Measles: Understanding and preventing this infectious disease

Measles is a highly contagious infectious disease caused by a virus of the paramyxovirus family. It manifests itself through respiratory symptoms and a characteristic rash. Although vaccination has considerably reduced its incidence, measles remains a public health concern, particularly in view of recent outbreaks in several regions, including Quebec.

Measles on the rise in Quebec

In recent years, Quebec has seen an upsurge in measles cases. This increase is attributed to several factors, including :

-Decline in vaccination coverage: Despite public health efforts, some populations remain under-vaccinated.

-International travel: Measles is still endemic in many parts of the world, and travel can introduce the virus to non-immune populations.

-Community spread: Once introduced, the virus can spread rapidly, especially in environments where vaccination coverage is inadequate.

Current situation

In 2024, Quebec reported a significant increase in measles cases. Public health authorities are actively working to contain this upsurge through vaccination campaigns and awareness-raising measures. It is crucial for parents to have their children vaccinated, and for non-immune adults to receive the MMR vaccine to prevent new epidemics.

Symptoms and Complications

Symptoms of measles generally appear 8 to 10 days after exposure to the virus and include :

-High fever

-Dry cough

-Rhinitis (runny nose)

-Conjunctivitis (red eyes)

-Malaise and irritability

-Koplik spots: small, specific whitish spots on the inside of the cheeks, often near the molars, appearing before skin eruption.

-Skin rash: maculopapular rash (small red spots, raised or not), red, spaced out from healthy skin, typically appearing first on the face before spreading to the rest of the body.

Complications of measles can be serious, especially in young children, pregnant women and immunocompromised individuals. They include ear infections, pneumonia, encephalitis (inflammation of the brain) and, in rare cases, death.

Evolution and Healing

Most cases of measles progress to full recovery in around ten days, although fatigue may persist for longer.

Contagion time

People with measles are contagious from five days before the onset of the rash until around five days after its appearance. The period of maximum contagion is around the time of rash onset, making transmission of the virus particularly easy during this period.

School Eviction

To limit the spread of measles, affected children should be kept away from school for at least four days after the rash appears.

Treatment

There is no specific antiviral treatment for measles. Treatment is mainly symptomatic and supportive:

-Rest and hydration: To help the body fight infection.

-Antipyretics: such as acetaminophen or ibuprofen to reduce fever and relieve pain.

-Vitamin A: Children with measles can receive vitamin A supplements, as vitamin A deficiency can worsen the disease.

Prevention

Vaccination is the most effective way to prevent measles. The MMR (Measles-Mumps-Rubella) vaccine is administered in two doses, usually at 12 months and between 4 and 6 years of age. This vaccine is safe and effective, offering long-term protection against the disease.

Differential diagnosis

It is important to differentiate measles from other diseases with similar symptoms:

-Kawasaki disease

-Scarlatina

-Toxidermia

-Allergy

-Other viral rash

Mandatory declaration

Measles is a notifiable disease in Quebec. This means that all suspected or confirmed cases must be reported to public health authorities. This measure makes it possible to monitor and control the spread of the disease, particularly during epidemics.

Conclusion

Measles is a vaccine-preventable disease, but it remains a threat due to declining vaccination coverage and international travel. The recent resurgence of measles in Quebec underscores the importance of maintaining high vaccination coverage and raising public awareness of the risks associated with this disease. Together, by strengthening vaccination efforts and following public health recommendations, we can prevent the spread of measles and protect the health of our community.

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