What the World Health Organization (WHO) has to say about measles……
Measles remains a leading cause of death among young children, despite the availability of a safe and effective vaccine for the past 40 years.
In 2006, it was estimated that there were 242,000 measles deaths globally: this translates to about 663 deaths every day or 27 deaths every hour.
The overwhelming majority (more than 95%) of measles deaths occur in countries with per capita Gross National Income of less than US$1000 and weak health infrastructure.
Immunization prevents suffering, complications and death caused by measles. The measles vaccine is safe, effective and inexpensive.
From 2000 to 2006, an estimated 478 million children aged nine months to 14 years received measles vaccine through supplementary immunization activities in 46 out of the 47 priority countries with the highest burden of measles. These accelerated activities have resulted in a significant reduction in estimated global measles deaths.
Vaccination has had a major impact on measles deaths. Overall, global measles mortality decreased by 68% between 2000 and 2006. The largest gains occurred in Africa where measles cases and deaths fell by 91%.
Global Immunization Vision and Strategy (GIVS) calls on countries to reduce global measles deaths by 90% by 2010 compared to 2000 estimates. WHO and UNICEF have developed a comprehensive strategy to sustainably reduce measles deaths.
Measles is one of the most contagious diseases known. Almost all non-immune children contract this respiratory disease if exposed to the virus. Measles is an acute illness caused by a virus in the paramyxovirus family. Measles virus normally grows in the cells that line the back of the throat and in the cells that line the lungs. It is a human disease not known to occur in animals.
Signs and symptoms
The first sign of infection is usually high fever, which begins approximately 10 to 12 days after exposure and lasts one to seven days. During the initial stage, the patient may develop a runny nose, cough, red and watery eyes and small white spots inside the cheeks. After several days, a rash develops, usually on the face and upper neck. Over a period of about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades.
The rash occurs, on average, at day 14 after exposure to the virus, with a range of seven to 18 days.
Measles is often an unpleasant mild or moderately severe illness. Severe measles is particularly likely in poorly nourished young children, especially those who do not receive sufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
Children usually do not die directly of measles, but from its complications. Complications are more common in children under the age of five or adults over the age of 20.
The most serious complications include blindness, encephalitis (a dangerous infection of the brain causing inflammation), severe diarrhea (possibly leading to dehydration), ear infections and severe respiratory infections such as pneumonia, which is the most common cause of death associated with measles. Encephalitis is estimated to occur in one out of 1000 cases, while otitis media (middle ear infection) is reported in 5-15% of cases and pneumonia in 5-10% of cases. The case fatality rate in developing countries is generally in the range of 1 to 5%, but may be as high as 25% in populations with high levels of malnutrition and poor access to health care. People who recover from measles are immune for the rest of their lives.
Then there are those that initially recover from the measles and are thought to be immune but after a few years the measles virus dramatically changes its form…..and causes SSPE.
What the National Institute of Neurological Disorders (NINDS) has to say about SSPE………..
What is Subacute Sclerosing Panencephalitis?
Subacute sclerosing panencephalitis (SSPE) is a chronic persistent infection of the central nervous system caused by an altered form of the measles virus. It affects primarily children and young adults and usually has a progressive downhill course which results in death within a few years in most patients with a 5% chance of spontaneous remission. It can occur anywhere from 2 to 10 years after the original measles illness, and generally results in progressive neurological deterioration due to brain inflammation and nerve cell death. Since the widespread use of the measles vaccine, SSPE has become very rare. However, studies have shown that the incidence of SSPE has remained high in the Middle East and India. Initial symptoms usually include abnormal behavior, irritability, intellectual deterioration, and memory loss which may be followed by involuntary movements and seizures (in the form of myoclonic spasms). Subsequently, the patient develops further mental deterioration, inability to walk, speech impairment with poor comprehension, and difficulty swallowing (dysphagia). Blindness may also result. In the final stages of disease, the patient may remain mute or comatose. The electrical activity of the brain, as recorded by electroencephalogram (EEG), shows progressive changes during the disease which are typical of SSPE and parallel the slow deterioration of central nervous system functions. A number of clinical staging scales have been used for several decades to categorize patients with SSPE according to their corresponding clinical status. More recently, a different staging system was developed based on the radiological findings of the brain by computed tomography (CT) and magnetic resonance imaging (MRI). This method, however, has not succeeded in establishing a complete correlation between radiological abnormalities and clinical progress.
Is there any treatment?
For several decades, the palliative treatment for SSPE has included anticonvulsant therapy and supportive measures (tube feedings and good nursing care especially in patients with advanced disease). Medical literature during the last decade, however, has shown stabilization of disease and delay in clinical progression after therapy with inosine pranobex (oral Isoprinosine); oral isoprinosine combined with intrathecal or intraventricular interferon alpha (up to 50% rate of remission or improvement); oral isoprinosine combined with interferon beta; and intrathecal interferon alpha combined with I.V. ribavirin. However, no controlled studies have been performed. The Food and Drug Administration has added inosine pranobex (Isoprinosine) to its List of Orphan Products Designations and Approvals (1988) for the treatment of SSPE.
What is the prognosis?
When not treated with immunomodulators (interferon) and antivirals (ribavirin and inosine pranobex) SSPE is almost always a fatal disease. Death usually occurs between 1 and 3 years after onset, although some spontaneous remissions (up to 5%) have been reported.
What research is being done?
The NINDS supports research on infections and diseases of the brain and nervous system including SSPE. Much of this research is aimed at learning more about the cause(s), prevention, and treatment of these disorders. Currently no clinical trials on SSPE are being conducted at the NIH.
Why there should be research on measles and its complications:
Measles was the first virus known to suppress the immune system, years before HIV and those immunosupprressed recover after a few months. How do they recover while HIV patients do not?
Measles is used by some investigators/researchers as a vehicle for vaccination and is used to vaccinate against malaria and other infections.
Measles is used by some investigators as a vehicle to treat certain cancers due to high infectivity of lymphocytes.
Measles is used by those interested in knowing how a virus infects nerve cells and transported in the brain and cause brain disease.
Measles has been identified by the World Health Organization as the infection after polio to be eradicated from the world. Measles still affects more than 20 million people every year.