Measles: understand why the disease is so dangerous for children and see the importance of vaccination – Revista Crescer

When she woke up with a sore throat one morning in August 2019, administrator Veronica Nery, 32, had no idea it would be the start of one of the worst months of her life. A mother of three – Mateus, 7, Lucas, 5, and Júlia, 3 – she shrugged off the discomfort of looking after the kids (the youngest was just 7 months old at the time), but other symptoms quickly appeared, such as fever and spots on the skin. Unable to bear the discomfort, she was admitted to hospital and diagnosed with measles.

“I couldn’t believe it, I didn’t know anyone who had the disease,” Veronica said in an interview with CRESCER. She had taken both doses of the vaccine as a child and, although the vaccination is very effective (95%), rare cases of infection like hers can occur. “I spent a week in hospital, but when I was finally released and returned home, the real nightmare began. Julia had a fever and when we took her to the emergency room we found out she had the virus too.

+ 18 answers to the main questions about measles

Measles warning sign (Photo: Getty Images)

Measles warning sign (Photo: Getty Images)

Veronica’s older children had already taken both doses of the vaccine and had not contracted the disease, but the little one had not been vaccinated because she was not old enough at the time. “There, the measles evolved very quickly. In the morning I had “only” a daughter with the disease, but at night I had a baby in intensive care with encephalitis and thrombosis in the leg and arm. She had several complications and needed a blood transfusion. I collapsed! “recalls the mother.

Júlia was hospitalized for 20 long days until she was discharged. “The doctors told me that if she survived, there was a good chance that she would have sequelae. But she went against the plan, fully recovered and even rode the bike without training wheels! I am very grateful to her for the care she received, and this experience has made me even more supportive of all types of vaccines. If people knew how quickly they can lose someone they love, they would never miss vaccinating or delaying the schedule,” says Verônica.

real threat

Since 2018, when measles returned to Brazil, stories like that of Verônica and Júlia have transformed the lives of some families. In 2021, the country recorded 653 measles cases and two deaths of babies aged 7 and 4 months due to the virus. Now, in 2022, only in the state of São Paulo, 2 autochthonous cases of the disease have already been confirmed and 25 others are still under investigation. “With the return, little by little, to the pre-pandemic routine, measles appears as an even greater threat, mainly due to the drop in vaccination coverage during this period,” explains Rosana Richtmann, disease specialist infections, from the Emílio Ribas Institute. Infectious Diseases (SP). ).

Unfortunately, the news about childhood vaccination rates in Brazil is not good. Only 71.36% of children took the 1st dose of triple viralvaccinating against measles, mumps and rubella. The recommended index for population protection is at least 95%. Other vaccines had even lower compliance, such as those that provide protection against polio (67.6%) and hepatitis A (64.9%). “The pandemic broke the camel’s back, but we already knew a significant drop in vaccination coverage,” explains the infectious disease specialist.

According to the director of the Brazilian Society of Vaccinations (SBIm), pediatrician and infectious disease specialist Renato Kfouri, the vaccine ends up being a victim of its own success, because people end up not encountering cases of the disease, and they forget how point they are. “Many people have stopped vaccinating little ones for fear of leaving their homes in quarantine, and the anti-vaccine movements, fueled by several fake news, misinformed part of the population. We are very worried, even more now in autumn, when the highest incidence of respiratory viruses occurs. He is desperate to see diseases that were no longer circulating, such as measles, causing new cases. There is an urgent need to reverse this scenario, and the only way is to update the vaccination record”, explains Kfouri.

 (Photo: Getty)

In 2022, in the state of São Paulo alone, 2 indigenous cases of measles have already been confirmed and 25 others are still under investigation (Photo: Getty)

Below are the top questions you need to know about measles.

How is measles transmitted and what are the main symptoms?

Measles is highly transmissible and is spread through the air by droplets expelled by infected people when they cough, sneeze or talk. The virus does not die immediately after leaving the body and can remain in the air or on a surface for some time, allowing disease to be transmitted even in the absence of direct contact between individuals.

In addition, the virus has a relatively long transmission window. An infected person begins to transmit the disease between four and five days before the onset of symptoms and stops transmitting, on average, between four and five days after the appearance of the spots on the body. It is estimated that one person with measles transmits the virus to 16 others in unvaccinated populations. Compared to covid-19, for example, measles is much more transmissible

The main symptoms are:
– fever accompanied by cough;
– eye irritation;
– runny or stuffy nose;
– severe malaise;
– red spots on the body.

Why is this disease so dangerous for babies and children?

It causes more complications in children under 5 years old and is even more dangerous for babies under 1 year old. According to data from the Ministry of Health, approximately 1 in 20 children with measles may develop pneumonia, 1 in 10 may have acute otitis media and 1 in 1,000 may have acute encephalitis due to the virus, a serious complication that can leave sequelae, such as blindness and neurological and respiratory disorders. one in a thousand of children with measles die.

What is the measles vaccination schedule?

The vaccine against this disease is composed of attenuated viruses and is administered subcutaneously. In the SUS, the child receives the first dose at 1 year, as well as the mumps and rubella vaccinations, combined in the MMR vaccine. The second dose is given at 15 months, this time, in addition to mumps and rubella, the vaccine against chickenpox (chickenpox), the viral tetra. In private clinics, both doses are tetraviral.

In the vaccination record of persons aged 15 months to 29 years, two doses of the vaccine should be included, and for those aged 30 to 59 years, one dose. Those who have not received one must go to a health center to complete the vaccination schedule.

With the appearance of cases in Brazil since 2018, some states have implemented, in addition to the scheme recommended by the National Vaccination Plan (PNI), the so-called zero dose for babies between 6 months and 1 year old. It is still recommended in Amapá, Rio de Janeiro and São Paulo.

Is it possible to protect babies under 6 months who cannot yet be vaccinated?

Yes, the parents must be vaccinated against the disease up to date and avoid exposing the child to agglomerations.

Are there any sequelae during pregnancy?

Measles is associated with a higher frequency of serious illness in pregnant women and hospitalization. In early pregnancy, this can lead to miscarriages and stillbirths. At second and third trimesters is associated with premature births, low birth weight as well as possible complications for the newborn.

Since the measles vaccine is not recommended for pregnant women, for safety reasons, it is recommended that women who intend to increase the family check that they have their vaccination record up to date, at least 30 days before becoming pregnant. If you discover pregnancy after vaccination, you should remain calm and seek prenatal carebecause, despite the precautionary recommendations, to date there is no evidence of complications during pregnancy due to the measles vaccine.

Sources: Eduardo Jorge da Fonseca Lima, pediatrician in the Scientific Department of Immunizations at the Brazilian Society of Pediatrics, Renato Kfouri, pediatrician and specialist in infectious diseases, director of the Brazilian Society of Vaccinations, and Rosana Richtmann, specialist in infectious diseases at the Emílio Ribas Institute of Infectious Diseases (SP)

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