Measles

Measles is a highly contagious infectious disease, which can occur in both children and adults and can cause serious complications. The disease is avoided by vaccination with two doses. 

What is measles?

Measuring is an infectious disease caused by the morbillivirus. This virus is transmitted from person to person by direct or indirect contact with droplets from nose or mouth (e.g. coughing, sneezing or touching handkerchiefs). 

Symptoms

Measles exhibits a typical skin rash and high fever. The rash begins in the face, often behind the ears, and gradually spreads from the upper to the lower part of the chest and to the limbs. A few days before the appearance of the rash, the disease begins with a cold, general malaise and fever (catarrhal phase). This is a highly contagious period.

Infectivity

Measles is highly contagious and can very quickly lead to epidemics in groups or individuals in the general population who are insufficiently protected by vaccination. Measles is contagious from 4 days before to 4 days after the onset of skin rash, with maximum infectivity during the catarrhal phase (cold phase, see symptoms).

Complications

Measles is a serious infectious disease that can lead to complications (otitis media (inflammation of the middle ear), pneumonia, diarrhea in 10 to 20% of cases. In 0.05 to 0.1% of cases, encephalitis can occur. In rare cases, several years after the occurrence of measles, subacute sclerosing panencephalitis (SSPE) may occur. In recent years serious complications have also been observed in adults. In pregnant women, measles increases the risk of miscarriage, premature birth and fetal death. The disease can be avoided by vaccination.

Diagnosis

A diagnosis of measles is first made based on clinical signs and then confirmed by laboratory tests (serum, saliva and/or nose and throat swab).

Treatment

There is no specific treatment for measles. The disease can be prevented by vaccination (2 doses).

Vaccination

The vaccination schedule provides for two doses, one at the age of 12 months and one at the age of 10-12 years. These vaccines are part of the basic vaccination scheme for children and adolescents and are offered free of charge through government vaccination programs.

It is important to note that there is strict monitoring of the quality of all vaccines on the market in Europe. Only after a European Official Medicines Control Laboratory (OMCL) has checked the quality of a vaccine can it be placed on the market. This control consists on the one hand of a critical review of the production data and quality analyses carried out by the vaccine manufacturer and on the other hand of additional analyses carried out by an OMCL. This control is one of Sciensano’s responsibilities.

Occurrence

Measles mainly occurs in winter and spring, but can occur throughout the year, especially during outbreaks.

Risk groups

All non-vaccinated persons constitute a possible risk group. In particular, children younger than 1 year of age, pregnant women, persons with immunosuppressive disorders and staff in the care sector. 

Compulsory notification

In view of the public health risks, measles is a compulsorily notifiable infectious disease.

Information for health professionals

Description of the measles outbreak in Wallonia in 2017.

Detailed information on the disease can be found in the guidelines of the Flemish Community and the guidelines of the French Community.

Sciensano coordinates all measles data from different sources (compulsory notification, Pedisurv, Epilabo and NRC) to evaluate measles activity and thus monitors the elimination status of measles in Belgium according to WHO guidelines. Sciensano is also the National Reference Center (NRC) for measles. The Belgian Official Medicines Control Laboratory (OMCL) of Sciensano, together with the European OMCL network, is responsible for the quality control of the measles vaccine prior to marketing.

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