Measles

Measles is not a harmless childhood disease. They are highly contagious and can cause serious complications and secondary diseases (e.g. chronic inflammation of the brain).In many countries, measles is one of the most important infectious diseases and deaths from measles are among the most common causes of childhood death worldwide.

Occurrence

The measles virus is spread worldwide. Through consistent vaccination, measles has been successfully eliminated in some regions of the world (e.g. North America) in accordance with the goals of the World Health Organization (WHO). A pronounced resurgence in measles case numbers has occurred in Germany. Major outbreaks have occurred (e.g. in Bavaria, Berlin, Hamburg and Baden-Württemberg).

Route of infection

The measles viruses are transmitted by inhaling infectious droplets that are produced when speaking, coughing or sneezing. Even brief contact with a sick person almost always leads to infection and disease in non-immune or non-vaccinated persons.

Incubation period

The time between infection and the appearance of cold symptoms is 8-10 days. It usually takes 14 days for the typical rash to appear.

Duration of contagiousness

Contagiousness begins as early as five days before the appearance of the rash and lasts until 4 days after its appearance.

Symptomatology

The disease begins with fever, conjunctivitis, rhinitis, cough and a rash on the mucous membrane of the palate. On the 3rd-7th day after the onset of the initial symptoms, a typical patchy rash appears, which disappears after about a week. Complications may include middle tube inflammation, pneumonia, diarrhea, or inflammation of the brain (encephalitis). These can also lead to permanent damage or even death. In Germany, too, complicated courses of the disease and deaths occur time and again.

Preventive measures

Anyone who has once contracted measles is protected for life against a new infection. Otherwise, vaccination is the only protection against measles. Currently, the permanent vaccination commission ( STIKO ) recommends a two-time combination vaccination in infancy. Older children, adolescents and adults should also be vaccinated against measles according to this recommendation, as far as there is not already a safe protection by two-time vaccination or an earlier disease.

Visiting community facilities (daycare centers and schools)

According to § 34 Infection Protection Act (IfSG), children are not allowed to visit schools and daycare centers if they have measles or are suspected of having it. Parents must inform the relevant institution about a measles infection. Community facilities may only be visited again after the clinical symptoms have subsided, but no earlier than 5 days after the exanthema outbreak. A written certificate is not required for this purpose. Contact persons living in the same household are not allowed to visit community facilities for 14 days after exposure, unless vaccination protection exists or a previous measles illness is confirmed by a physician. Teachers, educators, or other caregivers who have or are suspected of having measles may not perform their teaching; educational, caregiving, or other activities in the facilities.

Contact persons are allowed to visit the facility immediately if:

• proof of having been vaccinated twice can be provided
• in the case of non-vaccinated persons, immediate vaccination has been carried out within 3 days of contact with a person suffering from measles (postexposure vaccination), or
• is medically certified to have already had measles.

Vaccination records and certificates are checked by the Office for Health and Consumer Protection, which also issues the necessary prohibitions on visits in accordance with §§ 28 and 34 (9) IfSG.