Case of teenager with measles baffles doctors

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The 19-year-old man was having difficulty breathing, feeling very weak and had high fever and rashes on his body when he was admitted last week to the Saint Luke’s Medical Center in Quezon City last week.

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The teenager had the classic symptoms of measles. But what puzzled doctors was that the patient had had complete measles shots as child. He also comes from a middle- class neighborhood, not from a slum from where most measles cases have been reported.

The patient was discharged on Saturday, but the doctors at Saint Luke’s are interested enough to research on the case further.

They are looking at two possibilities: 1) the vaccines he was given had weaned because of his declining body resistance, or 2) the disease has mutated into a stronger strain.

While the doctors are studying case of the teenager, they shared with The Manila Times some facts about measles:

Measles (particularly in adults, a very uncommon thing) have telltale signs like sore throat, fever and dot-like, dull looking rashes in the face, arms and legs.

Measles commonly affects children under 18 years old during summer, and the medical community is at a loss explaining the current outbreak in Metro Manila.

Though preventable through vaccines, measles especially in adults can be fatal once viral pneumonia and complications set in.

Train riders must always wear face masks and wash hands thoroughly with soap and water or through liquid hand washes/alcohol, since trains are usually packed with all kinds of viruses, bacteria and other disease-causing agents. (Better yet take a non-airconditioned bus where air flows freely).

So far, no epidemic has been reported in Quezon City, the doctors said that because measles is highly contagious, it could spread in the city if residents do not take precautions.

Though measles is not as fatal and life-threatening as dengue (a mosquito-borne affliction that is highly contagious and which used to be seasonal peaking on summer and after the rainy season but had in recent years become year-round) or leptospirosis (that peaks in June and September) ignoring its early signs can cause it to eventually attack the brain.

Wikipedia lists the symptoms of measles as four-day fevers (4Ds) and three Cs (cough, coryza or head cold and conjunctivitis or red eyes, along with fever, anorexia and rashes.

The fever may reach up to 40 degrees and Koplik’s spots may appear inside the mouth, but the spots are not often seen in real cases of measles because they are transient and may disappear within a day.

The measles rash starts on the back of the ears. After a few hours it spreads to the head and neck before covering most of the body, often causing itching.

The rash appears two to four days after the initial symptoms and lasts for up to eight days. The rash is said to “stain” changing color from red to dark brown, before disappearing.

Complications from measles range from diarrhea to pneumonia, otitis, acute encephalitis (and very rarely SSPE or subacute sclerosing panencephalitis) and corneal ulceration (leading to corneal scarring).

Complications are usually more severe in adults. In the 1920s around 30 percent of the people who contracted measles pneumonia died.

Between 1987 and 2000, in underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates have been as high as 28 percent. In immuno-compromised patients (e.g. people with AIDS) the fatality rate is approximately 30 percent.

The known risk factors for severe measles and its complications include malnutrition, underlying immune-deficiency, pregnancy and vitamin A deficiency.

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