If you think of measles as just a simple childhood disease, you are mistaken. Measles is a very contagious acute viral infection, which is characterized by a disease of the upper respiratory tract and typical skin changes. Measles is a severe disease, often accompanied by high fever, cough, runny nose, conjunctivitis of the eyes and possible complications of inflammation of the brain (encephalitis), middle ear infection and pneumonia. In developing countries, measles is one of the ten most common and dangerous diseases. In Germany, there was a significant increase in measles cases for the first time since 1996, in December 2001.
Measles: Multistage disease
Measles disease proceeds in three stages. Approximately seven to 14 days after infection, the first stage is flu-like symptoms with fever, runny nose and cough. Those affected are often very sensitive to light and develop spots on the mucous membrane of the mouth, in the area of the back molars, which are outlined in red. After two to three days, these spots recede. In total, this stage lasts about three to five days. In the second stage of the disease, a rash typical of measles appears. It starts in front of and under the ears, and then spreads irregularly over the whole body. The spots often have a small blister in the center, from which the name of the disease is probably derived. “Measles” goes back to the old Dutch term “masele” and means pustule. After some time, the spots run into each other. This phase of the disease is accompanied by a renewed high fever. As a rule, the rash lasts for three days. During this period the disease is particularly contagious. During the subsequent recovery phase, patients are susceptible to other illnesses because their own immune system must first recover. When the rash subsides, the skin scales. At this stage, the disease is no longer contagious.
Few treatment options
Measles disease can only be treated symptomatically, that is, fever is lowered, and cough and cold symptoms can be relieved with tea and cool, humidified air. Patients must be isolated to avoid infecting others who have not been vaccinated. Most patients feel so ill that they prefer bed rest and recuperation to all other activities. Because of excessive sensitivity to light, it is recommended that the room be darkened. Possible complications may need to be treated with antibiotics. A physician should always be consulted if measles is contracted and care should be taken to avoid possible infection of other family members.
High risk of infection with measles
Measles is transmitted by the so-called droplet infection, i.e. by sneezing, coughing or even germs in the air. Because of this mode of transmission, measles can be easily passed on. Although sufficient vaccine is available today, and in the Federal Republic of Germany the costs of measles vaccination are covered by health insurance, the disease is still underestimated in this country. Due to changing conditions in the population structure – including, for example, the increase in “one-child families” – many childhood diseases are being shifted into adolescence and adulthood. At the same time, however, this increases the risk of serious complications such as brain infections with permanent damage or death. According to the Robert Koch Institute in Berlin, about 20% of brain infections after measles result in permanent damage. About 15% of those who contract the disease die. A passed measles disease leaves a lifelong immunity.
Measles vaccination helps
Experiences from the USA, Great Britain or even Finland show that measles can be completely repressed with a vaccination program. To interrupt the circulation of the measles virus, 95% of the population must be vaccinated against measles – but in many European countries this vaccination rate is not achieved. In Germany, a combination vaccination of measles-mumps–rubella has been given between the 12th and 15th month of life as part of the preventive medical check-ups since 1973. However, a measles vaccination is only really successful with a second vaccination, which can be given as early as four weeks after the first vaccination.
Compulsory vaccination since March 2020
In Germany, this second vaccination in particular was often omitted in many children, although it is particularly useful before they enter school, i.e. at the age of five or six. For this reason, the Measles Protection Act came into force in Germany on March 1, 2020. This is intended to ensure that all children from the age of one are vaccinated once and all children from the age of two are vaccinated twice against measles. When entering kindergarten or school, but also when being cared for by a childminder, proof must therefore be provided that a measles vaccination has been carried out. This proof can be provided by the corresponding entry in the vaccination card or a medical certificate. The same regulation applies to asylum seekers and refugees, even if they are already adults. Also affected by the Measles Protection Act are all those who have a job in a community facility or medical institution and were born after 1970. The background to this restriction is that there was no vaccination against measles until 1970. Adults born up to and including 1970 had therefore usually already contracted measles and are therefore now immune to it. It also makes sense for adults who have not been vaccinated or who have not had measles to be vaccinated, even for all travel to developing countries.
Vaccination: virtually no side effects
The measles vaccine contains attenuated, live pathogens. They can no longer trigger the disease, but can stimulate the body to produce antibodies. As a rule, the vaccine is well tolerated. Occasionally, mild measles symptoms occur one to two weeks after vaccination, but they are not contagious. There may be mild redness and swelling at the site of the vaccination, which is usually injected into the muscle on the upper arm, thigh or side of the buttocks. Those who are allergic to chicken egg protein should discuss this and other vaccinations with their doctor beforehand.
