“Understanding Measles: Symptoms, Treatment, and Prevention”

Measles (kerumut/gabagen) is a disease caused by a morbili virus infection, transmitted from human to human, through splashes of the sufferer’s saliva when coughing, sneezing or talking. This disease has the potential to become an epidemic, especially in susceptible people. Most sufferers of measles are children.

Risk factors for this disease include people who have not received measles vaccinations, people with weak immunity, and children with poor nutrition, as well as children with vitamin A deficiency.

Symptoms and signs of measles.
What are the symptoms of measles, and what should we be aware of this disease? Measles has three stages. The first, namely the prodromal stage, at this stage the symptoms of measles are difficult to recognize, often parents are not aware of it. The prodromal stage lasts 3 to 4 days. At this stage the disease is highly contagious, so it is necessary to quarantine so as not to infect other people.
Second, the eruption stage is characterized by high fever. As the temperature rises, a reddish patch appears that starts behind the ears, at the boundary between the skin and hair, and spreads quickly to the face, neck, trunk and all over the body. The eruptive stage lasts 4 to 8 days.
After the eruption stage, the rash will heal, this is the third stage, namely the convalence stage, in the form of reddish spots turning black with peeling skin. The period of transmission of measles ends after 4 days since the reddish spots first appear.

Cases of measles in children generally heal well, a small number can experience complications. Groups that are susceptible to worsening of symptoms are people with a low immune system or who have never received a vaccine before. Complications of this disease include inflammation of the middle ear, diarrhea with dehydration, pneumonia or inflammation of the lungs, and inflammation of the brain. If you experience this complication, the worst possibility is permanent disability or even death.

What you also need to watch out for from measles besides its complications is the condition of immune amnesia. This condition occurs due to the measles virus which attacks the sufferer’s immune system, causing the immune system to become paralyzed. This condition can last for weeks or even months. With a paralyzed immune system, sufferers can easily be attacked by other diseases such as tuberculosis, pneumonia, diarrhea and others. Causing measles sufferers to be very susceptible to disease until the condition of the immune system returns to normal.

Treatment of measles
Measles is a disease that is self-limiting disease meaning that this disease can heal itself. Treatment by doctors focuses on supportive therapy, namely therapy to help children get through their illness, by providing fluids, nutrition, and vitamin A.

The most effective treatment in dealing with this disease is treatment from a public health perspective, namely the application of clean and healthy living behaviors (PHBS) such as washing hands, using masks, applying cough and sneeze etiquette, exercising, and consuming nutritious food. The most important action is vaccination so that the chain of transmission of this disease can be broken.
We can reflect on the United States which has been declared free of this disease since 2000. Namely by forming herd immunity through measles vaccination with a minimum vaccination coverage of 95%. Indonesia itself has followed the commitment to eradicate measles in 2020 by implementing comprehensive vaccination with a minimum target of 95%. However, with the pandemic at the beginning of 2020 yesterday, the target for vaccination coverage decreased. Quoting data from the Ministry of Health, the coverage of basic vaccination for toddlers in the last two years in Indonesia has decreased, namely at 83.3% (2020) and 84.2% (2021) compared to the previous year’s 93% (2019). This figure is of course still very far from the target of 95%. The meaning of this low vaccination coverage is that in the future Indonesia is at risk of experiencing an increase in measles cases.

Community attitude
Then how to deal with this incident? People don’t need to panic, if a child has a fever, parents can do first aid by giving compresses. Use lukewarm water with a small clean towel/cloth, place it on the forehead, chest/stomach, and both armpits. Wear loose clothing. Maintain good air circulation, so that hot steam does not accumulate because it can make it difficult for fever to come down and can cause prickly heat. Take regular measurements of the child’s temperature, can be done every 4 hours.

The next step is to give the child good fluids and nutrition. Loss of fluids can exacerbate fever, so it is very important to replace this fluid loss. Provision of nutrition is equally important, complete and balanced nutrition is needed to fight disease and prevent malnutrition. For children under the age of 6 months, breast milk has a very important role in protecting children, because breast milk contains antibodies.

If the fever continues to increase > 38 0C, parents can give the child febrifuge. Give medicinal syrup that has been declared safe by BPOM and KEMENKES. Give according to the dosage, and don’t forget to check the expiration date of the drug. If the fever does not improve in 2 to 3 days or if the child has worsening symptoms, immediately consult a doctor or the nearest medical officer.

If the child has a fever with a red rash, then the child should be taken to a health worker. Fever with a reddish rash does not only occur in measles, it can also occur in other diseases such as DHF, Singapore Flu, Chickenpox and others, so it is better to consult a doctor.

Measles can be prevented by vaccination. Quoting from the American Vaccination Agency, giving 1 dose of measles vaccination to children at the age of 9 months has an effectiveness of 85% -90% and if it is given with a booster at the age of 18 months, the protective ability of the vaccine increases by 90% -95%. Immunity formed from vaccines lasts a very long time, even for a lifetime. Even though it doesn’t protect against infection 100%, vaccination can reduce the chance of experiencing serious complications.

Let’s make the vaccination activity a success, by vaccinating our children according to the schedule, and not easily falling for hoaxes or untrue rumors about vaccines, not spreading fake news and seeking truthful information from competent medical personnel. With vaccination, we protect our children and grandchildren from the threat of dangerous infectious diseases in order to create a strong Indonesia in the future.

Writer
dr. Muhammad Rifqi Khairi