Is a child contagious after vaccination: measles, rubella, mumps?

Hello, dear readers of our magazine! Today we will try to figure out whether a child after vaccination with measles, rubella, mumps is contagious to others? This issue is regularly raised by parents in childcare centers, provoking conflicts between supporters and opponents of vaccination.

Today we will try to figure out whether a child after vaccination with measles, rubella, mumps is contagious to others? This issue is regularly raised by parents in childcare centers, provoking conflicts between supporters and opponents of vaccination.

Why are measles, mumps and rubella dangerous?

Among many infectious diseases, measles, rubella and mumps (mumps) are considered the most dangerous for children of primary preschool and school age. The immune system cannot cope with viruses, and imperfect functioning of internal organs and systems is often accompanied by complications. With poor health, congenital pathologies of the heart or kidneys, the risk of irreversible consequences increases significantly.

Many parents are afraid of the side effects of the MMR vaccine, which is designed to protect the baby from these diseases. But when infected with pathogens, you can encounter more serious problems and consequences:

• When affected by measles, an inflammatory process in the membrane of the brain or spinal cord, hepatitis, and damage to the respiratory and digestive organs often develop.
• Rubella is often complicated by the development of viral encephalitis, damage to the child’s nervous system, and inflammation of the heart muscle. Every 4 babies develop varying degrees of limb paralysis. If infected during the 1st–2nd trimester of pregnancy, the risk of developing various defects or fetal death exceeds 56%.
• Mumps causes damage to the pancreas, and therefore threatens the development of chronic pancreatitis or diabetes mellitus. In addition to arthritis, meningitis and myocarditis, the virus causes infertility in men.

Therefore, doctors insist on a comprehensive MMR vaccination, which combines antigens for each of the listed diseases.

Measles - symptoms and treatment

Incubation period

The incubation period for the typical form is from 9 to 11 days (in some cases up to 13).

Symptoms of measles in adults

The onset of the disease is subacute (i.e., the main syndrome appears 2-3 days from the onset of the disease), however, with proper preparation of the doctor (identification of pathognomonic enanthema - a rash on the mucous membranes), an acute onset can be determined (during the first day). In adulthood, due to the characteristics of the immune system, these criteria may not be met.

Measles syndromes:

• syndrome of severe general infectious intoxication;
• pathognomonic enanthema syndrome (Belsky-Filatov-Koplik spots);
• maculopapular exanthema syndrome;
• conjunctivitis syndrome (severe);
• respiratory tract syndrome (pharyngitis, tracheobronchitis);
• generalized lymphadenopathy syndrome (GLAP);
• hepatolienal syndrome.

The so-called early diagnosis of measles is described, including:

• difficulty in nasal breathing;
• redness of the right eyelid;
• low-grade fever (permanent fever).

Typical complaints of patients : increasing weakness, lethargy, loss of appetite, sleep disturbances, “sand in the eyes”, swelling of the lower eyelids, sometimes a runny nose, increased body temperature (up to 39°C). Then a sore throat develops, a dry cough appears, shortness of breath, there may be abdominal pain, diarrhea (layering of secondary flora), a rash appears (with its appearance, the syndromes of general infectious intoxication and damage to the respiratory tract intensify).

Objectively: one can note the occurrence of a maculopapular rash, which appears in typical cases on the 3-4th day of illness, with pronounced stages (face, neck; then the trunk, arms, thighs; then the deer and feet, and at this moment the face turns pale). The rashes are papules surrounded by a red spot, prone to fusion (but in the presence of clear areas), and sometimes petechiae appear. After 3-4 days, the rash becomes pale and leaves behind brown spots and pityriasis-like peeling. Peripheral lymph nodes (occipital, posterior cervical and axillary) increase in size and become sensitive. Conjunctivitis is pronounced (the conjunctiva is massively hyperemic, edematous, and purulent discharge quickly appears). The patient's appearance is characteristic: a puffy face, red (like a rabbit's) eyes, swelling of the nose and eyelids, dry cracked lips. On auscultation, dry rales are heard in the lungs. Tachycardia and decreased blood pressure are pronounced. The size of the liver and spleen increases (generalization of infection).

During pharyngoscopy, hyperemia of the soft palate is visualized in the oropharynx; on the mucous surface of the cheeks at the beginning of the disease, Belsky-Filatov-Koplik spots (small whitish spots with a narrow reddish border), which disappear when exanthema appears. Sometimes spotted enanthema appears on the mucous membrane of the soft palate.

Mitigated measles has been described (in people who received specific anti-measles immunoglobulin during the incubation period), characterized by an extended incubation period to 21 days and a mild course.

The abortive form of the disease has a typical onset, but after 1-2 days the clinical manifestations disappear.

There is a concept - a reaction to vaccination (during the initial administration of a live measles vaccine), characterized by an increase in body temperature, catarrhal symptoms (inflammation) of the upper respiratory tract, a scanty, inconspicuous rash (more often develops in children and people with immunodeficiency).

In patients with severe immunodeficiency - AIDS (HIV, cancer patients, people receiving systemic cytostatics after organ transplantation) - the course of the disease is extremely severe (mortality rate up to 80%). [4][5]

Differential diagnosis

signs	measles	rubella	pseudotuberculosis	allergic rash
inc. period	9-11 days	11-24 days	3-18 days	up to 24 hours
epidemiological background	contact with the patient	contact with the patient	eating raw vegetables	contact with an allergen
inflammatory changes in the upper respiratory tract	expressed	moderately expressed	moderate or absent	No
conjunctivitis	expressed	weakly expressed	weakly expressed	No
GLAP (enlargement of lymph nodes)	expressed	pronounced (occipital and posterior cervical)	moderate (mesadenitis)	No
nature of the rash	maculopapular	small-spotted	punctate, scarlatiniform, maculopapular	maculopapular, pruritic
time of rash appearance	3-4 day	1 day	2-4 days	up to 24 hours
stage of rashes	expressed	No	No	No
pathognomonic signs	Belsky-Filatov-Koplik spots	Forchheimer's spots	"gloves and socks" symptoms	No

How contagious is a child after MMR vaccination?

MMR or measles, mumps and rubella vaccination is included in the list of mandatory vaccinations for children. It is made in two main types of drugs:

• live vaccines - contain the pathogens of the virus in a weakened form;
• inactivated - the composition contains particles of viral cells or completely neutralized antigens.

If a live vaccine is administered, real disease viruses enter the child’s body. He seems to be suffering from a mild form of illness, which helps the immune system “remember” the pathogen and develop an effective defense against it. Under certain conditions, such children can become carriers of the pathogen, which is theoretically dangerous for surrounding adults and other children.

An inactivated vaccine does not contain living cells. The immune system recognizes foreign antigens and forms a response. In most cases, the procedure takes place without complications, fever and weakness. Such a child does not become a carrier of pathogenic pathogens and is absolutely safe for peers in the group.

In recent years, doctors have avoided vaccinating with a live vaccine against measles, rubella and mumps, which has certain contraindications. With proper preparation and implementation, cases of infection are excluded. But violations or omissions can provoke the development of a full-fledged disease in a child a few days after administration of the drug. Such cases are rather an exception to general practice and require careful study.

What if a child gets sick and becomes contagious?

If a child gets sick and becomes contagious after being vaccinated with measles, rubella, mumps, the reason could be hidden in the following violations:

• The virus infection occurred several days before the vaccine was administered. Even an experienced pediatrician will not be able to recognize signs of the disease during the incubation period, when there is no fever or rash. The problem is observed during mass vaccination during an epidemic.
• The vaccine was produced with violations. All viruses undergo multi-stage processing, which should destroy and deactivate them. Violation of technology is fraught with the preservation of their viability.
• The baby has a greatly reduced immune system, which cannot resist weakened pathogens of measles or mumps.

Therefore, doctors recommend mandatory preparation for vaccination in order to exclude any complications. You should take simple urine and blood tests a few days in advance. Indicators may indicate an inflammatory process, a critical decrease in hemoglobin. In this case, the vaccination is postponed until complete recovery; they try to boost immunity with the help of proper nutrition, hardening and vitamin complexes.

Therefore, doctors recommend mandatory preparation for vaccination in order to exclude any complications.

Chances of getting sick in people who have not received the vaccine

Those individuals who have not been vaccinated as planned and have not had measles have a 99% chance of becoming infected through contact with an infected person. In adulthood, this pathology is more severe than in infancy.

Often the patient encounters the following complications:

• otitis;
• sinusitis;
• meningoencephalitis;
• bronchitis;
• hepatitis;
• pneumonia;
• meningitis;
• pyelonephritis;
• keratitis, leading to blindness in 20% of cases;
• eustachitis, which can cause hearing loss or complete hearing loss.

Meningoencephalitis is considered the most severe complication of measles for an adult: in 25% of cases this pathology leads to death. The disease affects the nervous system.

Meningoencephalitis develops in 0.6% of cases. The pathology manifests itself as follows: after the rash goes away and the temperature returns to normal, its indicators rise sharply again, the person experiences convulsions, and consciousness becomes confused. The only effective protection against this complication is timely immunoprophylaxis for adults and children.

Vaccinated people can also get measles. According to statistics, the probability of infection in persons who have been administered the vaccine is 5%. In this case, the pathology proceeds more easily and is usually not accompanied by complications.

Can a pregnant woman get infected from her child after vaccination?

After vaccination against measles, rubella and mumps, is a child contagious to his pregnant mother? This situation occurs quite often, so a pregnant woman is wondering: is contact with the baby dangerous after the vaccine is administered? During this “special” period, the female body is weakened by hormonal changes, experiences serious stress and restructuring, so any contact with viruses can result in inflammation.

For another 10–15 years, this issue did not bother doctors: universal vaccination protected people with weakened immune systems and prevented dangerous epidemics. Today, mothers are becoming young women who were not vaccinated as children at the request of their parents or for medical reasons. For this category of patients, the risk of contracting rubella or measles from their own children after administration of the vaccine cannot be excluded.

Indications for revaccination in adults

Measles is an acute viral disease manifested by a characteristic maculopapular rash on the skin, inflammation of the mucous membranes of the mouth and respiratory tract, fever and general intoxication.
This is one of the most dangerous pathologies in the world. Almost 100% of those in contact with the patient become infected with measles.

According to statistics, 165,000 people die from this pathology every year. The mortality rate is especially high among residents of Asia and Africa.

In our country, epidemics can be avoided through vaccination.

Measles immunization is usually given in childhood. But it happens that the schedule is violated and the person does not receive a repeat dose of the measles drug. Then revaccination is performed for adults on a schedule or unscheduled. Typically, the manipulation is performed before the age of 35 for those persons who have not previously had contact with patients and have not been vaccinated.

Indications for this procedure are:

• Comprehensive vaccination in accordance with the National vaccination calendar against mumps, measles and rubella.
• The person had contact with an infected person. In this case, vaccination is done on an emergency basis.
• You are planning to travel abroad (for example, to Thailand, Italy, Singapore, Turkey, China). The vaccine is administered a month before the trip.
• One of the family members contracted measles. Then everyone who lives with the sick person is vaccinated.

At risk are people who work in schools, higher education institutions, medical institutions and have contact with a large number of adolescents and children. Therefore, such persons should be vaccinated against measles first. As part of routine immunization, if contact with a sick person is suspected, the vaccination is given free of charge. People over 35 years of age have to pay a certain amount of money for measles vaccination.

For revaccination of adults, the following drugs are usually used:

• Priorix. This is a Belgian combination drug for rubella, measles and mumps. Manufactured by GlaxoSmithKline Biologicals.
• Cultured live measles vaccine. This is a Russian product registered in 2007. To make it, the virus is grown in a cell culture of Japanese quail eggs. The vaccine is single-component.
• MMR II. The drug is produced by the Dutch company Merck Sharp & Dohme. The vaccine is live, contains antibodies against rubella, mumps and measles.

All these vaccinations are interchangeable, safe, and effective. To minimize the risk of complications, you need to properly prepare for immunoprophylaxis.

Precautionary measures

In most cases, a child is not contagious after MMR vaccination, but doctors recommend following simple precautions for others:

• When planning a pregnancy, get the necessary vaccinations in advance and check your health.
• Do not refuse examinations and tests, monitor the baby’s well-being.
• In the first days, you should not take your baby to kindergarten and avoid traveling on public transport.

It is better to postpone vaccination if family members have recently suffered from ARVI or influenza or are being treated for bacterial infections. It is not done when teething or exacerbation of chronic diseases of the gastrointestinal tract or respiratory system in a child.

Today we talked about whether a child is contagious after vaccination with measles, rubella, mumps? Currently, domestic vaccines or foreign vaccines MMR, Priorix, Ervevax are used in pediatrics. They are based on non-living viral cells, therefore they are safe for babies and others, and no cases of infection from a vaccinated baby have been recorded.

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When should you not get vaccinated against measles?

Vaccination against measles is reliable protection against a dangerous disease.

But it is not always possible to carry out immunoprophylaxis.

Doctors identify absolute and temporary contraindications to measles vaccination.

The first group of restrictions includes the following:

• hypersensitivity to quail and chicken eggs;
• immunodeficiency;
• development of a strong reaction to a previous vaccination;
• intolerance to antibacterial agents of the aminoglycoside group.

In these cases, human immunoglobulin is used for prevention. This product contains antibodies from the blood of a donor.

As a rule, a person has a mild reaction to the measles vaccine in the form of:

• cough;
• temperature about 37.5 degrees;
• runny nose;
• redness in the injection area;
• joint pain.

In some cases, the following may develop: urticaria, anaphylaxis, Quincke's edema. Among the severe consequences of immunoprophylaxis are: myocarditis, encephalitis, pneumonia, meningitis. To avoid such complications, the person must be completely healthy at the time the vaccine is administered. It is advisable to get vaccinated while taking antihistamines.

Temporary contraindications to immunoprophylaxis are:

• surgery performed less than 30 days ago;
• lactation period;
• exacerbation of chronic diseases (before the pathology enters the remission stage);
• chemotherapy received about 3 months ago;
• treatment with blood products;
• leukemia;
• pregnancy;
• the presence of an infectious disease accompanied by high fever.

To identify temporary and permanent contraindications, an examination must be performed before immunoprophylaxis.

Victory over measles

Measles is caused by a virus and is transmitted through respiratory droplets. You can recognize it by tiny white spots on the mucous membrane of the cheeks, which are then replaced by a rash behind the ears, and later by rashes all over the body. Plus a runny nose, cough, itching and fever. Contrary to its apparent harmlessness, the mortality rate from measles in developed countries is 1-3 cases per 1000 diseases. As a rule, the main cause of death is the development of pneumonia.

Previously, only children were vaccinated against measles free of charge (under compulsory medical insurance). Four years ago, the Ministry of Health and Social Development decided to vaccinate adults under compulsory medical insurance, but not everyone takes advantage of this opportunity. After all, the statistics are reassuring: if previously up to 2 million diseases were registered per year, now this figure has dropped to dozens of cases.

However, today there is a lot of measles in China, Ukraine, France - from there some undervaccinated adults bring it. If unvaccinated children (under the age of 1 year) get measles, the cause is always infection from an adult who caught the virus somewhere abroad.

Complications of measles

Maternal antibodies to measles remain in the blood of infants for up to a year - if, of course, the mother had measles or was vaccinated against it. Children over one year old, as a rule, do not get sick because they are vaccinated. But adults, if they have not received the required two vaccinations in their lives, receive the full benefit. Not only does the disease tend to take longer and be more severe, but the most serious complications occur in people over 20 years of age. Measles leads to complications in 30% of cases, and here are their main types: pneumonia, otitis media and other bacterial infections; encephalitis – in 1 case per 1000; in 1 case per 100,000 - subacute sclerosing panencephalitis, which develops years after the disease, causes seizures, personality degradation and ultimately death.

Chicken pox

Unlike measles, we do not vaccinate against chickenpox for free in our country, since the vaccine is very expensive - about 1000 rubles. But we strongly recommend spending money on this vaccination.

Important!

Zelenka does not cure chickenpox, but it disinfects the blisters and prevents bacterial infection from penetrating through them. In addition, brilliant green helps doctors determine whether a child is contagious or no longer contagious. If there are no new rashes not treated with brilliant green, then the child is not contagious. Unlike measles, chickenpox is quite common in Russia today. About 800 thousand diseases are registered annually. Moreover, chickenpox is also gradually maturing.

Previously, the settlement was more crowded: many lived in barracks or in communal apartments. Therefore, all children suffered from chickenpox at the same time and at an early age. As social conditions improve, the infection spreads worse: most city residents live in separate apartments, many children do not go to kindergartens and are raised at home. Therefore, the statistics are as follows: approximately 1.5 million children are born in Russia every year, and 800 thousand of them suffer from chickenpox.

Thus, about 20% of young people are still defenseless against chickenpox. Therefore, the issue of vaccination is very acute. Experts who recommend chickenpox vaccination fear an impending epidemic of chickenpox in adults. Already now, in hospitals, most of the seriously ill patients with chickenpox are adults.

Chickenpox, like measles, is more severe in adults and produces about forty times more complications than in children. At the same time, complications include a large percentage of diseases such as pneumonia and encephalitis, which in 5% of cases lead to death.

Pharaoh's chickenpox

Despite the fact that “childhood” viruses survive very poorly outside the human body, their history goes back several thousand years. Scientists have even found traces of some viruses in the tombs of the Egyptian pyramids. Now, in the age of high technology and globalization, infections have received a new chance to develop: if previously an infected person could not leave their habitat, now there is no problem! For example, thanks to vaccination, measles has been virtually eliminated in Russia. But she successfully lives and thrives in China, France and Ukraine. Therefore, measles returns to us along with infected travelers.