When it comes to measles, prevention is better than cure. Experts at the Infectious Disease Service, KK Women's and Children's Hospital (KKH) explain.
Measles is a serious disease which caused 122,000 deaths, mostly of children, globally in 2012, according to the World Health Organisation (WHO).
In Singapore, the incidence of measles is low because of the widespread use of the MMR vaccine. MMR or Measles, Mumps and Rubella, is a combination vaccine which protects children against measles as well as the infectious diseases mumps and rubella (German measles).
“For measles, an ounce of prevention is worth more than a pound of cure. Once a vulnerable person is exposed, the likelihood of contracting measles is very high,” says Dr Thoon Koh Cheng, Head and Senior Consultant at the Infectious Disease Service,
KK Women’s and Children’s Hospital (KKH), a member of the
Measles, also called rubeola, is caused by a virus and is transmitted through droplets from the nose or mouth of an infected person.
Measles symptoms typically appear 10-12 days after infection. Common measles symptoms include the following:
- High fever – usually lasts 4-7 days
- Runny nose
- Red and watery eyes
- Small white spots inside the mouth
- Red or reddish-brown rash – starts on the face and neck 3-5 days after the fever, and spreads throughout the body
Some patients, especially those who are malnourished or have a weak immune system, may develop severe measles with complications related to the brain, lungs, eyes or ears. Severe measles can be fatal.
“Potential complications include severe pneumonia, middle ear infection, brain infection or even widespread infection leading to multiple organ failure,” says Dr Thoon.
There is usually no specific treatment for measles. Patients usually get better with adequate rest and home care and may be given over-the-counter medication to relieve symptoms.
They are advised to avoid interacting with people in the first few days after the rash appears when it is highly infectious.
The rash usually subsides on its own, after 5-6 days, and most patients make a full recovery. A person who has had measles develops lifelong immunity to the disease.
Measles prevention – MMR vaccine
The best way to prevent measles is to get vaccinated against it in childhood. The MMR vaccine, given in two doses, has reduced global measles’ related deaths by 78 per cent.
In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year, according to the WHO.
In Singapore, a child is given the first dose of the MMR vaccine at the age of 12 months, while the second dose is given at 15-18 months.
“Most newborns are protected against measles infection till about 3-6 months of life because of maternal antibodies,” says Dr Thoon.
What to do if your child has not been vaccinated against measles
If your child has not received the MMR vaccine, he or she can get vaccinated at a later date and still develop the same immunity against measles. However, delaying the vaccine is not recommended.
“Since the risk of infection remains as long as one is not vaccinated, it is highly recommended that a child receives the MMR vaccination at the appropriate age,” says Dr Thoon. “For a missed booster dose, the child should catch up as soon as possible without restarting the schedule.”
If a child who hasn’t been vaccinated is exposed to measles infection, the risk of developing measles is 60 - 90 per cent.
What to do if a child who has not been vaccinated is exposed to measles infection
If just 72 hours have elapsed since the exposure to measles infection, a dose of the MMR vaccine can be given to try to avert clinical measles. However, this does not guarantee that the child will not develop the disease.
“Success is highly variable,” says Dr Thoon. “In a few rare cases where the exposed person has some form of immune system deficiency (e.g. due to chemotherapy), intravenous antibody transfusions may be required to prevent a devastating measles infection.”
Is there a potential link between the MMR vaccine and autism?
The MMR vaccine is completely safe and is not linked to autism despite some reports to the contrary. “The reported link between the MMR vaccine and autism is based on a fraudulent study conducted in the UK,” says Dr Thoon. In fact, the main author has been discredited and struck off medical practice. “Multiple large studies have failed to show any association between the MMR vaccine and autism.”
In many communities where children do not get MMR vaccine (for example for religious reasons), the rate of diagnosis of autism is similar to the rate of autism in communities who get MMR vaccination.
Dr Thoon stresses the benefits of the MMR vaccine.
“Failing to vaccinate a child could potentially increase the risk that the child gets measles and passes on the infection to another person whose immunity is compromised and who might die from it,” he says.