Measles Going the Distance with the Virus

MEASLES

Going the Distance with the Virus

Measles is a viral infection that was once one of the most common childhood illnesses. But thanks to the measles vaccine, it is relatively rare in the United States today. Kids still do get the measles, though, if they aren't immunized. So if your child did not get the vaccine, he may very well come down with this unpleasant virus.

Measles starts out like the common cold, with a cough, runny nose, red and watery eyes and a mild to moderate fever. But you should suspect your child has measles rather than a cold if you detect tiny white spots on the inside of the cheeks. Give the doctor a call.

Usually, the progression of measles is fairly predictable. After two to three days of fever, a whole-body rash breaks out, the cough worsens and the fever pushes higher, into the 103° to 104° range. The fine red spots on the body may join together to form larger splotches. But the rash, which lasts from five to eight days, is not itchy.

Sometimes children with measles develop an ear infection, pneumonia or neurological complications. Most of the time, though, kids with measles just feel really sick for seven to ten days. There's not really much you can do about it, except to try to relieve some of the symptoms.

Ease the fever with medication. Give your child a nonaspirin pain reliever such as Children's Tylenol or Tempra to help reduce fever and irritability, says Blair M. Eig, M.D., a pediatrician in private practice in Silver Spring, Maryland. Check the directions on the package for the correct dosage for your child's age and weight. If your child is under age two, consult your physician. 'If your child has a high fever that is really debilitating, your pediatrician may prescribe some ibuprofen,' adds Dr. Eig. ( But ibuprofen should not be given to children unless you have a doctor's recommendation.)

MEDICAL ALERT

When to See the Doctor

Measles can be complicated by a bacterial infection such as pneumonia or by an ear infection. If your child develops either of these infections, he needs to be treated with doctor-prescribed antibiotics. You should call the doctor immediately if your child complains of an earache, if he has yellow discharge in the eyes or if he develops a nasal discharge which becomes yellow and stays yellow for more than 24 hours, say Betti Hertzberg, M.D., a pediatrician and head of the Continuing Care Clinic at Miami Children's Hopital.

'If your child has fever after the fifth day of the rash, or any symptoms of pneumonia such as labored breathing, wheezing, chest pain or severe coughing, you need to contact your child's pediatrician as soon as possible,' she says.

Your child will need immediate medical attention if he has any neurological symptoms such as a seizure, delirium or weakness or spasm of an arm or a leg, adds Blair M. Eig, M.D., a pediatrician in private practice in Silver Spring, Maryland. And if you can't wake him from a nap or from sound sleep, you should call for emergency assistance.

Try a sponge bath. A sponge bath may also help your child feel more comfortable when the fever is high, says Richard Garcia, M.D., a pediatrician and vice chairman of the Department of Pediatrics and Adolescent Medicine at the Cleveland Clinic Foundation in Ohio. Have your child sit in a tub that's partially filled with lukewarm water, and gently sponge the water over his neck and shoulders.

Be generous with beverages. 'Give your child plenty of liquids, as much as she can tolerate, preferably juice, Gatorade or Jell-O, which turns to liquid in the stomach,' says Betti Hertzberg, M.D., a pediatrician and head of the Continuing Care Clinic at Miami Children's Hospital. 'Beverages are important--with high fever and sweating, kids tend to get dehydrated more quickly,' Dr. Hertzberg says.

Immunization in Brief

Measles immunization, recommended when a child is 15 months old, gives lifelong protection for most people. But with some kids, one dose of the vaccine is not enough. Doctors recommend a second dose for children 11 to 12 years of age or older who have not had measles. Check with your school district to see when reimmunization is advised in your area.

Control the cough when necessary. You can try a mild cough suppressant that contains dextromethorphan to relieve the cough, especially if it's interfering with your child's sleep, suggests Dr. Eig. Over-the-counter products such as Triaminic-DM contain dextromethorphan. Be sure to read package directions--or check with your physician--for the correct dosage for your child.

Make the most of mist. 'A cool-mist vaporizer will put some humidity in the room air and make it easier for your child to breathe freely,' Dr. Garcia says. If you do use a vaporizer, though, you must clean it often, following the manufacturer's instructions. 'Otherwise, bacteria and mold could grow in the still water,' he cautions.

Keep the lights low. With measles, the eyes can become very irritated and sensitive to light. 'Keep the lights dim in your child's room, or give him sunglasses to wear,' advises Dr. Hertzberg.

Flush and wipe the eyes. 'Rinsing the eyes with plain saline solution--available at drugstores--may be soothing,' says Dr. Eig. Use an eyedropper to put several drops in the corner of each eye.

If your child's eyes get crusty, wipe them with cotton balls that have been wrung out with boiled water, says Dr. Hertzberg. 'Be sure to wipe from the inside corner of the eye to the outside, and use a different cotton ball for each eye,' she says.

Restrict activity. Be sure that your child stays indoors, preferably in bed, says Dr. Hertzberg. 'With the measles, he'll probably feel too sick to do much else,' she says.

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