Diagnosis

In addition to the typical symptoms, blood tests (laboratory values) are also used for diagnosis. Often it is a gaze diagnosis based on the typical rash. The bipolar fever also gives indications. Antibodies against the measles virus can be detected in the blood from the exanthema stage onwards. These were formed by the body’s own defense system in response to the invading viruses.

Therapy

There is no specific therapy for measles. The diseased persons should stay in bed and drink a lot. Measles can be treated symptomatically.

Thus, the viruses are not fought, but the symptoms are alleviated. For example, the fever can be reduced. If there are complications, such as an additional bacterial infection (pneumonia), antibiotics can be administered. Patients with measles must be isolated until the rash of the skin has disappeared.

Complications

There are various complications caused by the measles virus, which, incidentally, is only pathogenic in humans. The lungs, organs of the abdominal cavity and even the brain can be affected. If the lung is affected, it usually leads to bronchitis or pneumonia.

In developing countries, this is the cause of death in about a quarter of patients with measles. The lymph nodes in the peritoneal cavity can swell considerably and cause severe pain. The appendix can also become inflamed under the measles infection.

The most feared complication of measles is inflammation of the brain (encephalitis). It breaks out in about 0.1% of cases. It occurs three to ten days after the appearance of the exanthema and manifests itself by cramps, epileptic seizures and disturbances of consciousness.

In a few cases, permanent damage remains.These can occur in the form of paralysis, but also mental retardation. The mortality rate of measles – encephalitis is relatively high at 25 percent. Subacute sclerosing panencephalitis, on the other hand, is a complication that does not appear until 2-10 years after the measles disease.

It is an inflammation of the entire brain and is fatal in 100% of cases. Furthermore, complications can also arise from bacterial superinfections, i.e. additional infections with bacteria. In most cases the gums, the eye and the ear are affected.

If the eye is affected, in the worst case it can lead to blindness, in the ear to an inflammation of the middle ear. However, these complications can be quickly brought under control with antibiotic treatment. An indication of an additional infection with bacteria is a third fever increase after the exanthema stage.

Complications can also occur if the immune system has already been weakened. In developing countries, patients are weakened mainly because of malnutrition and thus provide a suitable host for parasites or the tuberculosis bacteria. A protective vaccination is available to prevent measles.

Infants are vaccinated against measles between the ages of 12 and 15 months. Mostly in combination with mumps and rubella. The vaccination is given in two parts.

The vaccinated children are not contagious under any circumstances, even if a rash similar to measles appears. The vaccination viruses are not transmitted. Both live and dead vaccines are available.

As a rule, the live vaccine is used for active immunization. In addition to children, persons at risk (e.g. staff in children’s hospitals or practices) are also protected in this way. Even if an unvaccinated person has come into contact with a sick person, the vaccination can be successfully repeated within the next three days – provided that the person to be vaccinated is immunologically healthy, i.e. strong enough to defend himself.

The death vaccine is usually only used for persons with a weakened immune system. Here too, the vaccine can be successfully revaccinated up to three days after contact with the disease. Even babies of a mother who is either vaccinated or who has already had measles enjoy immunity through their mother’s milk for the first six months of life.

Vaccination against measles was introduced in the GDR in 1970 and in the FRG in 1973. It is recommended by the STIKO (permanent vaccination commission) as a combined vaccination Mumps-Maser-Röteln in the first and second year of life. In principle, the measles vaccination is also available as a single vaccine, but since the combination vaccination is just as tolerable as the single vaccination, it is almost exclusively offered as a combination with mumps and rubella.

Measles must be vaccinated twice in total. Ideally, children receive the first vaccination between the 11th and 14th month of life and the second between the 15th and 23rd month. While the first vaccination provides the basic immunization, the second vaccination serves only as a refresher, because after the first vaccination there is already a protection of 95%.

Nevertheless, the second vaccination is necessary to ensure lifelong, safe protection. If the booster vaccination is missed, it should be made up for as soon as possible. If a non-vaccinated person becomes infected with measles, there is the possibility of passive immunization, a so-called exposure prophylaxis, in the first six days after infection.

Here, antibodies against the virus are injected directly, which can prevent or at least attenuate the outbreak of measles. However, since the antibodies are not produced by the body itself, there is only protection for three to four weeks, as no memory cells are formed in this type of vaccination. It is also difficult to detect the disease in time.

This type of vaccination is only given to people with a weakened immune system for whom a live vaccination is too dangerous. Furthermore, the vaccination of as many people as possible is advantageous because the measles virus is purely human pathogenic. This means that it only infects humans. If enough people are vaccinated, the virus could be eradicated. In addition only 1 case per million humans might occur or differently said a vaccination ratio of 95% would have to be present.