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Measles or rubeola is the most deadly childhood rash/fever illnesses caused by the virus, rubeola, and spreads very easily. Getting vaccinated is the best way to prevent measles. It is highly contagious and spread easily through the air when an infected person coughs or sneezes or by contact when the infected particles settle on surfaces. Sharing drinking glasses or eating utensils with an infected person increases the risk of infection. The virus can live on surfaces for several hours.
Measles is the leading cause of death in children. Approximately 89 780 people died from measles in 2016, mostly children under the age of 5 years old according to the World Health Organization. That was the first year the death toll from measles was under 100,000. The drop is attributed to an aggressive global vaccination program.
Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.
Signs and symptoms
The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).
Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
In populations with high levels of malnutrition, particularly vitamin A deficiency, and a lack of adequate health care, about 3–6%, of measles cases result in death, and in displaced groups, up to 30% of cases result in death. Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives.
No specific antiviral treatment exists for measles virus.
Severe complications from measles can be avoided through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhoea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.
All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.
Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 50 years. It is safe, effective and inexpensive. It costs approximately one US dollar to immunize a child against measles.
The measles vaccine is often incorporated with rubella and/or mumps vaccines. It is equally effective in the single or combined form. Adding rubella to measles vaccine increases the cost only slightly, and allows for shared delivery and administration costs.
In 2016, about 85% of the world’s children received 1 dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose.
Currently in Europe there is a measles outbreak with approximately 41,000 cases reported. The out break is due to an increase of the number of people who not vaccinated.
Ukraine was the hardest hit among the 5 European countries covered in the WHO analysis, with more than 23,000 cases so far in 2018.
Six other countries in the region — Italy, Greece, Georgia, Russia, Serbia and France — have recorded more than 1,000 infections in adults and children in 2018.
Serbia reported 14 deaths related to the disease this year, the highest number of any country included. Thirty-seven people have died across Europe, according to WHO.
While 43 of the 53 member states suspended the endemic spread of measles — where the continued transmission of measles persists for more than 12 months — the WHO is still concerned about low immunization coverage in some countries as well as the quality of disease monitoring, factors that interrupt the spread of the disease.
There is a lot of misinformation about vaccine safety being spread through social media. It was recently reported that the same group of Russian, trolls who infiltrated the 2016 election, have taken to Twitter to sow division and distribute malicious content.
Scientists at George Washington University, in Washington DC, made the discovery while trying to improve social media communications for public health workers, researchers said. Instead, they found trolls and bots skewing online debate and upending consensus about vaccine safety.
The study discovered several accounts, now known to belong to the same Russian trolls who interfered in the US election, as well as marketing and malware bots, tweeting about vaccines.
Russian trolls played both sides, the researchers said, tweeting pro- and anti-vaccine content in a politically charged context. [..]
Russian trolls appeared to link vaccination to controversial issues in the US. Their vaccine-related content made appeals to God, or argued about race, class and animal welfare, researchers said. Often, the tweets targeted the legitimacy of the US government.
“Did you know there was secret government database of #Vaccine-damaged child? #VaccinateUS,” read one Russian troll tweet. Another said: “#VaccinateUS You can’t fix stupidity. Let them die from measles, and I’m for #vaccination!” [..]
“To me it’s actually impressive how well-organized and sophisticated the anti-vax movement has become,” said Dr Peter Hotez, the director of the Texas children’s hospital center for vaccine development at Baylor College of Medicine, and the father of an autistic child. Hotez, who maintains an active Twitter presence, said he struggled to identify whether Twitter accounts were human or bots.
“There are clearly some well-known anti-vax activists that I know to look out for and I know to block or to mute, but that’s a minority,” said Hotez. “A lot of it just seems to come out of nowhere, and I’m always surprised by that.” [..]
One of the most striking findings, (David) Broniatowski said, was an apparent attempt by Russian trolls to Astroturf a vaccine debate using the hashtag #VaccinateUS. Accounts identified as controlled by the Internet Research Agency, a troll farm backed by the Russian government, were almost exclusively responsible for content emerging under #VaccinateUS.
Some of the Russian trolls even specifically used a hashtag associated with Andrew Wakefield, the discredited former physician who published fraudulent papers linking vaccines with autism, such as #Vaxxed and #CDCWhistleblower.
Fortunately, here in the US most people believe vaccines are safe and have had their children vaccinated.