Measles and Rubella

Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.

Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards. In the beginning the rash contains small red spots, and then it spreads and covers large areas of the body. The rash gets paler after approximately 3 days from its appearance, and at that point there is usually a general improvement. The disease can also cause severe complications in the respiratory system and the nerve system.

 

Approximately a third of the patients will develop complications such as otitis media (infection of the ear), diarrhea and infection of the cornea of the eye. Other dangerous and rare complications include pneumonia and encephalitis, an inflammation of the brain. There is a very rare complication that could manifest 10 years after the initial illness and cause a degenerative disease of the brain, leading to an irreversible damage to the nervous system that manifests as mental deterioration and seizures. Children under the age of 5 and adults beyond the age of 20 are at greater risk for a severe disease and its complications is in the case of infection, especially patients with weakened immune system.

Rubella - Transmitted in airborne droplets when infected people sneeze or cough, Rubella is an acute, usually mild viral disease traditionally affecting susceptible children and young adults worldwide. It usually manifests with swollen lymph nodes, fever, pink rash that starts in the face and spreads to the rest of the body, inflammation of the eyes, pain and swelling of the joints and testicles. In severe cases the disease can cause inflammation of the nervous system (which is more prevalent among adults) and bleeding due to lack of thrombocytes (the cell in the blood that is responsible for clotting), more prevalent among children.  Rubella infection just before conception and in early pregnancy may result in miscarriage, fetal death or congenital defects known as congenital rubella syndrome (CRS). The severity of the damage caused to the fetus is affected by the time of the infection; the earlier the mother gets infected - the higher the risk is for congenital rubella syndrome.

The vaccine for Measles and Rubella is administered in Nepal at two doses, at the ages of 9 and 15 months. It contains live attenuated viruses. Some of the children might develop a local rash as a response to the vaccine at the injection site, with or without fever. This response starts 5-12 days after the vaccination, and lasts 1-3 days. Other adverse effects might include swollen of the lymph nodes or local redness and swelling in the injection site. Rare cases might lead to febrile seizures, most probably due to the fever and not the vaccine itself.

Apart from the basic precautions mentioned before, you must avoid vaccination in the following cases:

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1.   A severe allergy to Gelatin or Neomycin antibiotics

2.   In case of immune suppression disease, you must advise your doctor before vaccination

3.   Prior blood transfusions - advise your doctor before vaccination

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