Some people eg pregnant women, will be at increased risk of severe illness from Swine Flu (H1N1 09) this winter More info »
Measles is a highly contagious disease caused by a virus. The virus spreads when the infected person coughs or sneezes. The measles virus can survive up to 2 hrs in the air. Persons infected with measles are likely to get a fever, runny nose, sore eyes and rash beginning on the face and upper neck, and than becomes generalised. People with measles are usually infectious from just before the symptoms begin until four days after the rash appears.
Measles is often a severe disease, frequently complicated by ear infections, pneumonia and diarrhoea. More concerning is that the possibility that the measles infection may lead to acute encephalitis. This is an inflammation of the brain, which can leave permanent damage or lead to death. Acute encephalitis occurs in 1 per 1000 cases, and has a mortality (death) rate of 10 to 15%, with 15 to 40% of survivors suffering permanent brain damage.
Even if an infected person recovers, a rare, but deadly late complication of measles called subacute sclerosing panencephalitis (SSPE) may occur years after the infection (average 7 years). SSPE causes progressive brain damage and is always fatal. SSPE occurs in 0.5 to 1 per 100 000 measles cases.
Complications from measles are more common and more severe in the chronically ill, in children under 5 years of age and in adults. Approximately 60% of deaths from measles is due to pneumonia complications, especially in the young, while complications of encephalitis are more frequently seen in adults.
Treatment. People with measles infection are normally advised to rest, drink plenty of fluids, and take paracetamol to treat the fever. There is no specific treatment.
Mumps is an acute viral illness. Mumps virus spreads through coughing and sneezing, or direct contact with infected saliva. People with mumps can be infectious up to seven days before and nine days after swelling of the salivary glands begins. It usually causes fever, headache, loss of appetite, tiredness and swollen painfully salivary glands. One or both of the parotid salivary glands (which are located within the cheeks, near the jaw line, below the ears) are most frequently affected. About one third of infected people do not show any symptoms at all. Mumps is usually a more severe illness in people infected after puberty. Complications from the mumps are uncommon and can include inflammation of the brain (encephalitis), reported to range as high as 1 in 200 cases with a case fatality of 1%; inflammation of the lining of the brain and spinal cord (meningitis) up to 15% of cases but permanent damage rare; inflammation the testicles (orchitis), reported in up to 20% of clinical mumps cases in post-pubertal males, may lead to sterility (inability to have children). Less frequently symptomatic involvement of other glands and organs includes the pancreas (pancreatitis), the ovaries (oophoritis), breasts (mastitis), liver (hepatitis) heart (myocarditis). Nerve damage causing permanent hearing loss is one of the serious complications of mumps infections. Before mumps vaccination, many children suffered deafness from this cause. Mumps infection in the first trimester of pregnancy may result in spontaneous abortion.
Treatment There is no specific treatment for mumps. Simple analgesics may reduce pain and fever. Warm or cold packs to the swollen glands may provide relief.
Rubella (or Geman measles) is an infectious viral disease. It is spread by coughing and sneezing or direct contact with infected saliva. It is generally a mild, but highly contagious disease. Symptoms might include slight fever, swollen glands and joint pain. It is also possible to become infected without obvious symptoms.
Rubella infection during pregnancy, especially in early pregnancy, can have devastating effects on the baby’s development. This is referred to as congenital rubella syndrome. Birth defects include intellectual disabilities, heart defects, blindness, deafness, intrauterine growth retardation and inflammatory lesions of the brain. Unborn babies are most at risk in the first 8-10 weeks of gestation (8-10 of the mothers pregnancy), where 90% of affected pregnancies will result in birth defects, possibly multiple defects. The risk damage declines to 10 to 20% by 16 weeks gestation. After this stage foetal damage is rare but has been reported up to 20 weeks gestation. Fortunately the number of cases has dropped rapidly since rubella vaccine become available.
Treatment There is no specific treament. Simply rest and have plenty of fluids.
Protection from all three diseases is available in the Measles, Mumps and Rubella vaccine known as MMR vaccine. MMR is recommended at 12 months and 4 years of age. The vaccine provides immunity to 95-99% of people after two doses. The vaccine contains live attenuated measles, mumps and rubella viruses. Attenuation is the process in which the virus is modified and weakened to reduce it's ability to cause disease, while still be able to induce an immune response.
MMR has received bad publicity in the past about containing mercury (ethyl mercury) in the form of thiomersal. In Australia, thiomersal has been removed from all routine childhood vaccines since the year 2000. In many countries, thiomersal continues to be used in vaccines. The Global Advisory Committee on Vaccine safety (GACVS) of the World Health Organisation (WHO) has concluded that "there is currently no evidence of mercury toxicity in infants, children or adults exposed to thiomersal-containing vaccines" and that "there is no reason to change current immunisation practices with thiomersal-containing vaccines on grounds of safety".