Epidemic of measles : the warning signs and how to avoid it ?

Health 30 January, 2018


Published the 30.01.2018 at 16h18
Update the 30.01.2018 to 16h34


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In France, between 1 November 2017 and 18 January 2018, 123 cases of measles have been identified in New Aquitaine, according to the ARS. Still according to the Regional Agency of Health of New-Aquitaine (cited by Le Parisien), there are currently 6 new cases reported per day”, and it would be in 130 cases in a little less than 3 months. Other outbreaks of measles are reported elsewhere in France and the region Nova-Aquitaine represents only 81% of these cases. According to the ARS, the coverage is insufficient to halt the epidemic. It becomes necessary to protect yourself.

The measles virus strike groups

Measles is an infectious disease of viral origin, eruptive and very contagious, which is linked to a “paramyxovirus”. It is transmitted mainly by the airborne route, for example when a sick person who is contagious coughs, he sends in the air of micro-droplets of saliva infected with virus. It is also possible to get measles after contact with a surface contaminated by nasal secretions and sputum.
To spread, virus-like, therefore, the promiscuity, the meetings. It is the university campus that is part of the epidemic of Bordeaux. The phase of contagiousness starts on the eve of the appearance of the first signs and stretches for up to 5 days after the beginning of the appearance of the buttons. Thus, a person who is infected, according to experts, contaminate 15 to 20 others.

Measles is not a benign disease

Measles may be complicated, especially in infants or in persons with fragile, and lead to a hospitalization. It is primarily a pneumonia with superinfection by bacteria. It is a serious infection of the lung that can lead the patient in the icu.
Then, it is a risk of viral infection of the brain (” encephalitis “) with violations of the eye that can lead to blindness. These complications can lead to death, and give of pulmonary sequelae and neurological life.

The diagnosis is made when it is already contagious

The signs of measles after a precise chronology in connection with the development of the virus in the body.
First of all, there is a period of incubation of the virus 10 to 12 days during which no sign appears. It is a mute period during which the virus multiplies.
Then the first signs occur during the phase of invasion. It lasts 3 to 4 days during which the patient is tired, has a fever of 38°5-40°, and has a dry cough, red eyes and a runny nose. Children may often complain of a tummy ache. These signs are not very suggestive but in the mouth, we find, if we look, for small white spots on the inner lining of the cheeks, ” it is the sign of Köplik “.

The eruption is late

The distinctive rash happens in a brutal way but on the 15th day after the contagion, that is, ” the exanthema morbiliforme “. It is made of pink patches swollen irregular, who do not scratch and are not separated by intervals of healthy skin. It begins behind the ears and down quickly on the face and trunk and then on the whole body.
During this phase, the fever persists as long as the rash has not stabilized. Little by little, the different signs disappear one after the other in a week. The fatigue and cough may persist beyond 15 days.

How do you make the diagnosis ?

The diagnosis of measles is done mainly on the clinical signs characteristic of the disease. This poses a problem because the first signs were not characteristic, but the sign of Köplick, the small white spots on the inner lining of the cheeks, but it needs to go there to look at. In most cases, there is no interest to perform additional examinations.
However, when the diagnosis should be confirmed with certainty, it is possible to do a blood test looking for antibodies against the measles virus, then a ” serology viral “.
Techniques more costly molecular biology exist to directly search for the presence of the virus in secretions, this is the ” PCR ” or ” Polymerase Chain Reaction “.

How to protect yourself ?

The measles virus is a virus that does not like the heat, (it dies after thirty minutes spent above 60 degrees), and which is destroyed by alcohol 70%. But, as it is transmitted during a simple conversation, in the event of coughing or sneezing, it is possible to catch quite easily at the touch of an infected person, the fact that you ignore it more often since the eruption on the skin occurs at least 10 days after the patient is contagious.
The only true way to avoid getting measles is to get vaccinated. Very effective, the vaccine is only contraindicated in the allergic to egg white, in the immunocompromised, and pregnancy.
Traditionally, the regimen consists of the injection of a dose of MMR vaccine (Measles, Mumps, Rubella) at 12 months and then a second injection between 16 and 18 months. For people who have never been vaccinated against measles, catch-up is possible. It consists of the injection of two doses of vaccine at least one month apart.
In the event of an outbreak, it is possible to receive the vaccine up to 72 hours after contact with a person suffering from measles to prevent the occurrence of the disease (catch-up vaccination).

A failure of the immunization policy in France

In 1980, before widespread vaccination, there were 600, 000 cases of measles in France. The current outbreak of measles shows that France is still endemic situation vis-à-vis this contagious disease which has returned to mandatory reporting and that we are not immune to a new outbreak of magnitude as the card of the infections of 2017 makes it appear that the diagnostics are divided in rather homogeneous over the territory.
The scenario of an epidemic is all the more credible that the immunization coverage is too low. Only 79 % of babies of 2 years old are vaccinated. However, with a virus of the level of contagiousness of the “paramyxovirus” of measles, it would be necessary to achieve 95 % vaccine coverage to prevent any circulation of the virus in France.

Immunization coverage required in Europe

France is far from isolated in the face of this resurgence of measles. Our neighbours italians, belgians and germans have been faced with a sudden increase in cases. Further to the east, Romania must also combat an outbreak that is very active.
In Europe, a plan for measles elimination was set in place between 2005 and 2010. We are talking about elimination when no outbreak – however small – does not take place for a year or more. It is based on vaccination, where the logic of the vaccination requirement in France from 2018.

For nearly 15 years, the surveillance had led to a decline in the number of cases and reduce the peak of the epidemic in the spring. The case of the Region-Aquitaine demonstrate that these efforts are being erased by the resistance of some to the vaccination … so that the MMR vaccine does not even contain aluminum.