ISSN:
2181-3906
2024
International scientifijournal
«MODERN SCIENCE АND RESEARCH»
VOLUME 3 / ISSUE 4 / UIF:8.2 / MODERNSCIENCE.UZ
339
FEATURES DURING MEASLES IN CHILDREN AT THE PRESENT STAGE
Turazoda Kumushkhon Botirbek qizi
Yuldasheva Sogdiyona Utkirjon qizi
Abdullayeva Sabohat Akmal qizi
students of the 507th group of treatment faculty
of the Tashkent Medical Academy.
Aladova Lyudmila Yurevna
Supervisor.
https://doi.org/10.5281/zenodo.11181816
Abstract.
This article deals with important statistics about measles, its special features and
development in children. Furthermore, brief historical data and clinical manifestation were noted.
Key words:
infectious diseases, immunoglobulin, nasopharynx, measles-specific,
rheumatological diseases, non-coding region, symptomatic therapy.
ОСОБЕННОСТИ ТЕЧЕНИЯ КОРИ У ДЕТЕЙ НА СОВРЕМЕННОМ ЭТАПЕ
Аннотация.
В статье представлены важные статистические данные о кори, ее
особенностях и развитии у детей. Кроме того, были отмечены краткие исторические
данные и клинические проявления.
Ключевые слова:
инфекционные заболевания, иммуноглобулин, носоглотка, коревые
специфичные,
ревматологические
заболевания,
некодирующая
область,
симптоматическая терапия.
Measles is a viral disease with a high potential for spread and the development of
complications in about 30% of cases, the main contingent of patients are children under the age of
5 years, mainly with a nutritional deficiency and a weakened immune system. At the present stage,
measles remains a significant morbidity and remains a significant cause of death worldwide,
especially among young children, due to its widespread spread, even despite the availability of a
safe and effective vaccine. Measlesin in child is one of the most common infectious diseases of
childhood. It is common in the age group of 3 to 5 yrs. and rare during first 6 months of life be-
cause of passive immunity transferred from mother. Though it is a self-limiting disease rate of
complications and mortality is quite high. Complications are more common malnourished children
which can prove fatal. The post measles effect may linger on for several weeks after the recovery.
It may present in form of loss of appetite, failure to thrive, increased susceptibility to
infections. With the availability of vaccine and reasonably effective implementation of vaccination
programme in last 30 years the incidence of measles is declining, but still during winter season
many cases are seen in slums and thickly populated area. Frequent observation, good nursing care
and early detection of complications can decrease the mortality due to measles[1].
The most common confirmation of measles is carried out by a laboratory method based on
a positive serological study for antibodies to immunoglobulin M (IgM) to measles with a four fold
or more increase in the titer of specific IgG in dynamics, isolation of the virus from cultures of
mononuclear cells of blood, urine, smears from the conjunctiva or nasopharynx and detection of
measles virus RNA using reverse transcriptase polymerase chain reaction (RT-PCR) in blood
samples, a smear from the pharynx and nasopharynx or urine. Unfortunately, measles specific IgM
ISSN:
2181-3906
2024
International scientifijournal
«MODERN SCIENCE АND RESEARCH»
VOLUME 3 / ISSUE 4 / UIF:8.2 / MODERNSCIENCE.UZ
340
antibodies can be detected only 4 or more days after the rash appears, which can lead to false
negative results if the examination is carried out earlier. Approximately 75% of patients with
measles-specific IgM antibodies are detected within the first 72 hours after the rash appears, but
almost all affected children will have measles-specific IgM detected 96 hours after the rash
appears. In addition, false positive results can sometimes occur in patients with infectious
mononucleosis, rubella, parvovirus infection B19 and rheumatological diseases. Testing of
measles virus RNA using RT-PCR is more specific and gives a positive result before the
characteristic IgM antibodies to measles appear, and allows identifying the genotype[2]. The
clinical picture of measles, depending on the seasonality and geographical location, can simulate
the manifestations of other viral diseases. It should be emphasized that MeV infection in people
with weakened immunity may not cause the typical symptoms of measles, while often causing
severe outcomes of the disease, with the development of pneumonia. Virological surveillance data
show a decrease in the overall genetic diversity of measles, since the number of genotypes in the
examined patients decreased. Sequencing of larger fragments of the MeV genome makes it
possible to increase the resolution of MeV transmission routes, including the difference between
several import sources of the same genotype and jointly circulating lines in countries with an
endemic virus. Areas of interest for extended sequencing include the non-coding region between
the matrix (M) and F genes, as well as the entire genome, which can be sequenced by Sanger
methods or next-generation methods.
The information obtained from MF-NCR provides phylogenetic trees with a topology
similar to that obtained by sequencing the entire genome, demonstrating that this region is useful
for improving molecular surveillance of measles. Treatment In our country, the treatment of
children with measles is carried out in accordance with the Clinical Protocol "Diagnosis and
treatment of measles in children" of the Republic of Kazakhstan №. 4 of June 9, 2016. The basis
is symptomatic therapy, which includes the use of antipyretics, vitamins, preventive measures,
proper and enhanced nutrition [44]. In the case of the addition of secondary bacterial flora,
treatment is carried out with appropriate antibiotics. According to the 2017 Cochrane Systematic
Review, in the treatment of patients with measles, vitamin A should be added orally once a day
for 2 consecutive days in age-related doses (50,000 IU, 100,000 IU and 200,000 IU for infants[3].
The first clear description of measles clinical signs was made in the ІХ century by Persian
doctor Rhazes (Abū Bakr Muhammad ibn Zakariyyā al-Rāzī). In the XVІІ century measles signs
were described by the English doctors Thomas Sydenham (1624-1689) and Richard Morton
(1637–1698). In 1895 the famous Russian pediatrician N.F. Filatov (1847-1902) described 4
periods in the development of measles and termed them latent (incubation), catarrhal, rash and
According to new statistics, MPC TMA number of patients diagnosed with Measles treated
in 2023:
February - 3 patients
March - 17 patients
April - 4 patients
May- 37 patients
June - 47 patients
July - 70 patients
August - 120 patients
September - 153 patients
October - 228 patients
November- 217 patients
December - 266 patients
Total: 1162 patients 103 of them were vaccinated.
ISSN:
2181-3906
2024
International scientifijournal
«MODERN SCIENCE АND RESEARCH»
VOLUME 3 / ISSUE 4 / UIF:8.2 / MODERNSCIENCE.UZ
341
desquamation (pigmentation). In 1911 А. Andersen and D. Goldberg proved a viral etiology of the
disease, and in 1954 D. Enders and Т.К. Peebles isolated a causative agent. Treatment (according
to the Order of the Ministry of Public Health of Ukraine №354 dated 09.07.2004) is administered
mainly at home. Non-complicated, mild, moderate forms of measles and atypical forms of the
disease do not require medical treatment. Patients should follow bed regimen during the feverish
period, hygienic measures of the oral cavity and eyes, living quarters should be aired. In case of
running nose vasoconstrictor drugs are used, in case of cough – mucolytic agents. In the USA
vitamin A administration for children suffering from measles was proved to reduce severity of the
disease and risk of complications. Vitamin A is recommended for children older than 6 months of
age in combination with vitamin C. complications are treated according to the appropriate
protocols of the Ministry of Public Health of Ukraine. According to the international guidelines
treatment of measles is essentially supportive care with maintenance of good hydration and
replacement of fluids lost through diarrhea or emesis. Intravenous (IV) rehydration may be
necessary if dehydration is severe. Vitamin A supplementation, especially in children and patients
with clinical signs of vitamin A deficiency, should be considered.
Postexposure prophylaxis should be considered in unvaccinated contacts; timely tracing of
contacts should be a priority. Patients should receive regular follow-up care with a primary care
physician for surveillance of complications arising from the infection Antiviral Therapy. Measles
virus is susceptible to ribavirin in vitro. Although ribavirin (either IV or aerosolized) has been used
to treat severely affected and immunocompromised сhild with acute measles no controlled trials
have been conducted; ribavirin is not approved by the US Food and Drug Administration (FDA)
for this indication, and such use should be considered experimental[4]. Vitamin A supplements
have been associated with reductions of approximately 50% in morbidity and mortality and appear
to help prevent eye damage and blindness. Because vitamin A deficiency is associated with severe
disease from measles, The World Health Organization recommends all children diagnosed with
measles should receive vitamin A supplementation regardless of their country of residence, based
on their age, as follows:
• Infants younger than 6 months – 50,000 IU/day PO for 2 doses
• Age 6-11 months - 100,000 IU/day PO for 2 doses
• Older than 1 year - 200,000 IU/day PO for 2 doses
• Children with clinical signs of vitamin A deficiency.
The first 2 doses as appropriate for age, then a third age-specific dose given 2-4 weeks later
Indications for admission. Patients of their first year of life, those with severe forms of measles,
complications, and according to epidemic indications are hospitalized. Measures concerning
individuals in contact. Individuals who were in contact with patients at the age from 1 to 30, non-
vaccinated, who did not suffer from measles before, and do not have contraindications against
vaccination, should be vaccinated no later than 72 hours from the moment of contact with an
infected person. Vaccination made later than 72 hours after the contact can be not only ineffective
but harmful. Children at the age to 1 year of life, those with immune deficiency conditions,
contraindications for vaccination with live vaccines, pregnant women being in contact with
measles, normal immunoglobulin is injected in the dose of 0,25 ml/kg of the div weight no later
than 5 days since the moment of contact. Quarantine is placed on contact children in children
ISSN:
2181-3906
2024
International scientifijournal
«MODERN SCIENCE АND RESEARCH»
VOLUME 3 / ISSUE 4 / UIF:8.2 / MODERNSCIENCE.UZ
342
groups and establishments from 9 to 17 days from the moment of the contact, and those children
who received immunoglobulin – till 21 days. Patients should be isolated from the onset of the
disease to the 5th day of rash, in case of complications – till the 10th day of rash appearance[5].
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