in thinking Measles can't be more dangerous now than it was 15 years ago ?

[Onajourney]

Hi

Wondering if there are any GP's out there that can tell me this ?

My eldest child is 15 and I still have his baby books and they say Measles is a mild disease and just to keep their temperature down etc, they liken it to chickenpox. I remember not being worried about it at all when he and his 11 year old brother were small.

Fast forward 14 years and we have a 1 year old who is at "huge risk from this killer disease" according our GP, but I can't understand how it can have changed so much.

Can anyone tell me, is Measles worse now than it was 15 years ago and if so why ?

Thanks

pfft
a little bit more
how to manage measles infection
stats on complications of measles

In most cases measles is a mild disease. But it's always been more dangerous than chicken pox (IIRC, pre-vaccination there used to be around 100 deaths a year from measles versus around six from chicken pox -- may have the figures slightly wrong but the measles deaths were definitely a lot higher).

Vaccination for measles has been pretty standard for ages. I'm nearly 38 and I was vaccinated as a small child.

Without wanting to get into debates about vaccination, i think the issue is probably herd immunity.... though it sounds like your baby books were a bit out of date 15 years ago, and understating the case rather.

If not many kids get a disease, and not many kids have got it for a very long time: people tend not to recognise it, doctors tend not to know what to do with it, and it all goes horribly wrong a greater proportion of the time than common diseases.

So a big part of why people see measles as more of a problem now is that it often doesn't come to a doctor until it's potentially quite serious. Then the doctor has never seen a case before, doesn't entirely know what to do with it, has all the tales in the back of his/her mind about all the vile things measles can do.... eeeeek.

Add to that the whole thing about people not vaccinating their kids and thus the potential for unrecognised outbreaks (with potentially very serious consequences), and you can see why people get antsy.

Great links iloveasylumseekers - thank you.

I am not a GP, but have a friend who experienced a young GP misdiagnosing her sons measles (he was too young to have had his MMR) which resulted in him being hospitalised and multiple visits to the eye hospital.

If they are likely to see these illnesses more than in thr past, but still relatively infrquently, is there a training need for GP's do you think?

Sorry, cross posted. I agree, that information could/should be better. I always try to give written information and double check each time, but time resources means sometimes I have to rely on memory. In fact, I see from the links I just posted that the chickenpox infectivity is now up for review - 6 days after the spots appearing rather than 5. (I usually say 5-7, but some people hear "5" and others "7").

Information about how to manage childhood infections should be universally available but the problem (as ever) is resources. Most of it is on the net via nhs.uk but many people aren't savvy enough to realise that internet information is at best variable and at worst dangerous and inaccurate. The trouble is that there is a significant minority who will distrust by instinct anything "official", and the majority of people given written information (like the purple pregnancy book given in antenatal clinics) never read the damn things.

I am not aware of VitA for measles but I am not an infectious disease physician. I see it so rarely that I usually take advice on an individual basis from the hospital physicians.

Tell the parents of children who have died from measles or were permanently affected by it that its a mild disease, see what reaction you get.

GPs also don't tend to diagnose whooping cough any more, IME, in spite of being presented with absolute classic textbook cases of it, and again it's the older doctors who tend to cotton on first.

The RCGP is trying to extend GP training (from the current three years after the two foundation years, to five years) but the govt are refusing as it costs too much.

Im not a doctor but a paediatric nurse. I have nursed children who have had complications from measles including encephalitis which can be fatal.

If its got 'worse' (which I dont believe it has as it used to be a killer back in the day) its likely to be because people getting measles is actually lower these days so less natural immunity and the disease makes the child more ill.

I know I am repeating what others have said, but measles is usually mild, especially if you have had the vacination. However in some cases it isn't mild and can have serious complications. Before the vaccine was used it was more serious, my mum nearly died from it as a child so it is safer to have the MMR.

Part of the problem is that the numbers vaccinated has gone down so we don't have 'herd immunity', when a certain proportion of the population is vaccinated so 'protects' the whole population.

Sadly, we are now seeing much more measles and sicker children with measles, probably because of this.

Silver - I'm surprised about your comments regarding chicken pox in the states. Having lived in the states for a number of years, I've never seen that kind of hysteria over chicken pox (and my DD was kind enough to have it twice). Perhaps it was the area you were in? We were in Arizona, and honestly it was more considered an annoyance and mild thing, rather than traumatic.

I do sometimes wonder if part of the reason for misdiagnosis of some of these things (for example, whooping cough or scarlet fever) is that not only are the younger GPs not seeing it much so not experienced or trained in it, but also because they assume it's rarer, so don't even consider it among the possibilities. Sort of a "oh no, that's not really something we see much nowadays, I can't imagine it's THAT" kind of mentality. Not all of them, mind you, just some of them.

That sounds like SSPE - subacute sclerosing panencephalitis. Thankfully a rare complication of measles.

I remember my sister having measles about 40 years ago. My main memory is the darkened rooms to protect her eyesight. She was still left with the eyesight in one eye impaired. I wouldn't say that Measles was considered a mild disease.

Stupid thing is, the "dangerousness" of measles can be limited, profoundly limited, by the use of Vitamin A. Who knew that? We're not told that are we? If everyone knew that, perhaps they'd be in less of a flap about it.

It really was an OTT response, Triggles. We had to see a doc, as needed a letter to fly home with, otherwise we wouldn't have bothered.

From the very first people.we spoke to, to find out where to take dd, right up to the reception we got at the hospital, e were greeted with horror and hysteria. It would have been funny if we weren't worried about dd1 being shoved into isolation or something. It was quite bizarre.

Added to that we had a doc who asked if we.were sure it was chicken pox (err, yes, but isn't that her job?!) And who didn't know how to deal with it, or what the exclusion period was etc. Wholly underwhelming, tbh

Agree, backtotalkaboutthis. One person has so far mentioned it, but no one else knew (inc a HP)

Frightening.

Grrr, phone autocorrect. Inc a gp

Is it frightening? It would be frightening if a infectious diseases paediatrician wasn't aware of it, but given that I have never ever seen a case of measles, GPs cannot be expected to know about every treatment for every condition - they just need to be able to diagnose and signpost their patient, requesting specialist help if needed.

um - I don't know anything about the vit A treatment, so I could be totally wrong here...

but don't forget that vitamin A is potentially teratogenic (makes deformed babies) and very very highly toxic in not-particularly-high doses, relative to other things (read all the diaries of polar explorers who ate their dogs'/polar bears' liver - a nasty death); and vitamin A is available in vitamin pills; so you want to be careful about how you deliver that information to the undiscerning.... (imagines nightmare scneario of google-happy parent with kid with measles AND vitamin A toxicity )

Vitamin A can be used to treat severe measles but the doses required are high and approach the toxic dose level. It is recommended in resource-poor countries for all measles cases, where disease more likely to be severe (i.e. in children

My Gran was blinded in one eye from measles, and DH and I both have horrible scars from getting chickenpox as adults (we had it at the same time).

DS has had the chickenpox vaccine he has been around poxy kids for years here (not many in Oz any more) and has never caught it.

My Mum gets recurring shingles which isn't much fun.

We have become forgetful/complacent about the old diseases. The years I spent in the developing world have ensured that I am slightly obsessed with getting immunisations on time for my kids. Not least because we still spend time there with the kids.

I am American and grew up in the US before the vaccine was around. Everyone got chickenpox. It was annoying. Scabs and itching and lots of pink calamine lotions. But, it wasn't a big deal. My two had CP here in the UK. Same experience. I wouldn't give the vaccine. And if they had added it to the baby jabs, I might not have got those. I don't mind the NHS offering the CP vaccine, but only if it is offred on it's own.

Likewise, if the measels jab was offered on it's own, more people would get that.