Measles - an acute viral infection.It manifested the disease rash on the child's body.Infection occurs through contact with the patient, which identifies the virus by coughing, sneezing.The first symptoms of the disease begin 9-10 days after infection.
characteristic symptoms of measles include fever, the typical skin rash and mucous membranes (rash and enanthema) and inflammation from the mucous membranes of the respiratory tract and eyes.How to cure this disease folk remedies.
Etiology and epidemiology .The causative agent belongs to the measles virus filtering.Epidemiological features of its studied well enough.The source of infection with measles is just a sick man.Outside the body of the patient pathogen measles dies quickly.The ability to transmit measles through healthy, were in contact with patients, and through things practically unproven and probably does not exist.Measles virus is in the patient's blood and in the discharge of the mucous membranes of the oral cavity, nasopharynx, upper
Measles virus is extremely volatile.So, if measles patient is in a separate room, but the common corridor connected to the other rooms, the infection spreads easily in all these rooms.If measles sick child in a hospital in the office or in the dormitory, in child care, it is necessary to consider all infect uninfected children living in this room with a common corridor.
The second factor contributing to the rapid spread of measles, is a complete lack of natural immunity to it in individuals without a history of previous measles.
Most adults have to measles active acquired immunity.Immunity to measles and the majority of children under the age of 4 months due to passive immunity obtained by them from the mother.If the mother herself was not sick with measles, and therefore has no immunity to it, her child may be ill with measles in infancy.
Moved measles leaves behind a persistent, lifelong immunity.Repeated measles occur only rarely.
On Faroe Islands in 1846 from the 7782 population ill with measles 6 000. Do not get sick with measles only those old men who had been ill during her former on the islands measles epidemic in 1781. All the rest of the population, which had contact with measles patientswithout distinction as to age, from small children to old men, sick with measles.
Pathogenesis and pathological anatomy. Atrium measles, apparently, are the upper respiratory tract.
Measles virus affects most of the respiratory tract.On the part of the cardiovascular and central nervous system in measles rarely seen sharp toxic disorders characteristic of the acute period of many infectious diseases such as diphtheria, scarlet fever, typhus, influenza and OE hypertoxic form with measles are rare and almost never leads to death.
the part of the upper respiratory tract inflammation observed katarralnoe, and in more severe sluchayah- inflammation with superficial mucosal necrosis.The consequence of this necrosis may be the formation of ulcers and transition process in the cartilage.
inflammatory process early in the disease may go on bronchi and bronchioles and lung tissue and often spreads to elastichnomyshechnuyu wall and peribronchial tissue.This can lead, due to the formation peribronhitov to bronchiectasis.Formed bronhopnevmonicheskie pockets easily undergo necrosis, which leads to the appearance of an abscessed pneumonia and lung abscess.
Severe lung disease are the most common cause of death from measles;they are observed in 70% of autopsies.
Besides respiratory tract, measles is often struck by the colonic mucosa (katarralny colitis).
Measles reduces the patient's resistance to pathogens (gipergiya).It worsens during scarlet fever, diphtheria, dysentery and other acute infectious diseases and reduces resistance to tuberculosis.
Clinic. measles incubation period lasts 8-12 days, and sometimes up to 21 days, stretching (vaccinated at Degkvitsu) even up to 28 days.The disease begins gradually.After an incubation period begins prodrome of measles: the child begins to sneeze, he has a rough cough, runny nose, mucous or mucopurulent conjunctivitis, photophobia, hyperemia of the pharynx.Nothing typical measles is not in the initial period;at this time it is easy to mix with the flu.The temperature in the prodromal period is increased to 38-39 °.
2 days before the rash, and often for 4-5 days there is a characteristic sign of measles - a symptom Filatov-Koplik.The symptom that was first described by Russian scientist Filatov.It consists in that the cheeks against molars pink spots appear with a white dot in the center.Their number increases, they become larger, also appear on the mucous membrane of the upper and lower lips.Fade these spots begin with the start of the eruption.On the soft palate appears measles enanthema as irregular bright spots, making the pharynx when examination seems to be "variegated".On the 4th day of catarrhal symptoms with high fever, significant deterioration of general condition and gain conjunctivitis, runny nose and cough rash appears on the face, behind the ears;The next day the rash spreads to the trunk and upper limbs, but on the 3rd day - on the lower limbs.As the rash gradually disappears, first on the face, then on his chest, and then on the limbs.
In the absence of complications along with blanching rash reduced temperature, general condition improved dramatically, catarrhal phenomena diminish and disappear, the patient recovers.
rash looks like pink, slightly rising to the surface of the skin spots the size of a lentil;sometimes it can be a drain;-uchastki same skin rash between elements have normal color, which gives the skin a measles patient mottled appearance.Face all completely covered with a rash than measles differs significantly from scarlet fever, in which are available from the rash areas - the nose and chin.Rash leaves behind pigmentation, and a week after the rash appears on the body small defurfuration;sometimes barely noticeable peeling occurs only on the trunk.
skin lesion at the site of measles exanthema expressed in inflammation and degeneration of the epidermis with keratinization and squamous peeling it.The duration of the average severity of measles 8-10 days.
the part of the white blood cells during the prodromal events and rash have a leukopenia.When remission process blood comes to normal.In the event of focal pneumonia and septic complications set leukocytosis.
Measles is not always typical flows, often it flows easily in abortive form.Katarr mucous in this form of measles expressed softly, rashes and spots Filatova-Koplik often appear simultaneously.
Abortive measles, which is usually observed in vaccinated children, takes place at a relatively low temperature not exceeding 38 °.The disease is stopped by a few days.Complications of this form does not happen;Sometimes measles, according to the description Filatov, proceeds without the rash.
Sometimes, mostly in the warm season, the epidemic of measles occurs very easily.Occasionally there are toxic form of measles with hemorrhages in the skin and mucous membranes, early collapse, meningeal phenomena.
Complications .The most common complication of measles - pneumonia.
Measles croup.With a pronounced inflammation of the mucosa of the larynx and trachea in young children may develop stenosis phenomenon -korevoy cereals.Measles croup appears in the prodromal stage of measles or with rash.
Symptoms of croup - barking cough, noisy and difficult breathing, inspiratory retraction of compliant places the chest;the amplification stenosis - cyanosis, a serious condition.
true diphtheria croup, which may join the measles, appears usually in the period pigmentation and requires immediate treatment serum.
mortality in measles usually depends on complications, mainly from pneumonia.Especially characteristic of early measles pneumonia, which appears during the eruption and occurs especially hard.
complication of pneumonia can appear and later - during blanching rash and pigmentation.
When pneumonia is often not possible to establish the corresponding physical symptoms, although the essence of complications indicates cyanosis, shortness of breath, heart weakness.Sometimes pneumonia becomes sluggish over with a tendency to the formation of abscess pneumonia and bronchiectasis.
common complication of measles is stomatitis.Severe forms of stomatitis is nome - gangrenous, deep ulcer on the inner surface of the cheeks;fortunately, this complication is very rare.Very frequent and dangerous, especially for a young child, complication is inflammation of the colon - colitis.The chair becomes liquid with mucus and sometimes blood, pain in the abdomen.Colitis can last very long and cause a significant depletion of the child.Keep in mind that diarrhea mixed with blood for measles may be associated with acceding dysentery.
A common complication of severe measles is otitis media (middle ear infection).
Measles is often otitis catarrhal character and in contrast scarlet rarely leads to mastoiditis (inflammation of the mastoid).
are occasional cases of congenital measles in a newborn if the mother hurt her just before birth.There
joint for measles other infectious diseases.Measles, joined the scarlet fever, diphtheria, dysentery and other acute infectious disease, occurs commonly and heavily impairs the course of the underlying disease.
TB children with measles should be closely monitored.
case-fatality rate is dependent on age;in older age, it is 4-5%, rising to 30-40% in children younger than 2 years.
If fever lasts for two days after the rash appears or is returned, you should call the doctor immediately or take a second child to the hospital.Complications can be serious and, unlike most of measles, are treatable with modern facilities.
differential diagnosis. Measles mixed with scarlet fever and rubella.
rash of measles covers the entire face, scarlet fever as the nose and chin covered with a rash;scarlet fever rash solid, punctulate, measles spots rises above the skin, which becomes mottled appearance;scarlet fever rash appears a day after the onset of the disease, measles - on the 3-4th day;measles, starting from the prodromal period, there is a strong mucous catarrh, scarlet fever - dry mucous membranes;measles are no sharp toxic phenomena such as ori scarlet fever, rarely vomiting.
When rubella rash resembles measles, but paler;no strongly pronounced catarrh of the mucous.The rash of rubella cover the whole body of the night, when measles is spread over 3 days.When rubella during eruptions child's condition is good, the temperature rises slightly.Especially characteristic of rubella increase in cervical and occipital lymph glands.On the buccal mucosa lesions may appear as small red dots.
When serum sickness can be morbilliform rash and mild catarrhal phenomena from the mucous membranes of the upper respiratory tract.Diagnosis is based on history (the introduction of serum for 1-2 weeks before the rash, rash at the site of the beginning of serum), and further picture of the disease.
erythema of different origin and septic rashes may give rise to diagnostic errors.
In all cases of suspected measles, you must carry out preventive measles vaccinations for children without a history of measles in contact with the patient.
Sometimes for measles can be adopted early stage of smallpox or typhus.
treatment. Treatment of uncomplicated measles is reduced to preventive and hygienic measures.The patient should be placed in a bright, well-ventilated room, and every 2-3 days to give him a warm bath.It should be 2-3 times a day to wash the eyes 2% boric acid solution, rinse your mouth with older children, younger children also squirt him with the same solution.When pneumonia is recommended mustard wraps, mustard, older children at the beginning of pneumonia put banks.At the beginning decline of cardiac activity shows heart: Sol.Coffeini natrio-benzoici 1-2% on a teaspoon 4-5 times a day;01. Camphorae 1 cm3 under the skin.
In early pneumonia with severe toxic effects is recommended for 4-6 days every day to pour intravenously 20-25 EM3 40% glucose solution.At low current use diathermy pneumonia and other thermal treatments, as well as gene therapy - intramuscular injection of 5-10 cm3 maternal blood several times every 2-3 days.The most effective treatment for measles or pneumonia with penicillin Sulfidine.The daily dose Sulfidine 0.1-0.2 per 1 kg of weight (the first 2 days Sulfidine given every 4 hours, and in the following days, the daily dose gradually).Penicillin is administered intramuscularly every 3 hours for 25 000-50 000 units.When colitis can also be used sulfa drugs.
important to correct a child's diet.Older children recommended to give light, but nutritious food: cereal, jelly, soup, yogurt and egg yolks, white bread;junior - milk with decoctions, jelly, cereal;infants - must breastmilk.In all cases it is necessary to give vitamin C (as berry juice or ascorbic acid 2-3 times daily to 0.25), and vitamin B1 (2-3 times per day to 0,005).
During the period of illness associated with high fever, the child almost completely loses appetite.Usually, he just drinks, and drinking it is necessary to give more often.The mouth should be gently cleaned three times a day.It used to be that you need to keep the baby in the dark to protect the eyes.But now we know that the eyes are not in danger.If the light is causing the child discomfort, you can darken the room.It should be warm, so that the child is not freezing.Two days after the child's temperature drop is usually discharged from the bed.It can be let out and allowed to play with other children, a week after the rash has completely disappeared if coughing and other symptoms.
Prevention. moment aggravating for measles, are poor sanitary conditions and a predisposition to airway disease.The objective is to prevent measles at an early age and in the room of the sick child in good sanitary conditions.
can not be allowed to rebenky with measles, a person with a cold or a sore throat, the bacteria that cause these diseases complications.Typically, once they fall ill with measles.
Uncomplicated measles proceeds favorably, and at home.It is not recommended to put the measles patients, particularly young children, in general hospital wards because of the possibility of complications from respiratory tract and other infections in the implementation closely sick children.If the House of measles patients have one or more of them develop pneumonia, then the rest of the children in this ward, in danger of the same complications.Isolate measles patient is necessary, or in an individual box, or in a small ward for 2-3 beds, and patients with uncomplicated measles can not be placed together with patients with pulmonary complications.Patients hospitalized with measles only from private children's institutions or in the presence of severe complications requiring hospital treatment, or in poor sanitary home environment (humidity, smoke, the presence of coughing patients in the room and so on.).