckwheat grain) pink papules (tubercles). After a few hours, each papule is surrounded by a zone of bright redness. Elements of the rash located close to each other (maculopapular elements) subsequently merge. At the same time, unchanged areas of skin remain between them, which stand out in a pale color against a red background. With a profuse rash, continuous fields of redness may form, but usually a patchy appearance of the rash remains on the chest and abdomen. Occasionally, the rash may be scanty and look like separate elements that do not merge with each other. Other options are also possible.

The elements of the rash retain their brightness (“bloom”) for 3 days and from the 4th day of illness begin to gradually fade away (first on the face, then on the torso, then on the limbs). They become flatter, acquire a bluish tint and, turning pale, turn into pigmented light brown spots.

Measles is characterized by a staged appearance of the rash. The first elements of the rash are found behind the ears and in the center of the face, and then within 24 hours the rash quickly spreads to the entire face, neck and partly to the upper chest. The rash, unlike scarlet fever, also covers the nasolabial triangle. On the second day, the exanthema spreads to the trunk and upper (proximal) limbs, and on the third day - to all limbs. Sometimes deviations are observed - acceleration or deceleration of the rash. Thus, the appearance of a red, spotted, sometimes merging rash, first on the face, its subsequent “sliding” onto the torso and legs against a background of high temperature, severe catarrhal symptoms (cough, runny nose, conjunctivitis) - this is the clinical picture of a typical measles infection.

Skin pigmentation lasts 1-2 weeks. Occasionally, the rash ends with small scaly peeling.

Pregnant

The course of the disease in pregnant women is more severe than usual, with the frequent development of measles pneumonia. It is believed that the measles virus does not cause malformations in the fetus, although it can induce abortion, premature birth and cause dystrophy in a newborn child.

Treatment

In pregnant women with severe cases, therapy with ribavirin aerosol is discussed.

Prophylactic immunization of exposed pregnant women and newborns with standard immunoglobulin can be carried out within 72 hours from the moment of exposure. Breastfeeding is possible.

Newborns: the course of measles can be smoothed or severe. The main danger is measles pneumonia with bacterial superinfection. Mortality is low. Treatment is symptomatic.

Measles is a highly contagious (extremely contagious) acute viral disease. Measles mainly affects unvaccinated children attending child care institutions. Adolescents and adults who have not previously had measles and have not received the measles vaccine also remain extremely susceptible to the infection.

How does measles spread?

The source of infection is a person with measles from the moment the first signs of the disease appear until the fifth day from the onset of the rash. In case of infection, after contact with the patient, 7 to 17 days pass before the disease manifests itself (incubation period).

Measles is an airborne infection. The virus enters the body through the mucous membranes of the upper respiratory tract and eyes from a person with measles, who spreads it
when breathing, talking, sneezing and coughing.

The measles virus is very volatile - with the air flow it can enter neighboring rooms and even other floors of the building through windows, ventilation, lock slots - so you can become infected simply by being in the same house with a sick person. At the same time, the virus quickly dies in the external environment, so the spread of infection through objects (bed linen, clothing, toys), as well as through third parties who have been in contact with the patient, is almost impossible. The room where the patient with measles was was sufficiently ventilated so that one could stay in it without the risk of becoming infected; disinfection is not necessary.

How does measles progress?

The disease begins acutely: the child complains of a severe headache, weakness, may rise to 40º, and there is no appetite. Soon a runny nose and cough appear - usually dry, painful, or barking - with laryngitis. The child's throat is red, swollen, and the cervical lymph nodes are enlarged. Inflammation of the mucous membrane of the eyes is characteristic - conjunctivitis. Its manifestations in measles are pronounced: the eyes turn red, lacrimation, photophobia appear, and subsequently a purulent discharge appears. On the second or third day of illness, pink dotted rashes (enanthema) appear on the palate, and tiny whitish spots (Belsky-Filatov-Koplik spots) characteristic of measles appear on the mucous membrane of the cheeks, gums and lips. Both can be seen before the rash appears on the body.

On the 4th-5th day of illness, a rash appears - first on the scalp, behind the ears, on the face. The next day it spreads to the torso, and the next day to the arms and legs. Measles rash consists of an abundance of small reddish spots and blisters that tend to merge and form larger spots. During the period of the appearance of the rash, the child’s condition sharply worsens - the temperature rises again, catarrhal symptoms intensify (runny nose, cough), and conjunctivitis worsens. The child is lethargic, refuses to eat, and sleeps restlessly.

If there are no complications, then from the fourth day from the onset of the rash the condition improves. The rash either disappears completely or is replaced by pigmentation and areas of peeling skin. The disappearance of the rash occurs in the reverse order of its appearance. The child's temperature normalizes, catarrhal symptoms disappear - he gradually recovers.

Possible complications

Nowadays, with timely, competent treatment, complications from measles are rare. Most children (unlike adults) survive this disease without consequences. Complications more often occur in children under one year old, low birth weight and.

The course of the disease can be complicated by damage to the respiratory system: laryngitis, tracheitis, bronchitis, pneumonia; eye - conjunctivitis, blepharitis; digestive system - dyspepsia; inflammation of the middle ear - otitis or auditory tube - eustacheitis. Young children often have stomatitis.

The most severe complications of measles, which, fortunately, are extremely rare, affect the brain - meningitis and encephalitis.

Treatment and care

Uncomplicated measles is treated at home, always under the supervision of a doctor. In severe cases of the disease and the development of complications, hospitalization is possible.

The doctor prescribes treatment for the child that helps cope with the symptoms of the disease and support the immune system: vitamins A and C, antipyretics based on paracetamol or ibuprofen; tablets or mixtures to relieve cough; antihistamines; vasoconstrictor nasal drops; drops and ointments for eyes, etc. Antibiotics are prescribed only when a secondary infection occurs and complications develop (otitis media, bronchitis, pneumonia, etc.).

The room where the sick child is located must be wet cleaned daily. Ventilation should be done as often as possible. It is better to keep the curtains drawn, as photophobia is observed with measles. A sick child's bed linen and pajamas should be fresh. The child needs to drink plenty of plain water, compotes, and fruit drinks often and a lot. should be light, gentle: fermented milk products (kefir, yogurt, yogurt); vegetable soups; vegetable and fruit purees; boiled pureed meat (lean veal, chicken, turkey).

After suffering from measles, the child is very weakened: for some time he may not feel very well, eat poorly, be capricious, and get tired quickly. His immune system remains extremely susceptible to any infection for at least two more months. We must try to protect him from unnecessary contact, stress, stress, hypothermia, etc. Much attention should be paid to his nutrition, consult a doctor about taking vitamins.

Preventing measles

A person who has had measles remains immune to this infection for the rest of his life; cases of repeated illnesses are rare.

Children under 6 months of age, especially those who are on, suffer from measles extremely rarely.

The main way to prevent this infection is active immunization. In Russia, children are vaccinated against measles at the age of 12 months, and revaccination is given at six years. Immunization against measles is also carried out for adolescents aged 15-17 years and adults under the age of 35 who have not previously been vaccinated and have not had measles.

Anyone who has been in contact with a person with measles, and has not previously been ill and has not been vaccinated against this infection, can undergo passive immunization. Administration of immunoglobulin within the first days after exposure can protect against the disease or make it milder (mitigated measles).

In preschool institutions, quarantine is established for children who have not previously had measles and have not been vaccinated for 17 days from the start of contact.

Mitigated measles

Infants who have received measles antibodies from their mother, children and adults who have been vaccinated against measles, or who have received passive immunization with immunoglobulin can still become infected and become ill. However, in these cases, measles is atypical and much easier - without high fever, severe rash and without complications. This type of measles is called “mitigated.”

Measles during pregnancy

If the expectant mother gets measles, premature birth is possible. The child may be born with low birth weight and even (according to unconfirmed data) with developmental defects.

Vaccination or revaccination against measles should be carried out for women who do not have measles antibodies at least a month before conception; it cannot be carried out during pregnancy.

If a pregnant woman who does not have immunity against measles has been in contact with a patient, passive immunization with immunoglobulin is possible during the first days after contact.

Measles in children is an extremely dangerous and common infection caused by a virus. It is transmitted by airborne droplets, is characterized by typical clinical manifestations and is severe.

After measles, children often experience complications leading to the formation of chronic pathology, including disability.

The cause of measles is the transmission of an RNA-containing paramyxovirus only from a sick person, that is, the pathology is anthroponotic. The measles virus quickly dies at room temperature, does not tolerate exposure to ultraviolet rays and antiseptics, and persists for a long time at low temperatures.

Microbes are transmitted through the air over long distances and penetrate the mucous membranes of the upper respiratory tract and eyeballs. Neurons and intestinal epithelium are also vulnerable. Infection through contact and household contact is rarely possible - through toys and other objects.

Features of the pathology:

Contact with an infected person is dangerous two days before signs of illness appear and within 5 days after the rash. A person with a weakened immune system sheds viruses for a longer period of time.
The peak incidence occurs during the cold periods of the year, with outbreaks recorded every 3–5 years.
The measles virus is highly aggressive, destroys red blood cells, and damages the walls of blood vessels. Germs settle and multiply in the lymph nodes, weakening the immune system.
Children under 10 years of age are affected, and sometimes adults. Babies under one year of age are rarely susceptible to this infection. Newborns can acquire the measles virus in utero from an ill mother.
After suffering from the disease, a person does not become infected again, as a strong immunity is developed. A weakened form of infection, or mitigated measles, is an exception. After it, it is possible to get sick again.

Measles in infants is often accompanied by the development of neurotoxicosis and other dangerous complications, often leading to death.

The development of measles in children under one year of age is explained by the following reasons:

the mother did not have measles and was not vaccinated against this infection;
the child is bottle-fed;
the baby has severe immunodeficiency of various etiologies.

Symptoms and stages

The signs of measles are:

severe intoxication;
catarrhal inflammation of the upper respiratory tract and mucous membranes of the eyes;
skin rashes of a maculopapular nature.

The disease occurs in several stages: incubation, prodrome, rash, pigmentation.

Incubation period

The incubation period for measles after contact with a source of infection lasts from a week to 17 days. At this time, the measles virus that has entered the body enters the epithelium of the upper respiratory tract into the blood and multiplies in the lymph nodes, but this does not manifest itself clinically. Only when it enters the blood again from the affected lymphoid tissue does catarrhal phenomena begin.

With the mitigated form and in a vaccinated child, the incubation period can be extended to three weeks. With reduced immune defense, the clinic develops during the first week after infection.

The baby is dangerous to others already two days before the onset of the disease. From the fifth day after the rash appears, the child is considered non-contagious, and visiting child care facilities is not contraindicated for him.

Prodrome

The first signs of measles are toxicosis and severe catarrhal symptoms. This period is difficult for children.

The following phenomena develop within 4-7 days:

Fever up to 40 degrees. At the height of the temperature rise, convulsive syndrome often develops and delirium appears. Headaches are often accompanied by vomiting.
Catarrhal syndrome in the form of bilateral conjunctivitis, blepharitis and rhinitis with copious mucous or purulent discharge.
In parallel, respiratory syndrome develops. A painful dry cough appears, gradually acquiring a wet character with the discharge of mucopurulent sputum. Due to swelling of the larynx, shortness of breath, hoarseness, and wheezing appear.

In addition, this stage is characterized by enlarged and painful neck lymph nodes, weakness, lack of appetite, intestinal dysfunction with vomiting and loose stools, and tearfulness.

Specific symptoms of measles include:

Belsky-Filatov spots - the appearance on the mucous membranes of the cheeks, lips, gums of small white dots surrounded by a red border;
spotted redness of the palate (enanthema).

These signs are caused by damage to the mucous membranes and allergization of the body under the influence of the virus. By detecting them, the pediatrician can make the correct diagnosis even before the rash appears.

Rash stage

After the catarrhal period, an exanthema, or rash, appears on the skin, which is the most important symptom of measles.

The measles rash lasts 3-5 days and is characterized by the following features:

elements in the form of spots or protruding nodules of pink-red color, reminiscent of hives;
a tendency for rashes to merge to form large, irregularly shaped spots;
uniform distribution throughout the body;
the skin background is not changed.

The first elements of the rash appear on the face, including in the area behind the ear, no earlier than 3-5 days after the onset of the disease. Gradually they spread downwards, covering successively the skin of the torso and legs.

Intoxication continues for several more days, but its severity decreases.

Pigmentation stage

The period of measles rashes ends with the appearance of light brown pigment spots, also gradually “sliding” from top to bottom. They have the following features:

lasts up to ten days;
when pressed with a finger, they do not change their color and do not disappear;
As they turn pale, fine peeling appears.

The period of pigmentation usually marks the beginning of recovery. The child recovers completely within three weeks. This course of measles is typical.

How does atypical measles manifest itself in children? The mitigated form is typical for contact persons who have been administered measles immunoglobulin, and for children receiving glucocorticosteroids due to concomitant diseases. The infection passes without intoxication, with a dull and unstable rash.

Symptoms of measles in a vaccinated child appear only on the tenth day after infection. When the course is erased, they are not clearly expressed, so sometimes measles is confused with a common viral respiratory infection. The disease does not cause complications.

Which doctor treats measles in children?

If catarrhal symptoms appear in a child, parents should always contact a pediatrician, especially if there is contact with a patient with measles infection. During hospitalization, an infectious diseases specialist treats a small patient.

Diagnostics

Diagnosis of measles is based on taking a medical history, identifying possible contacts with the patient and a thorough medical examination. Considering the characteristic signs of the disease, this may be sufficient to identify the pathology.

Before the clinic appears and in case of an atypical course, data from laboratory blood tests for measles help in diagnosis.

Measles virus can be detected using serological methods:

a 4-fold increase in antiviral antibody titers two weeks after the onset of the disease;
increased content of specific immunoglobulins during enzyme immunoassay - changes in the immunogram can reveal asymptomatic measles.

Conducting virological studies will help identify the pathogen using blood culture, nasopharyngeal swabs for tissue cultures, or using special microscopy.

A general blood test reveals a decrease in leukocytes, ESR increases moderately. A general urinalysis (appearance of leukocytes and protein), chest x-ray, and electroencephalography are also needed.

Treatment

Treatment of measles should begin as early as possible. In children, symptoms and treatment methods are interrelated - the choice of drugs is determined by the clinical picture. There are no drugs that directly destroy the virus. Therapy is aimed at relieving symptoms in order to improve the patient’s condition and strengthen his immune system.

How to treat uncomplicated measles? Drugs from the following groups are used:

antipyretics - Paracetamol, Nurofen;
antitussives for dry cough - Libexin;
hyposensitizing drugs - Tavegil, Claritin;
antiviral - Interferon, Viferon;
vitamin therapy - vitamin A, B vitamins and ascorbic acid;
immunomodulators - immunoglobulin.

For purulent-inflammatory complications, broad-spectrum antibiotics are prescribed. For lesions of the nervous system, diuretics (Mannitol) and vasoactive agents - Cavinton, Demiphosphon - are recommended.

Glucocorticosteroids (Dexamethasone), spasmodic and bronchodilators - No-shpa, Salbutamol, Eufillin - will help cope with respiratory disorders.

Drinking plenty of fluids (water, compotes, freshly squeezed juices, saline solutions) will help get rid of intoxication in mild cases of the disease. In severe cases, infusion therapy is performed.

Treatment of measles includes the following care rules:

bed rest until the temperature normalizes;
treating the eyes and mouth with decoctions of anti-inflammatory herbs and antiseptics, lips with vegetable oil several times a day;
rinsing the nasal passages and using vasoconstrictor drops;
ventilation of the room and wet cleaning at least twice a day;
a gentle diet consisting of vegetables, fruits, milk, cereals and lean meat, enriched with vitamins and microelements.

In case of moderate or complicated conditions, young children are treated in the infectious diseases department.

Complications

Why is measles so dangerous? The virus causes damage to various systems. Measles often causes the following complications:

inflammation of the brain or spinal cord;
pneumonia, bronchitis;
thrombocytopenic purpura;
keratitis;
purulent otitis;
ulcerative colitis;
multiple sclerosis.

Complications of measles are often caused by delays in seeking medical attention, which sometimes leads to death.