Measles

History of the Measles

In the 9th century, measles was described by an Arab physician, to note the medical differences between it and smallpox. The Persian physician Muhammad ibn Zakariya ar-Razi (“Rhazes”) noted in the 10th century that measles was different than two similar infections: chickenpox and smallpox. Rhazes also stated that measles was more dreaded than smallpox. He also published The Book of Smallpox and Measles.

In 1529, a measles outbreak in Cuba killed two-thirds of the people who had previously survived smallpox. Two years later, measles was responsible for the deaths of half the population of Honduras, and had ravaged Mexico, Central America, and the Inca civilization. In the last century and a half, measles has killed about 200 million people worldwide, including one-fifth of Hawaiian natives and more than 40,000 Fijians. In the 19th century, measles decimated the Andamanese population. It took until 1954 to isolate the virus, which took place in Boston, Mass.


American Measles

There are 21 known strains of the measles virus. Measles, often called English Measles, is not associated with German measles, and is a totally different strain. The virus that causes measles is called “rubeola,” and is often confused with German measles, which is also called rubella. These two infections are unrelated, however. The virus that causes measles has a short lifespan of less than 2 hours in the air and on objects and surfaces.

Measles is an air-born viral infection of the respiratory system caused by the rubeola virus (not to be confused with rubella, or German measles). The measles virus normally grows in the cells at the back of the throat and the lungs. Eventually the immune system filters it out of the body and the measles rash is the final stage of the illness. Symptoms include fever, cough, runny nose, conjunctivitis (or “pink eye”), lethargy, nausea, diarrhea and a body rash. Like all childhood illnesses, it is common among young children between that age of 3- 10 years of age.


The First Signs

The infection is highly contagious, and is spread through the air by breathing, coughing or sneezing. The incubation period is about 9 to 12 days after initial exposure, and the duration of the infection lasts anywhere from 4 to 9 days, including the pre-symptom stage and how well the person is fighting the illness. A symptom that a person gets before the generalized rash associated with measles is called Koplik’s spots. These are white lesions that may be seen in the mouth or back of the throat. They are often difficult to determine but look like grains of salt. These spots come about 2 days before the red body rash.


Measles Rash

The rash associated with measles is typically the first outward symptom noted on an infected person. The measles rash usually lasts 5 to 6 days and begins at the hairline, moves to the face and upper neck, and proceeds down the body. The rash is the immune system eliminating the illness and is the final stage. Once the rash begins it must run the course, there is no stopping it and usually that is when it is diagnosed. Unlike the chickenpox rash of red, itchy bumps that centralizes usually over the trunk of the body, a measles rash does not itch nor is it raised, looks like rough skin and it is spread all over the body.

Today, the Centers for Disease Control and Prevention state that there is no longer a risk of a measles epidemic in the U.S. All cases are said to be imported from another country, usually Asia or Europe. Outbreaks of measles in highly vaccinated populations showing that 75-99% of the outbreaks are in vaccinated children, contradicts the CDC statement that these cases are coming from other countries. 

In Children

Early symptoms of measles include fever, cough and runny nose, just like a common cold. Additional symptoms are conjunctivitis (“pink eye”), making the eyes sensitive to light and a rash all over the body. The generalized body rash associated with measles starts on the head, at the hairline. It will travel down the body, and every area of the body can be affected. The rash is not itchy but looks like rough skin.


First Signs

The early indication that one has been exposed to measles is Koplik’s spots (white lesions that look like grains of salt) that form on the throat and on the cheeks in the mouth. This is the first visible sign on an infected person, appearing about 2 days prior the generalized red body rash. If you see these, you know that it is not just a common cold. The spots are often difficult to determine, but lymph nodes in the neck will also likely swell as they begin to do their work, defending the body.


The Rash

The measles rash will start a few days later and is small red bumps that start at the hairline and work its way down the neck, arms, trunk and eventually the whole body. The rash is the sign that the immune system is dealing with the infection effectively, kicking it out through the skin and is the final stage of the illness. It is usually when the illness is diagnosed. Unlike chickenpox, this rash does not have a white spot in the center but will have a bluish color to the skin.


Fever

It is common and good to run a fever of about 102° – 105° while fighting the infection. It is the fever that burns the infection out of the skin and will help the body recover. As with all fevers it is important to be sure there is no dehydration.


Other Symptoms

Other possible symptoms include lethargy, (tiredness) diarrhea, loss of appetite and weight loss and sore eyes associated with the conjunctivitis. (Keeping the blinds closed and the room dark will help with the sensitive eyes). These symptoms normally go away before getting the rash but may linger.


In Adults

This illness is most common in children and if a person does not have the infection as a child, they are more susceptible as an adult. Adults with measles will feel worse symptoms and the illness later in life is more difficult on the body. Patients can show sign of liver stress, liver damage and jaundice. Most adults who get measles are usually immune compromised and may be already fighting with a bacterial infection. Adults can completely recover from liver damage within 7 years from the infection with proper nutrition and a healthy lifestyle. 

Measles is caused by an air-born virus. It is typically a childhood disease, affecting children by the time they hit their teenage years. Also called rubeola, English or red measles, it is highly contagious. Because it runs in cycles, it shows up in the United States every few years. Most believe that it comes to the country by infected people outside the U.S. who bring it into this country but there is evidence that highly vaccinated populations also have outbreaks


Exposure to Measles

Like all highly contagious viral infection, it is easy to become exposed to measles. The airborne virus spreads from person to person by coughing, sneezing, breathing, and also by touching objects or surfaces. (The life span of the virus on such objects/surfaces is less than 2 hours, however.) Close contact to an infected person usually means you will get measles unless you have natural immunity from previous exposure. For travel lovers, be wary of areas where measles is endemic (Prevalent in a particular environment). As measles is not a huge problem in the United States currently, traveling abroad is the easiest way to become exposed to the virus. Also, anyone within contact of travelers to such areas may be exposed. Then again, you could be exposed at the local grocery store, mall or park where children gather to play.


After Exposure

Measles enters the body via the respiratory system, by breathing in the airborne virus particles of an infected person. It travels through the body via the respiratory tract and the first visible symptom is a rash on the back of the throat or mouth and possible swelling of the lymph nodes in the neck. One can contract the virus from an infected person 4 days before the rash starts until 4 days after it appears. The rash often spreads before someone knows they are infected, as it is likely the first symptom noticed. Once you get measles, you cannot get it again. Most people born before 1957 have had the infection and have life-long immunity, according to the Centers for Disease Control and Prevention. People who got the measles vaccine will not have life-long immunity and will need booster shots for protection from the illness. Some people do not respond to the vaccine and are still vulnerable to the illness.


Who Can Get Measles

Anyone who has never had the wild measles illness is susceptible to contract the measles virus, though it is mostly a childhood disease. Especially at-risk are children with immune deficiency, infants and those who travel to areas where measles is common or those who have contact with travelers from such areas. People who were once vaccinated will also not have immunity after several years. Populations who are suffering from malnutrition, pregnant women who do not have natural immunity and anyone with a Vitamin A deficiency are at severe risk. Once a person contracts measles, he/she cannot get the virus again and will have immunity.

Measles is one of the most contagious diseases worldwide, and outbreaks can easily occur. Rare in the U.S. today, however, anyone traveling outside the country or in contact with people traveling here from other countries that have not had measles could potentially be infected. Measles cannot be prevented after being exposed to an infected person if a person has not been vaccinated or he/she has a weak immune system. Once a person has had measles, they are immune and will never get it again. People born in the U.S. and those who lived here before 1957 are most likely immune.


Medical Prevention Measures

Measles infection runs in cycles about every 2-5 years in the US and there will be outbreaks. Exposure to measles in the US is possible because we have people from all over the world coming to this country and people traveling to other countries where measles is still common. As with all infectious illnesses, they have a vaccine developed to try to prevent outbreaks. The vaccine to prevent measles has been around since 1963. There are currently two vaccines available that are given in combination: the MMR vaccine (measles, mumps and rubella (German measles), and the MMRV vaccine (measles, mumps, rubella and Varicella (chickenpox). The first measles vaccine was s single vaccine and no longer available. They claim that the combined vaccine is effective at preventing the measles.

Immune globulin (IG), a blood product containing antibodies to the virus, may prevent or at least lessen the severity of the infection if given within 6 days of exposure. If a person has not been vaccinated and has been exposed to the virus, the measles immune globulin vaccine may prevent the disease from being expressed if given within 3 days of exposure. Babies younger than 1 year old, pregnant women and people who have weakened immune systems that cannot fight infection may need to get IG if they are exposed to measles, as this is a high-risk group and normally cannot be given vaccines. Also, this group may see additional complications needing medical treatment. If unsure, seek medical attention.


Natural Prevention Measures

There is no way to prevent the measles; the focus needs to be on making sure you are healthy so that if exposed, you will get through the process without complications. Infections such as the measles build the immune system.


Proper Nutrition

Focus on a diet high in organic fruits and vegetables, clean filtered water, low sugar intake, plenty of fluids, chiropractic evaluations, exercise and a healthy lifestyle will support a healthy immune system so it can naturally fight the measles virus. Other than that, prevention is difficult, as symptoms show up long after a person has been exposed. Once exposed, it will take several days for the measles rash to appear and then the body must work through the process. However, if immune compromised, severe complications can occur from measles. Watch symptoms closely and seek medical attention if necessary.


Natural Exposure

We must acknowledge that we live with bacteria and viruses in our environment and they are not going away! Instead of fighting against them, fearing them and trying to “protect” ourselves from them, we should understand that they are only powerful if the host is weak and vulnerable. If we are social people and go to shopping centers, churches, parks and live around other people, we will be exposed to thousands of things on a daily basis. It is up to our bodies to adapt, get stronger and thrive in this environment, adjust and overcome these foreign things. We cannot escape the bacteria and viruses so it makes so much more sense to promote health, build the body up so that it can adapt to all the stresses in our environment that potentially make us feel sick. We also need to respect the immune process that controls the symptoms as we work through the illness and stop trying to manipulate and control the body! If we do this we will be stronger and better because of it! 

Death from measles dropped dramatically from 1900, when it was very high to 1970 when death from measles was almost completely gone. Children rarely died from measles from 1970 forward. In 1990 in the US, there were 64 deaths reported– the largest number in nearly 20 years previously. Measles is rare in the United States today, with about 2 deaths per 1,000 cases per year since the 1980s. The Centers for Disease Control and Prevention (CDC) states that there is no longer a risk of measles endemic in the U.S.; all cases are usually imported from another country, usually Asia, India or Europe.

Between 1989 and 1991, there was a dramatic increase in measles cases with 55,622 cases reported. Most of those infected were children under 5 years of age, were unvaccinated Hispanic and African American populations at four to seven times higher than non-Hispanic whites. Of all those cases in 1991, there were 6 deaths, 4 younger than 12 month of age, who were unvaccinated and died of pneumonia/encephalitis. 2 vaccinated children died and death was from encephalitis (brain swelling).

Since 1993, measles outbreaks have occurred mostly in populations that are not vaccinated or in poor countries such as Africa and India. Smaller outbreaks were reported in unvaccinated preschool populations, vaccinated school populations, among college students and in adult communities.


Rates of Infection – Not Deaths

The number of reported measles cases declined rapidly during the 1990s. By 2004, only 37 cases were reported, which was a record low. However, new cases if the infection are still seen, both in the unvaccinated and the highly vaccinated population. In 2008, the CDC received reports of 140 measles cases from 19 states and the District of Columbia – the highest since 1996. Of the 127 cases in U.S. residents, 7 were fully vaccinated and 99 of these individuals were children whose parents chose not to have them vaccinated and 21 their vaccine status was unknown.


Measles Today

There are still sporadic cases of measles in the United States. In highly vaccinated populations, we see outbreaks where 99 % are vaccinated and also because visitors from other countries or U.S. citizens traveling abroad can become infected before or during travel and spread the infection to unvaccinated or unprotected persons. Worldwide, there are estimated to be 20 million cases and 197,000 deaths each year. More than half of the deaths occur in countries without sanitation, poverty, poor nutrition and poor water supply like India.

Measles-related deaths are not caused by the virus itself, but are caused by complications associated with the disease.


Who is at Risk

Complications are most often seen in children younger than 5 years of age and adults older than 20 who do not have natural immunity and catch the disease later in life. Infants, pregnant women, malnourished children and those with Vitamin A deficiency, as well as people with weakened immune systems are in the high-risk category of developing severe complications from measles. In addition, this group may not be able to take the vaccine to prevent the virus with an unhealthy immune system. This group may want to seek medical attention if exposed to measles.

Realistically, we will never know when we are coming in contact with someone who is infected. As an air-born virus, it could happen anywhere at any time. There is no real way of avoiding exposure. What we can control is how well our bodies will fight against a viral infection. Promote health as a life style doing things daily to promote health. I heard it said one that you either promote health daily or you promote disease by default! There is no middle ground…something to think about!