Why parents must protect their children against measles – Dr Sherifat

Parents are presently complaining about measles, can you give us an insight into its causes and effects?
Measles is a highly contagious viral infection which mostly affects children. It was once an inevitable experience during childhood. Measles is a single stranded lipid enveloped RNA virus in the family of Paramyxoviridae  and genus Morbilivirus. It is characterized by fever, enanthen, cough, coryza, conjunctivitis, prominent exanthema, photophobia, erythematous and maculopapular rash.
The enanthem kopliks spots is the pathognomonic sign of measles and appears between 1 to 4 days prior to onset of the rash.
There are six major structural proteins of measles virus; two out of the six are most important in terms of induction of immunity.  They are the Hemagglutinin H protein and the Fusion F protein. The neutralizing antibodies are directed against the H protein, and antibodies to the F protein which limit proliferation of the virus during infection. A person can be affected with measles through the respiratory tract or conjunctivae which is portal of entry following contact with large droplets or small droplets aerosol in which the virus is suspended.

Apart from the aforementioned causes, are there other factors that can also lead to measles infection?
The virus infection can also affects malnourished children, (immune-compromised) with reduced immunity or immune-suppressive like HIV patient and negligence of some parents not to vaccinate their children on time. Also, about 90 percent of the exposed susceptible individuals develop measles. If the virus has settled on a surface and an uninfected person touches it and move the hand towards the mouth or nose, the person will be infected.

What are the complications of measles in an infected patient?
Measles can be serious and even fatal for children as it can lead to serious complications. It can result to diarrhea, hepatitis, otitis media, encephalitis pneumonia, blindness, pneumonia which is the common cause of death of infants and toddlers.

Where and what time  of the year does measles become rampant?
 It is common in temperate countries like Nigeria and the peak period of infection is during the hammatan. Take December 2013 for instance, we had some cases in our hospital here. Thank God they were hospitalized and they responded to the treatment and so were discharged.

How would you compare the rates, in which children were being affected with the virus previously and now?
Before now, measles kills several hundred thousands of children but with the introduction of the measles vaccine, the awareness campaigns, frequent advocacy and intensified vaccination coverage in both rural and urban areas by the National Immunization Program (NIP), the morbidity and mortality rates have reduced.

What are the steps to be taken so as to protect children from contracting the virus?
Measles is curable and can only be prevented by measles vaccine. Basically, there is no specific treatment for measles rather than its vaccine. Other measures are maintenance; hydration, oxygenation.   
The problem with people in developing countries is negligence. Despite government’s effort in providing the vaccine and the fact that medical experts are ready to give them the vaccines, parents prefer to stay at home or take the child to a nearby chemist which can also lead to more complication.
So, we should not take the health of our children for granted. 90 percent of people sharing houses with an infected patient can easily catch the virus while only 10 percent would remain safe. So, when we notice a child has been infected with the virus, the baby should be kept out from other children.
When you notice some unusual reaction in children, they should be taken to the hospital for check up and treatment. There was a complicated case we had just last month. The boy’s condition was terrible, when I asked the mother why she waited up to that time before bringing the child to the hospital, she said she was not aware of measles and that is why she took her child to a nearby chemist where there was no trained doctor or nurse and that had contributed to the complexity of the boy’s condition.
This is  because the virus had started affecting his eyes. We should ensure proper nutrition is given to the body.

What advice do you have for parents, health service providers and the government to ensure effective prevention?
Parents should ensure that whenever they observe a child  is coughing or having high temperature and running nose, he should be taken to the hospital or health care centre where the child will be given adequate attention before it gets complicated.
Immunization for children should be taken as very essential. Medical experts and providers need to make sure that adequate and proper counselling is given to parents; ensure all children receive measles vaccine as part of routine childhood immunization, and intensify effort in health talk, as well as continuous vaccination programme should be pursued rigorously.
With widespread coverage and intensive immunization strategy by National Immunization Programme NIP, there will be reduction of measles virus in the society.
In developed countries like UK (United Kingdom), measles is extremely rare because of the thorough and successful vaccination programme. Despite the vaccine provided by government, the anti therapy is not sufficient because children are still being affected.
Thus, government should provide supportive and anti- therapies, for hydration, oxygenation, and incubation.   If all these are taken into cognizance, it will go a long way in reducing the morbidity and mortality as a result of measles in Nigeria.