Friday, June 6, 2014

Measles Outbreak

This past month, we have seen a number of cases of measles.  Measles is one of the vaccines that most kids get when they are  little, so I haven't seen it in medical school or residency.

Measles isn't a disease that anyone wants, but it is a disease that is easy to get.  The classic signs and symptoms of measles are high fever, cough, red eyes and a rash.  The fever, cough, and red eyes aren't specific for measles, but the rash helps to distinguish it from other conditions.  However, even before the rash appears, you can pass measles along to another through respiratory droplets in the air.  So it is hard to isolate those who have it, because people don't often know that someone in their village has it, and they get infected as well.

We heard reports about 3-4 months ago that there was a measles outbreak in Port Moresby, our capitol city, but we weren't seeing any cases of measles in the Highlands.  I was thinking we might miss it, but I was sure wrong.  In the last 2 weeks, we have seen a number of cases affecting all ages.  We have had kids at 6 months, 3 years, teenagers, and adults all infected.

Having never seen it before, I wasn't sure initially what was measles and what wasn't.  Now, having seen about 15 cases of it, and 5 just today, at various stages of the disease, I have learned quite a bit about it, and now feel pretty comfortable diagnosing it.  There isn't a great treatment for measles that makes it go away quickly, instead, we treat the symptoms, and try and make them feel better.  We do all we can to not put them in the hospital and expose all our other patients to measles, if we can help it.  We are currently trying to vaccinate as many kids as we can.  Giving it to those on the ward, going out to the communities, and telling the kids in outpatient to go and get a shot.  We are hoping to somehow get ahead of it, but not sure how well that will happen.

Measles doesn't just cause the rash and high fever, but it can also affect the lungs, eyes, brain, GI tract, and heart.  We have seen pneumonia, diarrhea, and hepatitis associated with it, and I hope I don't see some of the other complications.  Around 12 years ago, there was another measles outbreak here and then years later we started seeing kids who had a progressive neurological decline that eventually killed them.  This is a bad complication of measles that can occur years later.  Hoping that doesn't happen again this time.