measles - child disease that can be fatal

Measles is an acute disease is easily transmitted and often serious complications occur.Almost all children under 5 years old in developing countries will be attacked by this disease, whereas in developed countries usually attacks children aged adolescents or young adults who are not protected by immunization.

Measles disease is fatal if not actually attacking the children healthy and well nourished. But if in a country where children are suffering from malnutrition are numerous, measles is a disease that is fatal.Measles is caused by paramiksovirus.

Transmission occurs via saliva spray from the nose, mouth and throat patients with measles.

The incubation period is 10-14 days before symptoms appear.

Acquired immunity to measles after vaccination, the infection is active and passive immunity in infants born to a mother who has been resistant (lasts for one year).

Transmission mode

Who should watch out, measles transmission took place very rapidly through the medium of air or saliva spray (droplet) that inhaled through the nose or mouth.

Clinical symptoms

Symptoms begin within 7-14 days (other references say about 10-20 days) after infection, which include: - sore throat - runny nose - cough - sore muscles - fever - red eyes - fotofobia (susceptible to light, glare) . However, not all of these symptoms in each patient tergatnung terjadai of stamina respectively.

Clinical symptoms were divided into three stages, namely:

• Stadium early (prodromal)

• Stadium incidence of spotting (eruption)

• Stage a period of healing (konvalesen)

Early-stage (prodromal)

Generally lasts about 4-5 days, characterized by fever, weakness (malaise), muscle aches, cough, runny nose, red eyes, fotofobia (fear of light), diarrhea caused by inflammation of the respiratory and digestive tract.

At this stage, symptoms similar to influenza. But diagnosis can be made towards Morbili 2-4 days later when the little white spots appear inside the mouth (Koplik spots). On the wall of the inner cheek (mucosa bukalis) and the patient had contact with patients morbili in the last two weeks.

Stadium incidence of spotting (eruption)

Rash (redness of the skin) which feels a bit itchy appeared occurs about 2-5 days after the initial stage. Characterized by fever rises, the red spots spread throughout the body, accompanied with itching. This can form macular rash (reddish rash that horizontal) or papules (reddish rash that stand out). At first the rash appeared on the face, ie in front of and below the ears and the neck next to the side. Within 1-2 days, the rash spreads to the torso, arms and legs, while a rash on his face began to fade. Furthermore, these symptoms will disappear around the third day.

Sometimes accompanied by diarrhea and vomiting.

At the peak of disease, patients feel very sick, ruamnya widespread and body temperature reaches 40 ° Celsius. 3-5 days later his body temperature falls, the patient began to feel better and the rash disappeared soon left. Fever, fatigue, runny nose, cough and sore and red eyes for a few days followed by a rash of red pimples on the face and began to spread into the body and there for four days to seven days.

Convalescing Stadium (konvalesen)

At this stage, the above symptoms gradually disappear. Body temperature becomes normal, unless there are complications.

Complication

In healthy children and adequate nutrition, measles is rarely serious repercussions. However, complications can occur due to decreased immunity as a result of measles disease. Some complications that can accompany measles:

1. Bacterial infections: pneumonia and middle ear infections

2. Sometimes it happens thrombocytopenia (decrease in platelet count), so pendeita easy bruising and bleeding

3. Encephalitis (inflammation of the brain) occurs in 1 of 1.000 to 2000 cases.

4. Bronkopnemonia (respiratory tract infection)

5. Otitis media (ear infection)

6. Laryngitis (infection of the larynx)

7. Diarrhea

Examination

Based on the anamnesis which may be of measles are fever, cough, red eyes, runny nose and sore throat

Physical examination

In measles, a physical examination obtained is the existence of a widespread rash makupapular, coplic spot, panasny increases.

Laboratory examination

On blood examination showed a normal leukocyte count or increased if there are complications of bacterial infections. IgM antibodies inspection is the fastest way to ensure there is an acute measles infection. Because IgM may not be detected on the second day of the first appearance of rash, then to draw blood IgM examination conducted on the third day to avoid any false negative. IgM titer began is hard to measure at four weeks after the rash appears. While IgG antibodies can be detected four days after the rash appears, most of IgG can be detected one week after onset until 3 weeks after onset. IgG can still be found until several years later.Measles virus could be isolated from urine, nasopharyngeal aspirates, blood that was given heparin, and throat swab during the prodromal period until 24 hours after the resulting spots. The virus can remain active for at least 34 hours in room temperature.

Treatment

1. Non Medika mentosa

a. provision of adequate fluid, eg water, fresh fruit juices, tea, etc. to restore the body fluids lost through heat and sweating with fever.

b. appropriate calorie and food type to suit your level of awareness and presence of complications

c. nutritional supplements

2. Medika mentosa

Indications hospitalization: hiperpireksia (temperature> 39.00 C), dehydration, seizures, oral intake is difficult, or there are complications.

Measles without complication:

1. Avoid infection

2. Bed rest

3. 100 000 IU vitamin A,

4. Diet foods have plenty of fluids, adequate calories. Type of food adjusted to the level of awareness of patients and the presence or absence of complications

Measles with complications:

1. Encephalopathy / encephalitis

a. Antibiotics when necessary, according to antivirus and other encephalitis PDT

b. Corticosteroids, if necessary in accordance with encephalitis PDT

c. Needs the amount of fluid is adjusted to the needs and correction of electrolyte disturbances

2. Bronchopneumonia:

a. Antibiotics in accordance with pneumonia PDT

b. Or with nasal oxygen mask

c. Correction of acid-base balance disturbances, electrolyte, blood gas nd

3. Enteritis: correction of dehydration according to the degree of dehydration (see Chapter enteritis dehydration).

4. In the case of measles with complications bronkhopneumonia and malnutrition need to be monitored for the presence of latent TB infection. Monitor the clinical symptoms and tuberculin test done after 1-3 months of healing.

Preventive

Measles immunization is included in the national immunization program since 1982, immunization coverage rates declined <80% in the last three years so it is still found areas of high risk pockets of measles virus transmission.