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The authoritative American edition of The Washington You the Post published an article in which published the results of medical studies on the complications of measles. According to new data, a complication of measles deaths occur much more frequently than previously thought. In this regard, US pediatricians are reminded of the importance of vaccination – only way to prevent the disease. Portal “Matrona” publishes articles translation and commentary of the Russian doctor, a specialist of the Institute of St. Petersburg children’s infections.

The annual survey on the results of the meeting of four organizations specializing in infectious diseases, presented in IDWeek, underlined the importance of vaccination. Widespread vaccination produces herd immunity and protects children who are contraindicated vaccination. Particularly vulnerable are children under the age of 12 months, which, because of young age still can not receive the MMR vaccine against measles, mumps and rubella.

Complication – a neurological disorder that can not be shown for years, but if the manifest is absolutely fatal. Researchers have not reached a consensus about what causes the virus to be reactivated, but the treatment is not found. The only way to prevent diseases – measles vaccination.

Measles – highly contagious respiratory infection that is caused by a virus. In the US, measles has been virtually eliminated in 2000, but returned because of the growing number of people who refuse to vaccinate their children or not to plant them in time.

The first dose of MMR vaccine is administered to children aged 12-15 months. Children under this age can be infected with measles in the future to get a complication – namely, subacute sclerosing panencephalitis, or PSP.

Previously, scientists believed that the risk of developing the CAP are subject to approximately 1 100 000 people. Recent research conducted in Germany among children who become ill with measles to 5 years, showed that the risk has increased and is 1 in 1,700 people. And according to new data, scientists obtained the Medical School of the University of California at Los Angeles and the California Health Agency, in infants, measles before vaccination, the figure is 1 in 609 human diseases.

“It’s really frightening results, so you need to make sure that everything will be vaccinated” , – said at a press conference, James Cherry, an expert in pediatrics and infectious diseases at the Medical School of the University of California.

Many parents who deliberately refuse to vaccinate their children, believe that “doing the right thing” , – says Gary Marshall, professor of pediatrics at the Medical University of Kentucky. “Unfortunately, they are wrong. If they want to protect their children against measles and probable dire complications, they should vaccinate them. ”

In 2014, a record number of cases of measles recorded in the US – 667. According to the Centers for Disease Control and Prevention, is the maximum value since the eradication of the disease. The largest outbreak recorded in the Amish community in Ohio.

In 2015, it recorded 189 cases and 131 cases associated with the outbreak of measles at Disneyland. Thus, Orange County, California became the center of the spread of measles in the United States. In 24 cases, the infected were children under 2 years of age, who are now in the development of risk complications with fatal PSP – says Jennifer Zipprich of the California Department of Public Health.
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Vaccination is a significant part of the population (about 90%) provides herd immunity, which means those who have banned immunizations, are also protected because the disease is unlikely. The MMR vaccine is not recommended for use immediately after the birth of a child, because children in this age group remain mother’s antibodies, making the vaccine less effective, experts say. Also, vaccination is contraindicated for people with impaired immune systems.

The researchers analyzed the cases of measles among children in California between 1998 and 2015, having found that the incidence of infection in children younger than 5 years is 1 in 1387. They identified 17 cases of PSP during this period among those who had been ill with measles before vaccination. All of these patients except one had died – 5-year-old boy who was infected during a trip to Germany, is now in hospice. It can not move and does not respond to commands.

The average age of diagnosis of CAP – 12 years, but the range varies from 3 to 35 years. Many of the patients had long-term cognitive or motor problems before their final diagnosis was made. SAPs are generally progresses in several stages. At first his unobtrusive signs, then there are behavioral problems, – said James Cherry. Then there are convulsions, and eventually a person falls into a coma.

Also, according to the study, Asians more likely to suffer from the CAP. The reasons for this are unknown, but Dr. Cherry suggests that this disease, as well as other diseases, like the flu, affects more Asians and often leads to death compared with other ethnic groups.

Measles infection causes fever, runny nose, cough, red eyes, sore throat and rash. The virus spreads through the body and usually disappears within 14 days. In rare cases, the virus enters the brain and sleep. Ultimately, this may lead to the CAP, and then death.

Other severe complications of measles, which affect one in 20 children – pneumonia, the most common cause of death in young children. Also about 1 in 1,000 children develops encephalitis, or swelling of the brain, which can lead to convulsions, followed by deafness or mental disability.

Since 5% of the children can not get the MMR vaccine, a second dose of the vaccine is given to children before they go to school. Measles is so contagious that it is necessary that 95% of the population had been vaccinated twice, to protect those who have a contraindication to vaccination. This means that all, including adults, who were not previously vaccinated should receive two doses of vaccine.

Almost 92% of children in the US between the ages of 19 to 35 months received the vaccine MMR. And this year, only 54 people out of 16 US measles.

All you need to know about measles

Measles – a highly contagious respiratory infection that is caused by a virus. In the US, it was dissolved in 2000, but today there was again mainly due to the growing number of people who refuse to vaccinate their children or postpone trip to the doctor.

Who is ill with measles? What are the symptoms?

Basically – the children, but also unvaccinated adults at risk. Measles begins with fever, runny nose, sore throat and red eyes, followed by a rash – red spots, which may cover the entire body.

Measles is much more dangerous than it seems?

Yes. While fatalities are rare – in the United States is 1 in 1,000 children. More frequent complications – pneumonia, encephalitis (swelling of the brain) and deafness. In pregnancy, measles can lead to premature birth or low weight of the baby at birth.

How is it spread?

Mainly through coughing or sneezing. In addition, you can catch measles if touch the surface on which the presence of the virus, and then touching your nose or mouth. The virus can live on the surface or hang in the air for about two hours after the infected person coughed or sneezed. In fact, measles is so contagious that 90 percent of people have no immunity against it, may become infected by being around a sick person. The patient is contagious four days before the rash appears and four days after she disappeared.

When the vaccine became available?

The vaccine in which the live virus is used to stimulate the production of antibodies to measles virus became available in the 1963 year. The widespread use began in the mid-1960s. Prior to this year revealed hundreds of thousands of cases of measles in the United States. Periodic outbreaks, mostly among unvaccinated children, occurred before 2000, and then measles in the US has been liquidated.

If I had the measles, I now have the immunity? What if I’m not sure?

Yes, you can get sick with measles only once. If you are over 52 years old, chances are you are already ill with measles. If you’re not sure, your doctor can do a simple blood test to eliminate measles. If you are younger, you should also take a blood test and a vaccination

How effective is the vaccine against measles?

The first dose of vaccine given to children at 12 months and 95% effective. The second dose is given to children aged between 4 and 6 years, and increases the efficiency by 98 or 99%. After two doses of vaccine contamination is highly unlikely.

If so many people are vaccinated, why measles in the United States spread?

Outbreak of measles in the United States was caused by unvaccinated travelers who brought the virus into the country. Also in the Southern and Northern California, there are communities where a high percentage of unvaccinated people. Last year, for example, the virus became more active in the Amish community in Ohio, where many people have not been vaccinated.

Children up to one year, are generally not vaccinated because their immune systems are not yet ready. Also, some children and adults can not be vaccinated for medical reasons. Therefore, these two groups have become vulnerable to the virus.

In the United States in all 50 states required vaccination before entering school from diseases such as mumps, measles, rubella, diphtheria, pertussis, tetanus and polio.

Why would anyone refuse to be vaccinated or have their children vaccinated?

In 1998, in the prestigious medical journal Lancet published a study, suggested that the measles, mumps and rubella can cause autism. Andrew Wakefield’s study was later discredited and removed from the magazine in 2010. But the article has launched a movement against vaccination, and some people continue to believe that there is a link between the vaccine and autism. This motion was also supported by some celebrities.

Also, some anti-vaccination for religious reasons, and there are countries where parents refuse to allow vaccination of children “due to personal beliefs.”

Kids really do at a time of 10 vaccinations?

Not really. According to the standard recommended vaccination schedule, the child should receive five injections and one oral vaccine two months. Some of these injections comprise more than one disease. For example, a DTP vaccine protects against diphtheria, tetanus and pertussis. For 12 months, the child can receive six injections, which protect against eight diseases if the doctor does not use a combination vaccine.

Doctors usually stretch the injection for a few weeks, if the parents are not willing to do everything at once vaccinated. But the problem is that some parents decide to postpone the vaccination for several months and even years. In this case, the children are too long remain without protection against very serious diseases.

In some countries, measles more usually? Why?

Yes. Twenty million people each year become ill with measles, and in 2013, 145 700 of them, mostly children under 5 years old, died. According to the World Health Organization in 2014, 53,357 cases of the disease have been recorded in the Philippines, China – 50960.

However, as a result of a coordinated vaccination campaigns, the situation has improved significantly. The number of measles deaths worldwide fell by 75 percent – from about 544200 in 2000 to 145700 in 2013, according to WHO.

What should I do if I’m going to travel to one of the troubled countries against measles?

Adults and adolescents who have not been vaccinated should receive two doses of vaccine within 28 days. Children under the age of 12 months should also get both doses.

If the child has already 6 months, it can also receive a single dose of vaccine. But in the future, these children should receive two more doses of vaccine.

Translated by Mary Stroganov specially for “Matrony.ru”

Commented Irina Friedman, PhD, Researcher FGBU Niida FMBA of Russia :

In Russia today, local outbreaks of measles are stored in different cities. The incidence of measles in the past year was 0.58 per 100 thousand people. The highest incidence was observed among children during the first years of life, in the age groups of children up to 1 year – 1-2 years and 3.75 – 2.89 per 100 thousand people. Among the cases – 71% of unvaccinated patients or without vaccination history.

One of the effective measures for the prevention of measles, of course, is vaccination. The risk of complications from the vaccination carried out thousands of times lower than that of most infections.

At the moment, Russia registered a few vaccines for measles prevention: live measles vaccine (Russia), measles vaccine (India), MMP II (USA), Priorix (Belgium). All these vaccines are live, that is, as part contains attenuated measles virus. In the post-vaccination period is valid from 4-15 day can be light catarrhal phenomena, fever and morbilliform rash.

An article published in The Washington Post, is relevant and reflects the existing problem of measles and prevention both in Russia and in other countries. At the same time can be regarded as incorrect in the given article is evidence that as the complications of measles can develop a brain tumor, as well as the idea that if a person is more than 52 years, most likely, he was ill with measles. This data is not scientifically justified.

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