MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-25
Часть–2_ Май –2025
356
THE COURSE OF MEASLES IN YOUNG CHILDREN
Keldiyorova Zilola Doniyorovna
Email: keldiyorova.zilola@bsmi.uz
https://orcid.org/0000-0002-0662-5787
Bukhara State Medical Institute
Relevance
Measles is an acute, highly contagious viral disease that can occur at any age.
The most severe cases have traditionally been observed in young and adolescent
children. Complications typically include pneumonia, severe keratitis, and the
coexistence of other infectious diseases such as diphtheria, chickenpox, and others.
Currently, measles primarily affects the following vulnerable groups: unvaccinated
infants and newborns without passive maternal immunity to the measles virus, as well
as children in the latter half of their first year of life, who are at high risk for developing
severe complications.
Measles is a disease that has affected humanity since ancient times and is
considered nearly universally susceptible. Historical records show repeated epidemics
with high mortality, especially among children. It has been one of the most widespread
childhood infections globally and was previously referred to as the “plague of
childhood.” The disease is believed to have been brought to Europe in the 6th century
during the Saracen invasion, along with smallpox. The first clinical descriptions of
measles are attributed to the 9th-century Arab physician Rhazes, who regarded it as a
milder form of smallpox. In the 15th century, the term "morbilli" was used to refer to
measles. The disease was often confused with other exanthematous infections such as
scarlet fever and smallpox.
During the Middle Ages, measles spread from Europe to the Americas,
becoming one of the most prevalent infectious diseases worldwide. In the late 17th
century, physicians such as T. Sydenham in England and R. Morton in France
described the clinical features distinguishing measles from scarlet fever and smallpox.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-25
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Major epidemics were recorded in Germany (1823–1824), Europe (1834–1836), and
North America (1846–1847). In 1846, P. Panum conducted the first epidemiological
study of a severe measles outbreak in the Faroe Islands, where 6,000 out of 7,782
inhabitants became infected. Not only children but also elderly people contracted the
disease. In the 19th century, researchers like Trousseau, Barthez, and Grancher
contributed significantly to clarifying the clinical manifestations and transmission
routes of measles. In 1895, N. F. Filatov described a characteristic early sign of
measles—whitish spots on the buccal mucosa, opposite the second molars. At the same
time, American pediatrician N. Koplik and Russian physician A. P. Belsky identified
this pathognomonic sign, which later became known as the Filatov-Belsky-Koplik
spots.
Purpose of the Study
To investigate the clinical course of measles in young children.
Materials and Methods
The study included 40 children aged 5 months to 3 years hospitalized with
measles at a pediatric infectious diseases hospital. Among them, 13 children (30.6%)
were classified as infants. Diagnosis was based on epidemiological data, medical
history, and a thorough evaluation of clinical signs throughout the disease course.
Special attention was given to identifying pathognomonic signs such as Filatov-
Belsky-Koplik spots and the staging of rash and pigmentation.
Serological confirmation was performed by detecting specific IgM antibodies
in the blood. Laboratory investigations included complete blood count, urinalysis, and,
when indicated, biochemical blood tests (ALT, AST, total and direct bilirubin, total
protein and fractions, creatinine). All patients received symptomatic therapy along with
proper diet, care, and bed rest.
Results and Discussion
The sources of infection were identified in all cases. Most children (32 cases,
88.9%) were admitted to specialized infectious disease wards within the first week of
illness. Of these, 7 children (19.5%) were admitted during the catarrhal stage (days 1–
3), 25 (69.4%) on days 4–6, and 6 (11.1%) on days 7–12. A typical moderate form of
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-25
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measles was diagnosed in 38 children (94.4%). Two children (5.6%) who had received
normal human immunoglobulin during the incubation period were diagnosed with
atypical measles.
In 36 cases, the disease followed a classic cyclic course, including incubation,
prodromal (catarrhal), peak (rash), and recovery (pigmentation) stages. Fever was
observed in 22 patients (64.7%) with temperatures ranging from 38.6°C to 39.2°C, and
in 14 children (35.3%) temperatures ranged from 38.0°C to 38.5°C. The intoxication
syndrome was characterized by decreased appetite (78.2%), weakness (76.4%), sleep
disturbances (75.3%), irritability and headache (70.3%), lethargy, and tearing (92%).
Catarrhal symptoms were present in all patients (100%), manifesting as dry
cough, nasal congestion, moderate mucous nasal discharge, and mild conjunctivitis.
Conclusion
In children aged 5 months to 3 years, measles most commonly occurred in the
typical moderate form (94.4%). Pathognomonic features included Filatov-Belsky-
Koplik spots (67.7%), staged rash (100%), and staged pigmentation (100%).
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