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What is Measles?
Measles is a viral disease. Not everyone recognizes
measles as a serious disease, which it really is. Measles
can be deadly. The 10th Century Persian physician, Rhazes
considered measles "to be dreaded more than smallpox."
Measles still kills about a million people a year around the
world.
Who are susceptible
of Measles?
All unvaccinated newborns are at danger from Measles.
Usually children become susceptible to Measles around the
age of nine months, probably because they are protected up
to this period by the antibodies (proteins that protect against
a disease) against Measles, received from their mothers.
How does Measles spread?
Measles is a highly contagious disease, which spreads
through air. Mere sneezing by an infected child in a group
of children can easily spread this virus. It spreads so easily
that any child who is exposed to it and is not immune will
probably get it. One can get measles from an infected person
who coughs or sneezes around you or even talks to you.
What is the prevalence
of Measles in India and the world over?
Measles is a leading cause of childhood deaths. Every
year around 3 million cases of Measles are seen and about
900,000 children die because of Measles around the world.
In India everyday, 500 children die because of Measles. The
most worrying part is that the vaccine coverage against Measles
in India is only 66% and even below 50% in many states.
What are the symptoms
and adverse effects of Measles?
The symptoms of Measles start about 10 days after
the infection and include high fever (103oF - 105o F), running
nose, cough, and redness of eyes (pin head sized bluish white
spots on a red base occur in the mouth. The child loses weight
and remains weak for several days). Rash appears behind the
ears and spreads rapidly over the face and the neck extending
downwards reaching the hands and feet over the next three
days. The rash fades in the same order leaving a brownish
discolouration, which persists for two months or more. In
general the disease is very trouble some for the child. In
fact, the term "measles" probably comes from a Latin
word meaning "miserable."
Complications of measles:
For most children, measles means a rash and cold,
and missing a few days of school. But there are several complications
caused by measles. These are:
· About
1 out of every 10 children who get measles also get an ear
infection (Otitis media).
·
Upto 1 out of 20 of them get pneumonia.
·
About 1 child in every 1,000 who get measles get encephalitis.
(Encephalitis is an inflammation of the brain that can lead
to convulsions, and can leave your child deaf or mentally
retarded.)
·
Out of every 1,000 children who get measles, 1 or 2 die
from it. In developing countries (like India), where malnutrition
and vitamin A deficiency is prevalent, measles has been known
to kill as many as one out of four children.
·
Diarhoea and pneumonia are other complications of measles
which can cause death
·
Measles can also cause permanent brain damage
·
In some countries measles causes blindness
·
Measles can also lead to degenerative disease of nervous system
named as SSPE (Subacute Sclerosing Pan Encephalitis). SSPE
can further cause paralysis.
These complications are more common among children under 5
years of age and adults over 20 years old.
What is the treatment
for Measles?
Few drugs like Interferon, Vitamin A, may be used
for the treatment of Measles. Moreover, certain antibodies
are required to treat ear and chest complications as well
as chemotherapeutic agents have been tried for the treatment
of Measles (SSPE) but unfortunately these remedies are not
very effective and hence vaccination is a better way to prevent
complications of Measles. Measles is a completely preventable
disease.
When should the vaccine
be taken?
The first dose of Measles should be given at the age
of 9 months (M-Vac). However, it has been observed that a
single dose of Measles is not enough for effective eradication
of this disease. Therefore, a second dose against Measles
as MMR (Tresivac) should be administered at the age of 12-15
months.
What is the vaccination
schedule if the above doses are missed?
If both of these doses are missed, then a child can
still be given the vaccine. This should be done at the earliest
possible stage. If the child is below one year, he must be
given the measles vaccine (M-Vac) and if the child is above
one year he must be vaccinated by administering a dose of
MMR (Tresivac) at the earliest, up to the age of 12-13 years.
How long does this vaccine
offer protection against Measles?
Usually two doses against Measles (first M-Vac at
9 months and Tresivac at 12-15 months) offer long term protection.
Clinical data is available showing antibody titers well above
the minimal limits up to 16 years after vaccination.
What are the side effects
of this vaccine?
Usually both M-Vac as well as MMR (Tresivac) are well
tolerated. However, in rare cases there are some chances of
mild reactions, usually low/mild fever and slight rash.
MUMPS
What is Mumps?
Mumps is a common childhood viral disease mainly involving
the parotid glands and other important organs of the body.
Who is at danger because
of Mumps?
All un-immunized children in late age group 5-15 years
of age and un-immunized adults.
How Mumps spreads?
Mumps spreads through air. Children get mumps through
contact with others who are already infected with the mumps
virus. The virus is spread through the air by coughing, sneezing,
or simply talking.
What is the prevalence
of Mumps in India and the world over?
Though Mumps is less severe as compared to Measles,
it has been observed that 10-15% children are susceptible
to this disease. The real problems are the serious complications
it can cause
What are the symptoms
and adverse effects of Mumps?
The most obvious sign of mumps is swelling of the
cheeks and jaw, which is caused by inflammation in the salivary
glands. This swelling usually lasts for 10 days associated
with fever for 1-6 days. It affects various organs like salivary
glands (Parotid glands), testicles (in boys) and ovary (in
females), pancreas, and joints.
Mumps can cause severe complications in children like Orchitis
in boys (inflammation of testicles), which may lead to infertility.
Mumps can also affect reproductive organs in females. Moreover,
Mumps can also cause permanent brain damage, deafness, joint
pain and even diabetes.
·
About 1 child in every 10 who get mumps also gets meningitis
(an inflammation of the covering of the brain and spinal cord)
·
Occasionally mumps also causes encephalitis. Mumps is a disease,
which causes high morbidity but low mortality. The symptoms
are troublesome, which is inflammation of the brain itself.
·
About 38% teenage or adult men who get mumps develop a painful
swelling of the testicles.
·
Mumps is a major cause of sensorineural deafness, which is
usually permanent
·
Studies have also indicated that Mumps can cause diabetes
mellitus that rarely causes death (about 1 in 10,000 cases).
What is the treatment
for Mumps?
Unfortunately, there is no sure treatment available
for Mumps. Vaccination is the only way to prevent Mumps.
When should the vaccine
be taken and what is the vaccine schedule for missed doses?
Usually MMR (Tresivac) vaccine is given to protect
against Mumps. Tresivac should be administered at the age
of 12-15 months, if missed anytime up to the age of 12-13
years.
What are the side effects
of this vaccine?
Usually MMR (Tresivac) is well tolerated. However,
in rare cases there are some chances of mild reactions like
low/mild fever and parotitis.
RUBELLA
What is Rubella?
Rubella is a viral disease, which mainly affects the
foetus. If a woman is infected with this virus during the
first three months of pregnancy.
Who are susceptible
of Rubella?
Rubella affects the foetus, if the mother is infected
in the early months of her pregnancy. All girls aged 11 to
19 years and women in the childbearing age are at risk of
developing Rubella.
How Rubella spreads?
Rubella is a contagious disease and spreads through
air by coughing, sneezing, or simply talking.
What is the prevalence
of Rubella in India?
It has been observed that around 40-45% of women in
the childbearing age are susceptible to Rubella. Moreover
it is surprising to know that over 2 lakh babies are born
with birth defects because of Rubella infection during pregnancy
in the Indian sub-continent.
What are the symptoms
and adverse effects of Rubella?
Rubella infection during the early
months of pregnancy may lead to congenital deformities (birth
defects). These birth defects include deafness, cataract,
heart defects and mental retardation in the newborns. Such
children become social and economic burden for parents. Rubella
can also lead to abortions. The chances of developing these
deformities are very high if the infection occurs in the first
three months of pregnancy. The following table gives the chances
of a particular deformity developing:
| Hearing loss |
92%
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| Congenital Heart Disease |
65%
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| Impaired vision |
56%
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| Behaviour disorders |
32%
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| Neurological deficit residual |
26%
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| Hearing and visual defect |
19%
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| Diabetes mellitus |
01%
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What is the incidence of deformities
in the various stages of pregnancy?
The Rubella virus interferes with the development of
organs in the foetus. Therefore, depending on the time of pregnancy
and the organs developing during that time, the type and the
chances of deformities developing in the child varies. The risk
of deformities developing is as follows:
|
Time of maternal infection
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Result
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1-2 weeks
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Harmless
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3-11 weeks
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100% infected fetus
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12 weeks
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80% infected fetus
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13-14 weeks
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54% infected fetus
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15-16 weeks
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35% infected fetus
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23-26 weeks
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25% infected fetus
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What is the treatment for Rubella?
Unfortunately there is no treatment for Rubella. Vaccination
is the only way to prevent all these complications.
When should the vaccine be taken and
what is the vaccine schedule for missed doses?
Children can be protected against Rubella with a dose
of MMR at 12-15 months. If missed anytime up to the age of
12-13 years. Moreover, a separate vaccine against Rubella
is also available (R-Vac).
R-Vac should be given to:
·
all girls at puberty (12 years and above)
·
all women of child bearing age and if missed
·
Post delivery.
Even males should be vaccinated against Rubella because infected
males can transmit this virus to the females of their family.
Can a pregnant woman take the vaccine?
No, rubella vaccine is not to be taken by a pregnant
woman. Pregnancy must be avoided for 28 days following R-Vac.
This is a precaution that must be taken.
How long does this vaccination offer
protection against Rubella?
Vaccine against Rubella offers long-term protection.
Clinical reports state that sufficient antibodies are present
in the blood even after 21 years of vaccination.
What are the side effects of this
vaccine?
Usually both R-Vac as well as MMR (Tresivac) is well
tolerated. However, in rare cases there are some chances of
mild reactions like low fever.
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