Measles in Children: What Happens and How to Manage It

Measles is a highly contagious viral infection that primarily affects children. While it was once considered a common childhood illness, widespread vaccination has significantly reduced its prevalence in many countries. However, outbreaks still occur, particularly in areas with low vaccination rates. Understanding the effects of measles on children, its symptoms, complications, and prevention measures is crucial for parents and caregivers. This article provides a detailed look at what happens when a child gets measles and how to manage the condition effectively.

Understanding Measles: Causes and Transmission

Measles is caused by the measles virus, a member of the paramyxovirus family. The virus spreads through respiratory droplets when an infected person coughs or sneezes. It is highly contagious and can remain in the air or on surfaces for up to two hours. A child can contract measles by inhaling these droplets or touching contaminated surfaces and then touching their mouth, nose, or eyes.

Early Signs and Symptoms of Measles

Measles symptoms typically appear 10–14 days after exposure to the virus. The early stage of the illness, known as the prodromal phase, lasts for about 2–4 days and includes:

• High Fever – Often exceeding 104°F (40°C), beginning gradually and worsening as the infection progresses.

• Cough – A persistent, dry cough that can become severe and irritating.

• Runny Nose – Nasal congestion and discharge, similar to symptoms of a common cold.

• Red, Watery Eyes – Eyes become red and swollen, often sensitive to bright light.

• Koplik’s Spots – Tiny white spots with a bluish-white center on the inner lining of the cheeks and inside the mouth. These spots appear 2–3 days before the rash and are a key indicator of measles.

• Fatigue and Irritability – The child may appear extremely tired, cranky, and reluctant to eat.

• Muscle Aches – Some children experience body aches and general discomfort.

The Measles Rash: A Key Indicator

A few days after the initial symptoms, a distinctive red rash appears. This rash usually follows a predictable pattern:

1. Starts on the Face – The rash begins behind the ears and spreads to the face and neck.

2. Spreads Downward – Over the next few days, it moves down the body, covering the torso, arms, and legs.

3. Raised and Blotchy Appearance – The rash consists of red, slightly raised spots that may merge together.

4. Turns Brownish and Fades – After several days, the rash darkens and begins to fade, often in the order it appeared.

The rash is often accompanied by continued high fever and worsening of other symptoms. In some cases, the child’s skin may become extremely itchy and uncomfortable.

Complications of Measles in Children

While measles is often mild in healthy children, it can lead to serious complications, especially in young children, malnourished individuals, or those with weakened immune systems. Possible complications include:

Common Complications:

• Ear Infections – Measles can lead to bacterial ear infections, which may cause pain, temporary hearing loss, or even permanent damage in severe cases.

• Diarrhea and Dehydration – Many children experience diarrhea, which can lead to dehydration if fluids are not adequately replenished. This can be particularly dangerous in infants and young children.

Severe Complications:

• Pneumonia – One of the leading causes of measles-related deaths, pneumonia occurs when the measles virus weakens the lungs, making the child more vulnerable to secondary bacterial infections. Severe pneumonia can be life-threatening, particularly in young children and those with weak immune systems.

• Encephalitis – This is a rare but dangerous inflammation of the brain that can occur in about 1 in 1,000 measles cases. Encephalitis can cause seizures, cognitive impairment, loss of motor skills, and, in severe cases, permanent brain damage or death.

• Subacute Sclerosing Panencephalitis (SSPE) – This is a rare but fatal long-term complication that can develop years after a child recovers from measles. SSPE progressively affects the brain, leading to cognitive decline, motor dysfunction, and eventually death. It occurs in about 1 in 10,000 cases but is more common in children who contract measles before the age of two.

• Severe Malnutrition and Vitamin A Deficiency – Measles can lead to a significant loss of appetite, making it difficult for children to consume essential nutrients. Vitamin A deficiency is particularly concerning, as it can lead to blindness and a weakened immune system, increasing the risk of secondary infections.

• Pregnancy-Related Complications – If a pregnant woman contracts measles, it can lead to miscarriage, premature birth, or low birth weight in the baby. This makes vaccination crucial for women of childbearing age.

These complications highlight the importance of measles prevention through vaccination and proper healthcare measures.

How to Care for a Child with Measles

Since measles is caused by a virus, antibiotics are ineffective. Instead, supportive care is essential to relieve symptoms and prevent complications:

• Rest and Hydration – Encourage bed rest and provide plenty of fluids to prevent dehydration.

· Fever Management – Over-the-counter pain relievers can help alleviate fever and discomfort.Aspirin should be avoided in children due to the risk of Reye’s syndrome.

• Vitamin A Supplements – The World Health Organization (WHO) recommends vitamin A supplements for children with measles, as they can reduce the severity of symptoms and lower the risk of complications.

• Eye and Skin Care – Keeping the child in a dimly lit room and avoiding bright light can help with eye discomfort. Regular cleaning of the skin and keeping the child comfortable can reduce irritation from the rash.

Preventing Measles: The Importance of Vaccination

The measles-mumps-rubella (MMR) vaccine is the most effective way to prevent measles. The CDC recommends:

• First dose at 12–15 months of age.

• Second dose at 4–6 years of age.

In high-risk situations, an early dose may be given as early as 6 months, followed by the standard two doses later.

Herd immunity plays a crucial role in preventing measles outbreaks. A high vaccination rate (above 95%) ensures protection for those who cannot be vaccinated, such as infants and individuals with weakened immune systems.

When to Seek Medical Help

Seek immediate medical attention if a child with measles experiences:

• Difficulty breathing or rapid breathing

• Persistent high fever for more than four days

• Signs of dehydration (dry mouth, no tears, sunken eyes)

• Seizures or confusion

Final Thoughts

Measles remains a serious illness that can lead to severe complications, but it is highly preventable through vaccination. If your child develops measles, providing supportive care, monitoring for complications, and seeking medical attention when necessary can help ensure a smooth recovery. Protecting children from measles starts with vaccination, awareness, and responsible healthcare practices.

Sources:

1. Centers for Disease Control and Prevention (CDC)

   • Website: https://www.cdc.gov/measles

2. World Health Organization (WHO)

   • Website: https://www.who.int/news-room/fact-sheets/detail/measles

3. American Academy of Pediatrics (AAP)

   • Website: https://pediatrics.aappublications.org/content/early/2017/06/29/peds.2017-1289

4. Mayo Clinic

   • Website: https://www.mayoclinic.org/diseases-conditions/measles/symptoms-causes/syc-20350324

5. National Health Service (NHS) - UK

   • Website: https://www.nhs.uk/conditions/measles/