Measles cases have become more common in Russia. Is it dangerous? How to protect yourself?

We first published these cards in July 2017. Due to a new measles outbreak in February 2019, we decided to publish them again - with minor edits.

Measles cases have become more common in Russia: according to Rospotrebnadzor, the number of cases since the end of last year has increased by 3.5 times compared to the same period in 2017. From December 2018 to January 2019, 2.5 thousand people fell ill.

Measles is not just a Russian problem. In Magadascar, more than 50 thousand people have fallen ill since the fall of 2018, about 300 have died, and most of the victims are children. In 2017, several thousand people also fell ill in Europe and some died . The main outbreaks of the disease were in Germany, Italy, Poland, Romania, France, Switzerland and Ukraine.

In general, yes. Measles can occur without complications: a person has a very high temperature, he feels very unwell, he does not eat, he coughs, he has a runny nose, his eyes become red and watery - all this can easily be mistaken for ARVI or the flu. But after a couple of days, white spots appear in the mouth, and then a rash appears on the face, which gradually “goes down”. And then it becomes clear that it is measles. Without treatment, it usually goes away in 7–10 days. There are no medications for measles - there are only those that relieve symptoms (mostly antipyretics). Of course, you also need to drink plenty of fluids to prevent dehydration.

Complications occur in a third of patients. This can be relatively harmless diarrhea (in 8% of cases) or otitis media (usually occurs in children, frequency is 5–10%). Pneumonia occurs in 6% of people who become ill, and it most often leads to death in children with measles. Encephalitis affects 1 person in 1000. In developed countries, measles ends in death less often than in developing countries: for example, in the USA it is 1-2 cases per 1000 sick children.

Measles is also known for the fact that it is the only viral infection (not counting HIV) that greatly impairs the functioning of the immune system and makes a person susceptible to other infections. Because of this, in fact, many complications arise, and after recovery, a person still has a higher risk of developing various infections for weeks or even months , and they are more severe.

Complications most often occur in children under 5 , people over 20 , pregnant women (both themselves and the fetus - measles can lead to miscarriage, stillbirth or premature birth) and people with weakened immune systems (really weakened - due to AIDS, lymphoma or something equally serious).

Yes, very much. It is spread by airborne droplets and is highly contagious - the virus will cause infection in 90% of people who are not immune to measles and communicate with someone who is sick. A sick person can sneeze in a room - and those who enter there within two hours may well become infected. Moreover, measles is transmitted four days before the rash appears and four days after.

First, follow the banal rules of personal hygiene, which protect against many airborne infections: do not touch your face with dirty hands, wash them often and stay away from people who cough and sneeze.

Secondly, get vaccinated if you have not yet been vaccinated and have no contraindications. Their list is short: pregnancy (you can’t get pregnant within a month after vaccination; the instructions for vaccines registered in Russia say three months), serious immunodeficiency and a severe allergic reaction to a previous measles vaccination. In Russia, up to 35 years of age can get vaccinated for free at a district clinic.

Currently, only domestically produced vaccines are available in Russia, but as MSD told Meduza, the M-M-R II vaccine (for measles, rubella and mumps) is planned to be imported in late February - early March 2019. According to a company representative, the first batch will be enough to cover the basic vaccination needs of patients from all regions of Russia. After this, deliveries will be regular.

GSK has announced that the Priorix measles, rubella and mumps vaccine will not be supplied in 2019. This was explained by the fact that, firstly, there are not enough vaccines for everyone: they are difficult and time-consuming to produce, and if there is a shortage, they are first supplied to those countries where no other vaccines for these diseases are registered. Secondly, Priorix was not purchased by the state, which is why sales volumes were relatively small, and this also influenced the company’s decision. But the Priorix-Tetra vaccine is entering the Russian market, which protects not only against measles, but also against other diseases - chickenpox, rubella and mumps. It is unknown when deliveries will begin: as the company reported, they are delayed worldwide due to production difficulties.

But for now, doctors recommend not waiting for supplies of foreign vaccinations and using Russian ones. Or, if you wish, get vaccinated abroad, if possible.

There are two options: either do a test for antibodies to the measles virus and then, if there are none, get vaccinated, or just get vaccinated without testing - it won’t make you any worse, and the cost of testing for antibodies and the vaccine are comparable.

After one vaccination, 93% of people will develop immunity, and after the second, 97% of people will develop immunity. Adults are advised to be vaccinated once. According to the Russian calendar, children should be vaccinated at one year of age, and then at 6 years old, but depending on the situation, the doctor can adjust this recommendation. In the United States, they believe that at least four weeks should pass between vaccinations; Russian instructions say six months.

Theoretically, if he is more than six months old, then according to foreign instructions he can already be vaccinated, but for this there must be serious grounds in the form of a documented measles outbreak. And, in general, this cannot be called a common practice. Then the child will need to be vaccinated according to schedule - this vaccination will not count: up to a year the vaccine may not work well enough (although these data are currently being reviewed, and perhaps scheduled vaccination will begin several months earlier). Fortunately, children already have some kind of protection in the first months of life: if the mother had immunity to measles, then she passed on antibodies to the child that will initially protect him, although not one hundred percent.

If those people who communicate with the child do not know whether they are vaccinated, or know that they are not vaccinated, they should get vaccinated.

You have 72 hours to get vaccinated so you are less likely to get sick. In exceptional cases - when it comes to a pregnant woman without immunity to measles, a person with immunodeficiency, or a child under one year old - immunoglobulin can be administered.

If you do get sick, symptoms will appear in 10 to 12 days.

Daria Sargsyan

The editors would like to thank Sergei Butria, a pediatrician at the Medis family clinic and the Rassvet clinic, and an infectious disease specialist, deputy chief physician for anesthesiology and resuscitation at the City Clinical Hospital named after. S. S. Yudin Dmitry Troshchansky.