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- Ελληνικά
Description
Measles is an acute febrile exanthematous disease, highly contagious, caused by the measles virus. It may be complicated with otitis media, bronchopneumonia, laryngotracheobronchitis, encephalitis and diarrhea. Measles remains one of the leading causes of death among children worldwide.
Epidemiological Picture
Measles outbreaks usually occur in late winter and early spring. The disease is more severe in infants and adults, mainly due to complications. The disease currently affects unvaccinated children and adults, and epidemic outbreaks occur when the proportion of epidemics in the child population increases.
As of June 2023, there has been a steady increase in the number of measles cases in European countries. Most cases have been reported in Romania, the United Kingdom, Austria, France, while sporadic cases have been recorded in many European countries. In Cyprus no cases had been recorded in the last two years, while sporadic cases in previous years were imported cases. Since the beginning of 2024, two positive cases of measles have been reported to date and they involve children.
Modes of Transmission
Measles is caused by the measles virus, an RNA virus belonging to the group of paramyxoviruses of the genus Morbillivirus. Humans are the only host of the virus in nature. The disease is extremely easily transmitted in confined spaces under crowded conditions. Transmission is by direct contact with infected respiratory secretions or aerially through respiratory droplets spread by an infected person through coughing, breathing or sneezing. Transmission can occur from four days before the rash eruption to four days after (the day of rash onset is defined as day 0), when the concentration of virus in the secretions is very high and the cough, runny nose and sneezing more intense. The incubation period of the disease ranges from 7 to 21 days (usually 10-12 days from exposure to the precursor stage and 14 days from exposure to the appearance of the rash).
Clinical picture
There are 3 stages of the disease:
- precursor (catarrhal): lasts 2-4 days, characterized by fever, severe catarrhal symptoms (lacrimation, rhinorrhoea, sputum), cough, conjunctivitis and photophobia.
- rash: lasts 5-6 days and is characterised by an eruption of a spotty rash.
- remission (convalescence) stage: characterised by a decrease in fever and gradual disappearance of the rash.
About 30% of measles cases have one or more complications that are more common in children <5 years of age and adults >20 years of age. Also at increased risk for severe disease are women who are pregnant and immunocompromised individuals. More serious complications are pneumonia, acute otitis media and acute encephalitis (1%). Subacute sclerosing spongiform encephalitis (SSPE) is a rare complication and occurs after an average of seven years after the onset of measles.
Prevention and Transmission Control
In Cyprus, measles vaccination is carried out with the measles-mumps-rubella (MMR) triple vaccine, which is administered according to the National Vaccination Programme in two doses: at 12 months of age (1st dose) and at 4 years of age (2nd dose), but can be given earlier as long as 4 weeks have elapsed since the 1st dose. The vaccination is free of charge to all beneficiaries of the GHS and at the Maternity and Child Protection Centres for non-beneficiaries. During epidemic periods, MMR vaccination can be given from six months of age. In this case, they should be revaccinated with two doses of MMR after 12 months of age according to the schedule. Infants aged 6 to 11 months who are going to visit countries where measles is endemic are recommended to be vaccinated with one dose of the MMR vaccine before their departure.
The Ministry of Health, to prevent the disease, recommends vaccination with the MMR vaccine for children, adolescents and adults who have not been vaccinated with the necessary doses.
Guidance for travellers
Those who have not been vaccinated in childhood under the National Immunisation Schedule, and are planning to travel abroad, are advised to be vaccinated with the MMR vaccine.
You should contact your doctor as soon as possible in the following cases. It is also recommended that you tell the doctor about the suspected symptoms before your visit so that the necessary arrangements can be made at the appointment to reduce the risk of measles transmission. [*]If you have been in close contact with a person who has measles even if you do not have any symptoms. [/LIST]
Contents of this article including associated images are owned by PIO
Views & opinions expressed are those of the author and/or PIO
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