Rubeola, also known as measles (and not to be confused with rubella), is a very contagious viral infection of the respiratory system, which is spread through contact with the fluids of the infected person, either by direct contact or through coughing and sneezing. After incubating for anywhere between one and two weeks, the virus triggers an ever-increasing fever that spans several days, along with a cough, symptoms associated with a head cold, and red eyes. Symptoms intensify over the next few days before the rash classically known as measles appears. A person is most contagious in the days before the onset of the rash.
The rash itself starts in the area of the head, in small patches on the face and neck, then spreads to the trunk, often converging. The rash can last up to one week before disappearing, resulting in some degree of flaking of the skin. The fever lasts for several days after the rash recedes, and the cough up to another week and a half after that.
Complications arising from rubeola are numerous and dangerous. These include pneumonia and other respiratory infections, middle ear infections, inflammation and scarring of the cornea, and acute inflammation of the brain. The effect of measles on the immune system, it must be noted, is debilitating, contributing to the decline of the white blood cells necessary to protect the body against opportunistic disease. This deficiency can last up to one month after the rash appears, leaving an individual vulnerable to other illness.
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Fatality rates are highest in developing countries that have weak health care infrastructures. Complications and fatalities resulting from measles are highest in children younger than five, adults and pregnant women. Despite immunization practices, between 1987 and 2000, the United States still saw a rate of three measles-attributed deaths in every 1,000 cases. According to the World Health Organization (WHO), there were 164,000 measles-related deaths globally in 2008, which amounts to 450 deaths every day. This is down from the 777,000 measles-related deaths recorded in 2000. The decline is a result of vaccination efforts around the globe; before vaccination became widespread, measles-related deaths are estimated to have been 2.6 million annually.
Vaccination protects more than 90 percent of recipients against disease. The purported link between the measles, mumps and rubella (MMR) vaccine and autism reported in 1998 has been declared fraudulent, the paper has been retracted, and the author, Andrew Wakefield, has been revealed to have conducted his research "dishonestly and irresponsibly" and been struck from the Medical Register.
Despite the retraction and correction, however, popular support for vaccination has decreased and, coupled with recent measles outbreaks in Africa, Europe and India, the WHO estimates that the fatalities will begin rising by 500,000 each year, completely destroying the progress that has been made against the disease by 2013.
In reality, the measles vaccine is an incredibly cost-effective form of health intervention; in 1994, it was estimated that without measles vaccination, treating and caring for infected people in the United States would cost some $2.2 billion annually, with an additional $1.6 billion in indirect costs of care. The vaccine itself costs little in comparison: one dollar.
Currently, those inclined can provide vaccines to an entire village through the Red Cross for $500 dollars; 100 vaccines for $100; 50 for $50; and 25 for $25.
You can make a difference. That difference starts with knowing the facts. But just in case these are not clear, please refer to the list below for complications arising from measles (in plain English, with medical terms in parenthesis).Respiratory
Middle ear infection (otitis media), infection in the temporal bone of the skull (mastoiditis), respiratory infection causing swelling of the throat (croup, or laryngotracheobronchitis), inflammation of the trachea (tracheitis), inflammation of the lung (pneumonia), build-up of air in the lung (pneumothorax), a collection of air between the lungs (mediastrinal emphysema, or pneumomediastinum).Neurological
Seizures caused by a significant rise in body temperature (febrile convulsions), acute inflammation of the brain (encephalitis), chronic and progressive infection of the brain (Subacute sclerosing panencephalitis, SSPE, or Dawson Disease), a disorder in which the immune system attacks the peripheral nervous system, resulting in paralysis (Guillain-Barré Syndrome, GBS, or Landry’s paralysis), a deadly disease affecting all organs, most notably the liver and the brain (Reye’s syndrome or RS), inflammation of both sides of a segment of the spinal cord (transverse myelitis).Gastrointestinal
Diarrhea, inflammation of the small intestine (enteritis), inflammation of lymph nodes surrounding the small intestine (mesenteric adenitis), inflammation of the appendix (appendicitis), inflammation of the liver (hepatitis), inflammation of the pancreas (pancreatitis), inflammation of the lining of the mouth, tongue, lips, or throat (stomatitis), a rapidly-progressing infection that kills facial tissue (cancrum oris, or noma).Ophthalmic
Inflammation of the cornea, the transparent part of the eye that covers the iris and pupil (keratitis), serious inflammation of the cornea that affects its connective tissue (corneal ulceration), extensive damage to the cornea (corneal perforation), blockage of a blood vessel preventing blood from reaching the eye (central vein occlusion), blindness.Hematologic
Red or purple discolorations caused by bleeding underneath the skin associated with a reduction in blood cell fragments known as platelets (thrombocytopenic purpura), abnormal bleeding and coagulation of blood leading to disrupted blood flow to organs (disseminated intravascular coagulation, DIS, or consumptive coagulopathy).Cardiovascular
Inflammation of the heart muscle (myocarditis), inflammation of the sac surrounding the heart (pericarditis).Dermatologic
Severe skin-shedding (severe desquamation), inflammation of connective tissue affecting various layers of the skin (cellulitis, which is not at all related to cellulite, FYI).Other
Low serum calcium levels in the blood, an electrolyte disturbance (hypocalcemia), inflammation of the muscles (myositis), inflammation in the structure of the kidney (nephritis), the failure of the kidneys to filter waste products from blood (renal failure), malnutrition, and death.SOURCES:
The Clinical Significance of Measles: A Review by Walter A. Orenstein, MD on The Journal of Infectious Diseases
Wakefield’s article linking MMR vaccine and autism was fraudulent by Fiona Godlee, Jane Smith, Harvey Marcovitch on BMJ, 2011
World Health Organiation’s Measles Fact Sheet (fact sheet N°286), 2011
Special thanks to JAYFK for the inspiration to write this piece.
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