Measles in adults

definition

Measles is an extremely contagious infectious disease that is transmitted by viruses. Measles is characterized by two phases. The catarrhal stage is characterized by fever, conjunctivitis of the eyes, runny nose and a special rash in the oral cavity, so-called "Koplik spots". After a temporary defever, the rash stage follows. It is characterized by a high fever and a widespread rash that usually begins behind the ears.

You can find more on the subject at: measles

causes

The cause of a measles infection is the "Morbilli" virus. The pathogen enters the body through inhalation via finely distributed droplets in the air and causes measles to develop. These fine droplets are created by the speaking, coughing and sneezing of a sick person. Even brief contact over a distance of a few meters can lead to infection. Almost one hundred percent of the virus leads to an infection and 95 percent to symptoms, which makes measles one of the most contagious diseases in Germany. They are most contagious five days before to four days after the rash.

Although the disease is highly contagious, the number of cases in Germany is on the decline. This is due to the fact that a lot of people get vaccinated and thus no longer become infected. However, unprotected people can still develop illness.

Concomitant symptoms

In addition to the main symptoms that define measles, there are other, sometimes very dangerous, accompanying symptoms. The pre-catarrhal stage includes fever, conjunctivitis of the eyes, runny nose and a very special rash in the oral cavity. It is called a "Koplik stain", which looks like lime-like splashes on the oral mucosa and cannot be wiped off with a spatula.

After a temporary defever, the disease phase of the large rash on the skin and the increased fever follows. This rash often starts behind the patient's ears and then spreads throughout the body. The associated reddening fades after four to five days, whereby a “bran-like” flaking of the skin often appears. Cough and diarrhea can also occur.

For more information, see: Measles rash

The more severe symptoms and comorbidities include middle ear and pneumonia, which can be caused by additional bacteria. In addition, the "measles croup" is a dreaded accompanying complaint. He describes a laryngitis that can scar the vocal cords. Furthermore, as a result of measles disease, various inflammations of the meninges and the brain (Meningoencephalitis) that are extremely feared.

Read more at: Symptoms of measles

How dangerous is measles in adults?

In general, the danger of a disease depends largely on the age, nutritional and immune status of a patient. It can be assumed that healthy, middle-aged adults in Germany are more likely to have a milder outcome than infants, older adults or adults with weakened immune systems.

Nevertheless, measles infection is to be taken seriously in any case. Serious bacterial infections can occur during this time, which can affect the middle ear or the lungs. In addition, severe laryngitis and encephalitis are complications that can affect adults as well. The acute and subacute forms of this encephalitis due to measles infection are often associated with consequential damage and a relatively high mortality rate. They are among the most dangerous complications that can occur not only in children but also in immunocompromised adults.

Is measles disease possible despite a vaccination?

As with any vaccination, it is possible to contract measles despite supposed vaccination protection. This vaccine is believed to be 91 percent protected from measles virus after the first vaccination and 92 to 99 percent after the second vaccination. One to eight vaccinated people would get measles if they came into contact with the virus.

The reason for this can be various immunodeficiencies in the vaccinated person or an improper vaccination by the doctor. Without such a vaccination, however, most people who come into contact with the virus would get it because of the extremely high risk of infection. After two vaccinations in childhood, usually in combination with mumps and rubella, you have lifelong vaccination protection. Refreshments are not necessary.

For more information, see:

• MMR vaccination (mumps, measles, rubella)
  or
• Measles vaccination

Does vaccination make sense for adults?

Even if the vaccination is usually given in childhood, vaccination in adulthood is also recommended. If there is proven complete vaccination protection, which consists of two vaccinations at the age of 11 to 14 months and at the age of 15 to 23 months, there is no need to re-vaccinate in adulthood.
However, it is advisable to give people born after 1970 who have not received a vaccination or whose vaccination status is unclear or incomplete with a single vaccination with the mumps, measles and rubella vaccine.
In particular, employees in medical areas and community facilities should be fully vaccinated. The measles vaccination not only protects against the measles itself, with all its complications and accompanying diseases, but also against years of immune deficiency after such an infection.

diagnosis

The diagnosis of measles is primarily based on the patient's appearance and description of the disease. Measles are characterized by two disease phases. The first phase is the catarrhal stage and includes fever, conjunctivitis of the eyes, runny nose and a special rash in the oral cavity. This rash is called "Koplik's spots," which looks like lime-like splatters on the lining of the mouth and cannot be wiped off. It only occurs in measles and thus makes diagnosis easier.

After an intermittent defever, the phase of large rashes on the skin and increased fever follows. This rash often starts behind the patient's ears, which is also very specific to measles, and then spreads throughout the body. This sequence of complaints is decisive for the diagnosis. In addition, if anything is unclear, the virus or the body's own antibodies against the virus can be shown in the blood.

Treatment of measles disease

The treatment of measles infection can only be symptomatic, i.e. to improve the complaint. Antipyretic drugs such as paracetamol, ibuprofen and metamizole are used for this. In addition, cough suppressants and fluids can be administered via the vein to ease the patient's phase of illness and to avert dangerous processes.

Antibiotics, which should be adapted to the pathogen, should only be administered if there are additional infections caused by bacteria. In order to avoid infection after contact with the virus, so-called immunoglobulins can be given to unvaccinated people or those with immunodeficiency within six days of contact. This measure can be discussed especially for babies and pregnant women.

How long does measles last?

The duration of the measles illness can be very variable, always depending on how old and otherwise healthy the patient is. In most cases, the first phase of the disease lasts three to seven days. Here, non-specific cold symptoms are the most important. After a short defever, the rash stage follows, which begins to fade after four to five days. Taken together, the measles disease duration can be assumed to be two to three weeks.

The course of a measles disease

The measles show a two-phase course. The first phase, the "prodromal phase" or "pre-catarrhal phase", includes flu-like cold symptoms such as fever, runny nose, cough and conjunctivitis of the eyes. After about three days, a rash appears in the oral cavity that resembles lime-like splashes. It cannot be wiped off, is called "Koplik stain" and is very specific to measles. This phase lasts for three to seven days until a short intermittent defever occurs and the "rash stage" follows.

It is characterized by a high fever, feeling very sick, and a widespread rash that starts behind the ears and then spreads throughout the body. This rash will begin to fade after four to five days. A total of two to three weeks can be assumed.

As a result of having suffered measles, there is an immune deficiency that can often last for months to years.

Measles in pregnancy

Measles infection is particularly dangerous during pregnancy. For one, the measles virus can cross the placenta and infect the unborn child. On the other hand, the viruses often cause miscarriages and premature births that are difficult to stop. For this and other reasons, it is advisable to have a look at the vaccination certificate before a desired pregnancy and, if necessary, a vaccination against measles, preferably in combination with mumps and rubella. Another advantage of the vaccination is the nest protection it creates. In this way, the baby receives antibodies in breast milk before he can be vaccinated, which protects him from infection.

Incubation period - how long have I been infected?

An incubation period of eight to ten days is assumed for measles. This describes the time between contact with the virus and the first signs of illness. After about 14 days after viral contact, the rash appears, which initially appears behind the ears. The patient is most contagious five days before to four days after the rash.