WWhat happens with Measles ?

Phase 1 the "Prodromal phase" or incubation.

Measles actually starts as a seemingly minor illness. The victim ( usually a young child) appears to be getting a cold, he will have a runny nose, be a bit snuffeley and stuffed up in the nose, along with a mild conjunctivitis.  The eyes look a bit pink and watery, and become light sensitive and uncomfortable.

At this stage the child looks like any other kid with a bit of a cold. This phase lasts for two or three days with little change.  Unfortunately, whilst the child is not particularly ill in itself, it has measles virus pouring out in every drop of snot, sweat, pee, pooh and any other " bodily fluid" that you can think of.

Yes, as usual the disease is most infectious before you know that you have it.  This makes any hope of containing an outbreak by isolation quite futile. Even if every child with the slightest runny nose was instantly isolated, it would still spread as measles is highly infectious for two or three days before the very first symptom.

If you are very observant and "on the ball" there is one give away that can alert you to the possibility of measles. For a day or two before things turn nasty, whilst kiddy is off colour and snotty, tiny little white spots appear in the mouth. Known as "Koplick's Spots" these are very small 1-2 mm or smaller and seem quite painless. Sometimes there is some redness of the mouth lining around the spots but not always. Koplick's spots are quite transient lasting 1-2 days. If the spots are still in the mouth when the child hits the "ill feverish stage", then you have got the wrong diagnosis. In measles this does not happen.

If you are really looking there is some tender enlargement of the lymph glands in the neck and under the chin when the spots appear.

 

 

 

What is Measles ?

Measles is a highly infectious disease caused by the "Measles Virus", a virus of the "paramyxo-virus" type. It primarily causes an inflammation of the upper respiratory tract together with a high fever and a characteristic skin rash.  Other organs and tissues can be involved in the inflammatory process, this has the potential to have serious consequences, particularly if nervous tissue is involved. For instance,   measles infection and inflammation of brain tissue can have disasterous effects. Whilst it will usually improve with time,  there is usually some degree of permanent damage.  This can be comparatively minor, such as damage to one or both of the Optic Nerves causing partial or total blindness in the affected eye.  However it can be much more serious causing widespread brain damage or death.

The fact that permanent damage to sight is considered a minor complication should give some idea of the severity of illness that is being considered.

 

Phase 2.  "The Nasty Bit"

After a few days of an irritable, grumbling child who is off colour but not a great deal seeming wrong, they get ill.

Often quite suddenly, and certainly with no warning , the child becomes distressed and gets a high fever. As this happens the characteristic measles rash starts to appear. This is a widespread, blotchy pink rash. Starting as small pink spots, it rapidly darkens and spreads until the spots coalesce into larger blotches. Whilst this is happening the child will be getting more and more distressed and irritable as the fever increases. In this "acute stage" of measles the child looks ill, sounds ill and is ill !

The high fever with measles can be very alarming, a temperature in excess of 40`C is not unusual, and this often responds poorly to paracetamol, ibuprofen and the other usual anti-fever drugs.  Whilst anti-fever medicines may not seem to help much, they at least do no harm and if the child is hot having taken a dose, he would probably have been hotter without it.

Very high fevers like this can have a strange effect on children. They quite frequentlt get vivid, and presumably very frightening hallucinations. For some odd reason they nearly always seem to see things crawling up the walls and crawling up their body. Spiders and beetles seem to be the favourite things for them to see, but presumably this depends on where you live and what crawling animals you are used to seeing. ( I wonder what Eskimo kids see !)  These hallucinations are very real to the child seeing them, and must be very frightening. It is little wonder that by this stage most kids are very hot, verydistressed, covered in a bright red rash and screaming the place down whilst almost hysterically trying to brush off the mass of crawling bugs coming over the bed.

This is not a pretty sight. Please believe me that once you have seen a terrified child with a bad dose of measles virtually tearing its skin off, it is not a sight that you will forget. It is even worse when you think that this disease, for which there is no effective treatment at all, is totally 100% preventable.  No child need ever go through Measles.