Cases of measles are increasing: some have been reported in Italy 213 in the first 3 months of 2024. In all of 2023 there were 43 cases of measles. These figures are enough to explain how attention towards measles has grown to the highest levels. In recent days even the Liguria Region has adopted an extraordinary vaccination planalso in light of the hospitalizations for this cause.
Matteo Bassetti, an infectious disease specialist, continues to fear the possibility of one spread of the infection and predicts problems for the summer. Meanwhile, there is only the certainty of the growing trend in the numbers recorded by the Istituto Superiore di Sanità. In 2023 in Italy the ISS surveillance system recorded an increase in cases, 43 compared to 15 in 2022. Furthermore, a complication is observed in approximately one in four cases. According to the Institute's Bulletin “26% of cases reported a complication, the most frequent being diarrhea, followed by pneumonia, respiratory failure, keratoconjunctivitis and hepatitis or increased transaminases”.
But Why is measles still scary? And what could be the complications of this viral infection, particularly for adults who are not protected by natural infection and the vaccine?
What is measles and how is it transmitted
Measles is an infectious disease caused by a virus of the genus morbillivirus (family of Paramyxovidae). It is transmitted exclusively in human beings and is very contagious. Once contracted, measles offers an immunization that is considered theoretically definitive. This means that you will never get sick again for the entire duration of your life.
Measles it is widespread throughout the world. It is one of the most frequent eruptive fevers: in countries with a temperate climate such as Italy, cases are mainly concentrated in children towards the end of winter and spring. As mentioned, the disease is among the most easily transmissible.
Contagion occurs through nasal and pharyngeal secretions, probably through the air via respiratory droplets that spread through the air when the patient coughs or sneezes. The incubation period is approximately 10 days: begins when the virus enters the body and ends at the onset of fever. The contagiousness lasts up to 5 days after the rash, and is maximum three days before, when you have a fever.
How measles manifests itself and how it can become complicated
In the majority of cases, measles does not cause particularly serious symptoms, even if therash linked to the viral infection can last up to three weeks. Initially it presents as an upper respiratory tract infection and resembles a rhinitis with dry cough, runny nose, conjunctivitis but with a fever that becomes increasingly higher. White dots then appear inside the mouth. After 3-4 days, the characteristic rash appears (rash), composed of small bright red dots, first behind the ears and on the face, and then all over the rest of the body. The eruption lasts 4 to 7 days, the rash disappears starting from the neck. Sometimes, a peeling of the skin remains for a few days.
Complications are relatively rare and are mainly due to bacterial infections which overlap in addition to the body's reaction to the viral infection. Conditions such as otitis media, laryngitis, diarrhoea, even severe pneumonia or encephalitis (inflammation of the brain and nervous system) may occur. At risk are especially those who are fragile or have a weak immune system.
Why we need to get vaccinated
As with many viral infections, there are no specific treatments for measles. Treatment aims above all to control symptoms and alleviate their intensity. Prevention comes through vaccination, remembering that to avoid epidemics it is necessary to vaccinate more than 95% of the population with 2 doses. Not for nothing, the reappearance of epidemic outbreaks is linked to the possible decline in the protection obtained with the vaccine: in general terms, vaccination is extremely effective.
The protection obtained after the first dose is around 95% and reaches almost 100% with the booster dose. Because of this the vaccination cycle must be completed. Even getting vaccinated within a few days of exposure to a sick person may be able to make the disease develop in a milder form, if not even protect against contagion.
There MMR vaccination (measles-mumps-rubella) or tetravalent MPRV (measles-mumps-rubella-chickenpox) is recommended for all children between 12 and 15 months of age; the second dose is administered at 5-6 years. The tri-/tetra-valent vaccine is advantageous for children because with a single injection it protects them from various diseases at the same time: even those who have had one of the pathologies against which the vaccine protects do not run any risk in getting vaccinated. In the end, We remind you that you can get vaccinated at any age, therefore the vaccine can also be administered to adolescents and adults who have not previously been vaccinated. The vaccine should not be administered to pregnant women.
The problem of “susceptible” people
Measles literally means “little disease”. But the picture, linked to the infection of a paramyxovirus, should not be considered trivial. And sometimes it doesn't end with the appearance of the typical spots inside the mouth and then on the body. Those at greatest risk are the bodies of adolescents and adults, more exposed to the risk of complications. Classically, the pathology presents epidemic flare-ups every few years. The reason? A certain number of children not protected by vaccination are exposed to the spread of the virus and can also transmit it to others. For this reason there can be many people, especially adults, who can contract the disease. These are “susceptible” subjects: being adults, they are at greater risk of the classic complications linked to the entry of the virus into the body.
