The measles (also called 1st disease ) is an acute eruptive infection, due to a Paramyxovirus, the Virus of the Rougeole, primarily reaching the children starting from the 5-6 month age, and definitively immunizing.

Contagion

Measles is transmitted by the droplets of cough suspended in the air. It is characterized by an high fever, cough, and an eruption of red buttons, initially on the level of the face, then on all the body.

Extremely contagious, measles is characterized by the morbilleuse eruption ( morbilleuse : referring to measles, morbilliforme : resembling the eruption of the measles ) which is typical: a Exanthème formed of not very projecting red spots, generalized with all the body, occurring a few days after the beginning of the Fever. The eruption begins with the face before extending to the remainder from the body. A Prurit (itchings) is frequent.

Sign of Koplick is pathognomonic disease (it makes with him only the diagnosis when it is present), indicating the appearance on the oral Muqueuse, with the height of the Molaire S, of small irregular red tasks with a small white central point. This sign is rare and fugacious, often present less than 12 midnight.

The most severe forms appear in the suffering young child of malnutrition, especially in the event of insufficient contributions in Vitamine has or in the event of associated immunizing deficit, the such AIDS. In fact, the newborn does not die directly of measles but of his complications, such: Encéphalite, Otitis, Diarrhea S severe or Pneumonia S.

Epidemiology

Often perceived like a minor illness in the developed Countries, measles is in fact a very serious disease: in 1999,873  000 died of this disease and 345  000 in 2005, primarily in the Developing country. In these countries, the Mortalité very high, immediate (1 death out of 10 cases in African rural area) or is delayed (by secondary aggravation of the Malnutrition). The infirmities are numerous, blindnesses (following Kératite S) being added to the Encéphalopathie S.

Before the arrival of vaccination at the beginning of the Years 1960, measles was the first world cause of mortality per infection (135 million annual cases involving 6 million death). Mortality was divided by it by 3 at the end of the Eighties, nearly 10 years after a policy of vaccination of mass. It remains however still of very many cases of measles because of a nonoptimal vaccine cover but also because of the failure of vaccination in nearly 15% to the cases.

In Europe of the epidemics prevailed in 1840, 1860 and 1880. In 1998, the the World Health Organization fixed for objective from here 2007 the elimination of measles in Europe. Indeed, the incidence of measles in France was still of 18  000 cases in 1998 due probably to the vaccine insufficiency of deposit rate. The monitoring of the evolution of the incidence in France is carried out by the Réseau Sentinels of the Inserm.

Vaccination

In 2005, the Vaccination concerns nearly 77% of the world population, involving a still increased reduction of mortality - less 345  000 deaths this year on 20 million patients. Half of the fatal cases being located in Southeast Asia, place where the vaccine cover is less.

Between 2000 and 2005, more than 300 million nine month old older children to fifteen years were vaccinated or revaccinés (in the event of failure of firstly-vaccination). The policies of systematic vaccination of mass could be improved thanks to the installation of storage system cooled for the vaccines and with the creation of a grid of Dispensaire S. In tropical Africa and equatorial Africa, it was thus observed a reduction of almost three quarters of the deaths passing of 506  000 with 126  000.

The objective of WHO and UNICEF, for 2010, is to reduce mortality on a worldwide scale 90  % compared to the figures of the year 2000.

In term of disease prevention, a vaccination is carried out at the age of 1 year (1st injection), then a recall at the 2 years age (2nd injection), in the developed countries.

See too

External bonds

• Iconography: Public Health Image Library
• Virus with the electronic microcope