In Part 1 I explained how a lack of knowledge about measles symptoms and resistance to MMR has resolved in some parents starting up 'measles parties' to ensure that their children's treatment measures early and so gain immunity that way. This is mistaken in my view and many people are unaware that measles is still a major killer. In part II I will explain to parents what the measles symptoms are, in what order they should appear and when to call a doctor.
As a parent you should learn how to recognize measles symptoms. If your child has had the disease, or is immunized, you probably do not need to know this, but if you could not save a life by being aware of the most important measles symptoms and when to get medical help. Back in the 1950s and 60s they all knew measles symptoms when they saw the, but not now, so let's try to spot them in the rough order in which they normally appear. It's not easy since many childhood infections have similar symptoms. However, they all have at least one which is particular to that disease.
Measles frequently start with symptoms similar to those of a cold or the flu.
1. First a runny nose and a 'sniffle', followed by a sore throat .. A typical 'barking' cough can then develop. So far, you would not think 'measles' The eyes will puff up, may become watery and get red and sore looking. If you know of a possible measles contact you can now get suspicious.
2. A slight increase in temperature will develop, and will increase to around 39 Celsius (102F). The child may shy away from the light or close her eyes when a light is switched on. At this point you may want to call a doctor. If so, you will catch the disease early, but the symptoms are not yet definitively indicative of measles. Most parents will still regard these symptoms as a 'bit of a cold' or a 'touch of the flu'.
3. You may not notice this, but about 2 to 3 days after the first symptoms appear, your child will get small spots on the inside of the cheek, round about the molars, called Koplik's Spots. These look like small red bumps with tiny grains of sand or salt in the middle. These may last less than a day and sometimes even appear within the first 36 hours. If you are with it and aware, you will see this, and you should call your doctor at this stage. This the definitive measles symptom. No other infection shows Koplik's spots. These spots disappear as the main rash appears. They are photographed on my website.
5. The temperature will probably have reduced a bit by now to 37 – 38C (just at or below 100F). You think maybe she is getting better.
6. The main rash starts to appear about 1 or 2 days after the Koplik's spots. It forms small spaces which join together to form blotches. Definitely doctor time! There is a picture of a measles rash on my website.
7. The rash appears on the forehead around the hairline first, then to the neck, body, arms and legs. By this time you will have called a doctor and your child is diagnosed with measures unless you have an inexperienced doctor, when samples may be taken to identify the virus.
8. The temperature increases again to over 40C or higher (105F). No need for samples now – if the Koplik's spots were missed, this is definitely measles, but by now it is dying out.
9. The rash lasts about 4 days then starts to disappear from the head down. The whole process, from start of symptoms to disappearance of the rash, takes about 10 days on average. The rash itself last about 6 days.
A person with measurements is infectious from 4 days before the rash appears to about 4 days after it has appeared, so it can be passed around before any measles symptoms show.
Those most at risk are:
Young children under one year old. Malnourished people. Children who have depressed immune systems, such as those on some cancer treatments or are infected with HIV or AIDS. Children suffering from a Vitamin A deficiency. Pregnant women: the infection can cause miscarriage or premature delivery.
It is said that a doctor's surgery can be a dangerous place. Measles is extremely contagious, and around 90% of close proximal contacts will catch the disease. If any of the above high risk patients are present in the surgery waiting room when you take your child suspected of having measles, you may be placing them at special risk.
Doctors may not like this, but for this reason alone I suggest that you call a doctor rather than take a child suspected of having measles to the surgery. This is another argument against those who would rather have their child catch measles at a measles party than be given a vaccination to prevent them from contracting it.
Copyright 2006 Peter Nisbet