Veins (Morbilli)

Veins are an acute infectious disease caused by the vein virus. An influenza similar pre-stage and the typical exanthema (exanthema) are characteristic for this illness. Because of their extremely high infection ability veins usually in the childhood appear and leave a lifelong immunity. Approximately 50,000 to 60,000 fall ill in some years even up to 100,000 people of veins in Germany every year. The veins are diagnosed and treated symptomatically to hand of the typical exanthema. Complications appear at 10 to 20 per cent the fallen ill (middle ear and lung inflammations, encephalitis and SSPE in western industrial countries. You aren't only frequent but are also accompanied by an increased case fatality rate (mortality). A very well effective protective vaccination as well as the possibility of the passive immunization are prophylactically available.

Veins are worldwide common. 90 per cent of the not protected children fall ill, the left until 10th year of life it can meet in the adulthood. Infants of mothers which have gone through the illness or were vaccinated are protected until the 6th life month. Already during the pregnancy they have got the antibodies against the virus about the placenta (nest protection).

The vein causative agent is the vein virus. It is part of the genus morbillivirus and of the family of the paramyxoviridae. The vein virus affects preferentially cells of the immune and the nervous system. Also so-called giant cells which are provable already in the nasal discharge at the beginning of the illness arise. The virus is transferred by droplet infection (cough, sneeze or speaking) also about greater resections (so-called flying infection) from man to man. But also about a contact with infected objects (dishes or flatware) the infection is possible. The admission gates of the virus are the mucosas of the respiratory systems and the conjunctiva of the eye. At present, veins are infection protection sedate a notifiable infection illness in Germany after this. This applies to suspicion, illness and death.

The illness leaves a lifelong immunity.

The infection power (contagiosity) of the shoot is very big, this means of 100 infected persons 99 fall ill. The infection ability of one starts fallen ill, before the first influenza similar symptoms appear and lasts until 3 -5 days after outbreak of the eruption with already 1-2 days. The danger to catch it is, however, the greatest during the prodromal stage (see course) and then decreases until end of the exanthema stage.

The incubation period, that is the period of time between the infection and appearance of the first symptoms is about 10 to 12 days.

The course can be divided up into two stadia: The catarrhal or prodromal stage (duration approx. 3 -5 days) which is marked by influenza similar symptoms and the exanthema stage (duration about 3 -5 days) with the typical skin appearances one. A two-part course of the fever curve is characteristic for the illness. The first fever peak is, the second at the beginning of the exanthema stage found during the prodromal stage.

During the prodromal stage, at first characteristic symptoms, like fever (to 39 º C), dry cough, common cold, sore throats and bronchitis, don't appear. The child moreover, has a conjunctivitis and is averse to light, the tear flow is amplified. The fever then sinks lightly and lime splash like whitish spots are found in the compress folds of the cheek mucosa. The mouth and pharynx mucosa is reddened strongly. The temperature has fallen on a normal body temperature toward the end of the influenza similar stage.

The exanthema stage starts with a steep rise of the body temperature (39 -40 º C.) The symptoms of the catarrhal stage increase. Simultaneously the typical exanthema appears with 3 to 6 centimeters of a big, at first pale red, irregular restricted spot, which flow into each other. The exanthema starts behind the ears, then spreads across face and neck and also covers the trunk and the extremities (arms and legs) after three days. The fever starts to sink if the eruption has reached the foots, around on the fourth day after the beginning of the eruption. The body starts at not complicated course to recover (convalescence). The spots change color more dark, almost brownishly and fade in which the skin scales itself. The other symptoms disappear gradually.

Consult your physician because of the possible complications as soon as possible. Call it immediately if your child feels worse after seemed to feel better it already. If you watch nape resistance, headaches or giddiness, this indicates an encephalitis. Go to your physician immediately, too, if your child does earaches good or symptom shows to a lung inflammation, how dry cough or dyspnea.

Your attending doctor will proceed as follows:

He can make the bipartite temperature curve and the typical exanthema the diagnosis with the influenza similar symptoms, the koplik spot. At the beginning of the illness giant cells can be proved from the nasal discharge. As of the beginning of the exanthema stage the detection of vein specific antibodies (IgM) is also possible from the blood.
Since veins are a virus illness, there isn't any specific medicine for it. It is treated symptomatically.
He probably will prescribe antibiotics at an ear infection or lung inflammation.
He can order suppositories or juices containing paracetamol against the fever. The child should remain bed also as long as it has fevers in which.
Against the conjunctivitis its physician will prescribe eye drops and give the recommendation, the dormitory to do without because of the photosensitivity as of dark and at television.
He can order a cough muffling medicine at a strong cough.

You help your child with the following measures:

Give him something to drink much because of the cough and the fever. You can lower the fever by compresses around the leg or the antipyretic agentses ordered.
You avoid a direct incidence of light and the room you grow dark. The children are often sensitive to light.
It is good for your child bothered by cough and common colds if you keep its room cool and moisten the space air regularly.
Provide primarily during the fever phase confinement to bed.
Leave your child to the nursery school and school only one to two weeks after completion of all disease symptoms so that its body's defenses can recover.

The complications at and after a vein infection are various:

Intense otitis medias can draw deafness after themselves.
In rare cases a pigmentary degeneration of the retina has to be watched whose consequence can be a loss of sight.
The most frequent reason for deaths is the veins pneumonia, that is a lung inflammation at veins.
This one is dangerous also "veins croup" with chokings and dyspnea.
An acute vein conditional appendicitis (typhlitis) usually makes an operation necessary.
The inflammation of the brain (encephalitis) which develops after appearance of the exanthema about 8 to 14 days is particularly dreaded. It appears approximately at one of 2000 vein cases. Over the blood vessels the causative agents reach the brain and damage the nerve cells there. You cause reduced consciousnesses, spasms, epileptic attacks as well as paralyses. Damages stay behind at are third Thely fall illustrated around 25% mental the fallen ill with vein enzephalits die.
Vein complication appearing as a very rare only after years is regarded the subacute sclerosing panencephalitis (SSPE). It is a neurological illness going deadly. The viruses penetrate into the brain and destroy nerve cells there. The illness breaks only seven years off on the average after a vein illness going at first complicationless. Indifference, apathy, nightly anxiety and outbursts of rage belong to the initial symptoms. Involuntary motions and mental dissimilation appear months later.

The prognosis at a vein illness is good at a complicationless course. The case fatality rate is 3 to 5 per cent at complications. Adults often fall ill more heavily than children.

The children can be vaccinated prophylactic. You recommend to vaccinate for the first time as of the perfect 11th life month. A second vein vaccination should be carried out in the 2nd year of life to ensure a reliable protection. The second vaccination can after also already four weeks the 1st is carried out. A polyvalent vaccine which also offers protection against mumps and rubellas is usually used at the two vaccinations against veins.

Due to the high case fatality rate rate at complications the risk of a vaccine damage is insignificantly low with death consequence. A vaccination has to be recommended therefore urgently.

It also has to be importantly known that the outbreak of the illness can be suppressed by a vaccination at full term effectively also after a causative agent contact. For not protected infants, infants, pregnant women, defense weakened and chronically ill patients there is the possibility of a passive immunization. Specific antibodies (human gamma globulins) are given. However, an avoidance or drop in the vein infection only can be reached if the gamma globulins are given 2 to 3 days after causative agent contact.

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