Measles
Measles is caused by a virus from the paramyxovirus family and is among the most contagious diseases that exist. An infected person can transmit the virus to up to 15 other people, mainly through respiratory droplets released when coughing, sneezing, or even talking.
Stories like Mariana's, who took her 8-month-old son to the emergency room with high fever and reddish patches on his skin that seemed to belong to the past of Brazilian medicine, have returned to happening.
"The data and clinical case cited in this article are fictional and are purely illustrative in nature, serving to facilitate understanding of the topic addressed."
Measles never really went away
The virus survives in the air and on surfaces for up to two hours, which facilitates transmission in enclosed environments such as schools, public transportation, and waiting rooms.
Brazil received the certificate of measles elimination in 2016, but lost that status in 2019, after the virus began circulating sustainably in the country again. In November 2024, the certificate was recovered. Nevertheless, isolated cases continued to appear, mainly linked to international travel and the decline in vaccination coverage in some regions.
The cases that are concerning now
This year, the state of São Paulo has already confirmed more than a dozen cases, concentrated in the capital, in Guarulhos, and in São Bernardo do Campo.
Among the patients are:
- Babies under 1 year old
- Adults between 20 and 50 years old
These age groups depend directly on being up to date with their vaccination, since younger babies have not yet completed the vaccination schedule and many adults have never received the two recommended doses.
In light of this, from August 3rd to September 1st, measles vaccination is being offered to the entire population aged 6 months to 59 years in these three municipalities, regardless of whether they have been vaccinated before. In the other municipalities in the country, the recommendation follows the national vaccination schedule, with updating of the vaccination card whenever there is a missed dose.
How measles manifests
The first signs usually appear between 7 and 14 days after contact with the virus, and for this reason they often go unnoticed as a common cold at first. The typical presentation follows more or less this order:
- High fever, which increases in the first days
- Dry cough, runny nose, and conjunctivitis (red eyes and light sensitivity)
- White spots inside the mouth, near the molars, known as Koplik's spots — considered a fairly characteristic sign of the disease
- Reddish patches on the skin, which appear a few days later, begin on the face and behind the ears, and spread down to the trunk and limbs
The period of transmission begins even before the appearance of skin rashes, which makes outbreak control more difficult.
What is the prognosis
In most healthy children and adults, measles progresses to complete recovery in a few weeks. But this is not a disease without risks: measles can be severe and, in some cases, fatal.
The risk is higher for:
- Children under 5 years old
- Pregnant women
- Immunosuppressed people
- Individuals with malnutrition
It is precisely because of this potential for severity that surveillance around any increase in cases is taken so seriously by health authorities.
Possible complications
Among the complications most associated with measles are:
- Otitis media (ear infection)
- Pneumonia, one of the leading causes of death associated with the disease
- Diarrhea and dehydration
- Encephalitis (brain inflammation), which can leave neurological sequelae
- Subacute sclerosing panencephalitis, a rare, serious, and late-onset neurological complication, which can appear years after the initial infection
- In malnourished people, increased risk of blindness
Why the vaccine remains the answer
The trivalent viral vaccine, which protects against measles, mumps, and rubella, is available free of charge through the SUS (Unified Health System) and is part of the national vaccination schedule.
Recommended vaccination schedule
- First dose: at 12 months of age
- Booster: at 15 months (at this age, it is often already combined with protection against varicella, in the tetra viral vaccine)
In cities with confirmed virus circulation, the Ministry of Health also recommends the so-called zero dose for babies between 6 and 11 months, as extra protection until they reach the age of routine dosing.
For adolescents and adults
Adolescents and adults who do not have proof of two vaccine doses should also seek out a health facility to update their vaccination schedule.
The return of cases that did not exist for years in Brazil is directly related to the decline in vaccination coverage in some regions, and reversing this depends on the vaccination of each person, not just children.
If you are unsure about your own vaccination record or your children's, it is worthwhile to check before any travel or exposure to places with greater circulation of people.
Important warning: This content is informational in nature and does not replace a medical consultation. Consult a healthcare professional for individual assessment, vaccination guidance, and management of suspicious symptoms.
Dr. Rebeca Soares Andrade CRM - GO 39335