The reports on measles date back to 700, but the first scientific description of the disease and its distinction from smallpox is attributed to Muslim physician Ibn Razi (Rhazes) 860-932, who published a book titled “Smallpox and measles” (in Arabic: Kitab al-fi jadari wa-al-hasbah). The disease develops from infection of the respiratory tract and is caused by a virus, a paramyxovirus of the genus Morbillivirus (Paramixovidae family), who like other paramyxoviruses is a coated virus, with a genome consisting of a single negative strand RNA.
The infection spreads through respiration (contact with fluids from the nose and mouth of an infected person, either directly or through aerosol transmission), and is highly contagious: 90% of people without immunity sharing a house with an infected person will be infected. The infection has a 14-day incubation period the mean (range 6-19 days) and infectivity lasts from 2-4 days prior to 2-5 days after the onset of the rash. Recovering usually occurs within 7-10 days.
Although more than half a century has passed since the introduction of the vaccine against measles in the United States and despite the availability of a safe and economical vaccine (vaccinating a child against measles costs less than € 1), measles remain one of the main causes of death among children. Only in 2014, 114 900 deaths – about 314 deaths per day or 13 deaths per hour – occurred in the world.
Disease occurs after an average incubation of 14 days with fever, rhinitis, dry cough and conjunctivitis. The appearance within the first 2-3 days of the first symptoms of Koplik’s Stains (white spots surrounded by a red alone) in the oral mucosa is pathognomic for measles.
The characteristic exanthema appears after 3-5 days of the onset of symptoms, usually 1-2 days after Koplik stains. The maculo papular exanthema initially develops around the neck and behind the ears and spreads quickly (in 1-2 days) to the face, trunk and back, with a downward trend.
The most common complications, which in industrialized countries are observed in 7-16% of total cases, are diarrhea, pneumonia and laryngitis. More rarely, the disease is responsible for serious complications of the Central Nervous System such as acute encephalitis (1/1000 cases), and even more rarely a severe sclerosing panencephalitis (SSPE) with ever-fatal outcome.
The disease may be fatal with a mortality rate ranging from 1 / 10,000 to 1 / 1,000 cases per year.
There is currently no specific measles therapy, apart from the use of antipyretics to lower the fever and specific therapies for the treatment of any complications. The best weapon against the disease is preventive vaccination, with a live attenuated vaccine, with a> 95% efficacy and which guarantees lifelong immunity. This is not a compulsory but highly recommended vaccination.
Vaccination is recommended between the 12th and 15th month of life for newborns, with a recall of 5-6 years, and in adolescents and young adults who are not immune. In addition, children should be vaccinated between 6 and 12 months during a measles epidemic and individuals with HIV infection without immune deficiency. Vaccination can prevent development of the disease if given within 72 hours in non-immune persons come into contact with measles patients.