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How informed are you about measles in children?

 Photo: Courtesy

Dear Doctor,

My sister’s son, who I have been taking care of, has been having flu and high temperature for close to one week. Two days ago, he came from school with a rash on the whole body. I took him to a nearby hospital, and the doctor told me to take him back home, that he has measles, and that I should give him the medicines he prescribed. He said he didn’t think I should worry about my son getting the measles, that now the risk is less. I am so worried. Do you think the advice they gave me is true? Is there anything I can do? Muthoni

Dear Muthoni,

Measles is a highly contagious disease, caused by measles virus that is usually seen in children, but can affect adolescents and adults as well. The early phase of the disease is characterized by weakness, fever, loss of appetite, and ‘the three C’s’: conjunctivitis (red, watery eyes), cough and coryza (runny nose).

Measles is airborne and is spread by droplets from respiratory secretions of infected persons; it is transmitted by breathing, coughing or sneezing, and also by direct contact with infected nasal or throat secretions.

 The rash of measles usually appears three to five days after the start of the early phase. It begins on the face and spreads down the body to involve the neck, trunk, and lastly the arms and legs, including the palms and soles. It usually lasts about five days.

Patients with measles are most infectious during the late part of the early phase of the illness when the cough and coryza are at their peak. The disease is contagious from about four days before the onset of the rash, or about four days after the onset of rash.

Treatment is usually supportive, including temperature control medicine and intravenous or orally taken fluids.

If the doctor feels that there is a bacterial infection alongside the virus infection, antibiotics are usually promptly prescribed. Vitamin A should be administered orally to all children with suspected measles as this may decrease the severity of measles complications.

It is therefore correct, to a large extent, for the doctor to have informed you that the boy is no longer very infectious now that the rash has appeared. He is still to some small extent infectious.

The best would be to give the child the suggested treatment, and return to the doctor if the condition worsens. Also observe the other children, for cough, fever and flu signs, which maybe the earliest indicator that they have developed measles.

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