Measles in Singapore – What You Need to Know

Child with measles, image by CDC's Jim Goodson, Wikimedia.
As measles cases spike to 116 this year, we find out the crucial things parents need to know about this disease and any precautions we can take for our children.

In the first 11 weeks of the year, the number of measles cases has tripled compared to last year’s. Out of the 116 cases, 88 were local, while the other 28 were brought in from countries like Dubai. 

What is measles?

Measles, or rubeola, is highly contagious and infects the respiratory system. It starts as a skin rash and is more common in young children. The virus passes through contact with an infected person’s saliva or mucus, via coughing, sneezing or touching contaminated surfaces. Symptoms will usually appear from seven to 14 days after coming into contact with the virus.

Signs and symptoms of measles in adults and children

If you have a hacking cough, high fever, runny nose and red eyes, you have a measles infection. Other symptoms include small red spots (Koplik’s spots) with blue-white centers in the mouth preceding the rash.

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Following this is a skin rash across the face, neck, trunk, palms, limbs and soles of your feet. Additionally, you might also have swollen lymph nodes, diarrhoea, vomiting or inflamed eyes. 

How are these symptoms different from HFMD or chicken pox?

Those with chicken pox will have red or pink spots all over the body, have little appetite and feel fatigued. Additionally, they may also experience slight stomach discomfort, and have the urge to scratch the itch. Compared to chicken pox, those with measles will be sick for a longer time. 

As for HFMD, the rashes will appear on the hands, feet and mouth, as well as ulcers in the mouth. Similarly, those with HFMD may feel lethargic and have poor appetite. 

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Rare complications

After receiving treatment, most patients should recover completely. However, there are instances where the patient falls very ill and has additional health complications. These comprise about 30 per cent of measles patients, usually affecting children under five or adults 20 and above. Accompanying this is also an increased risk of death, especially for younger children.

While rather rare, there are also instances where measles causes an acute brain inflammation or encephalitis. Thus, this increases the chance of  seizures, mental disability or epilepsy, coma or death. In other instances, measles might also attack the digestive organs, kidney or heart muscle. 

So... do we need to panic? Not if you're immunised.

One effective way to reduce the mortality rate is to get vaccinated for this disease. According to the World Health Organisation, the number of deaths decreased from 545,000 in 2000 to 110,000 in 2017. Currently, no deaths from measles have been reported in Singapore this year. 

Children in Singapore must get two doses of the measles, mumps and rubella (MMR) vaccine. The child should go for his first injection at a year old, followed by another between 15 to 18 months. Additionally, the vaccines are 97 per cent effective against measles. 

Women trying to conceive should make sure they’re immunised against measles as well as any other diseases that can affect the child in the womb.

What to do if we get measles?

Definitely isolate yourself and/or your child from others to prevent social media backlash, and of course from unwittingly infecting others. Hence, be sure to take the sick person out of school, childcare or work etc., for at least four days, and isolate other family members who haven’t got measles for about 18 days. While there is no specific treatment to cure measles once you get it, doctors can prescribe medicines and antibiotics, if necessary, to relieve the physical symptoms. 

If your infant (between six and 12 months) comes into contact with measles, vaccinate her or use immunoglobulin. In particular, immediate vaccination works best within three days, while immunoglobulin given within six days of first contact can reduce an infant’s chances of getting measles. 

However, avoid giving your child aspirin as it could increase his/her’s risk of developing Reye’s syndrome. This is an uncommon but serious condition that causes liver and brain swelling. 

Speed up their recovery by getting them lots of rest. Hydrate them with water and fruit juice, and let them eat more vegetables and fruits. In addition, dim the lights at home or wear sunglasses if their eyes are light-sensitive.

Relevant Reads: Learn about common childhood conditions like eye irritation, pneumococcal disease, rotavirus diarrhoea, and asthma.

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