Measles, a highly contagious viral infection caused by the measles virus (MeV), has resurfaced in households, posing a significant health risk to families. Traditionally associated with children, the increasing prevalence of the disease among adults underscores the crucial need for precautionary measures to prevent potentially severe health consequences.
A child who carries the infection from school can easily pass it on to others at home if they do not have adequate immunity against the virus.
Health experts say it is unlikely that people vaccinated with two doses of MMR (measles, mumps, rubella (German measles)) will develop any complications. The current surge in cases highlights the susceptibility of a growing segment of the population. According to the World Health Organization (WHO), India reported 12,301 measles cases, ranking among the top four countries with outbreaks in the last six months of 2023. The actual prevalence in the population is considered to be around 1.25 lakh.
An outbreak intensifies the risk of infection, particularly among the vulnerable population such as young children and individuals with compromised immune system. Prevention, early detection and treatment are paramount, as measles can lead to systemic complications.
Typically, measles manifests with symptoms including high fever, cough, runny nose, and a characteristic rash on the face. In normal cases, the fever begins to subside after developing the rashes and the rashes disappear in a week. Even without complications, measles warrants close monitoring due to its immunosuppressive effects, which can increase the severity of other diseases for up to a month following infection.
“Measles is not like a normal viral fever with rashes. It is an immunosuppressive disease. The chances of severity of other diseases after a measles infection is high. The immunosuppressive effect lasts for a month,” said Dr Sheeja Sugunan, a paediatric intensivist and associate professor of Sree Avittom Thirunal Hospital for Women and Children (SAT Hospital), Thiruvananthapuram.
She stressed the importance of taking the MMR vaccine as a post-exposure prophylaxis to get immediate protection and to prevent further infections among family members.
“If one family member is infected and other family members are not sure about their vaccine history, they should immediately take the MMR vaccine. It is safe and not very costly,” said Dr Sheeja. She however pointed out that the live virus vaccine should not be given to immunocompromised people. To protect such people from getting infected, others around them should take the vaccine, she added.
According to health experts, waning of immunity among adults could also make them susceptible to measles. “Measles used to be a problem in young children. During an epidemic, adults also get infected as their immunity starts waning off. This time measles cases were reported among adolescents, adults, pregnant mothers etc.
If mothers are not immune, babies are also not immune,” said Dr Purushothaman Kuzhikkathukandiyil, professor of paediatrics at MES Medical College, Malappuram.
There is no anti-viral drug for measles. Treatment for measles primarily involves supportive care to manage symptoms such as fever and hydration. Vitamin A supplements are provided to enhance the body's protective mechanisms. The role of antibiotics comes only when there is a secondary infection.
Dr Purushothaman pointed out acute and long-term complications of measles. “Many infected children develop acute complications. It can cause infection anywhere in the body especially the ear, larynx, lungs, brain etc. with pneumonia being a major concern. Measles can cause blindness and neurological problems. The complications and mortality are higher when the child is malnourished,” he said.
In rare cases, he added, the virus hibernates in the brain, mutates and causes a condition called subacute sclerosing panencephalitis (SSPE), a progressive neurological complication of the measles virus with no cure to date, 10 years after the initial infection.
As the measles outbreak continues to pose a significant public health challenge, comprehensive vaccination strategies, heightened surveillance and community awareness are crucial in containing its spread and safeguarding vulnerable populations from potentially devastating effects.