Measles Outbreak in Macedonia: A 4 Year Old Girl with Varicella and Measles Infection One after Another

Backgrounds: Varicella is a highly contagious disease caused by varicella-zoster virus. Most commonly, virus is affecting children, teens and young adults. Incubation period is usually 14 days. Varicella-zoster virus enters in the body through the respiratory system.

Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10-12 days after exposure to an infected person and last 7-10 days. Measles virus spreads easily through the coughs and sneezes of infected people.

Varicella and measles are important infectious diseases because they can cause severe complication even death in young children under one year.

Methods: A 4 year old girl came on exam four weeks after the onset of the varicella rash. She came with high fever over 40C, caught, vomitus and decreased appetite. Physical examination shown signs of pharyngitis. Blood test showed normal leucocytes and high elevated CRP. After 5 days of antibiotic therapy, she came on exam, still febrile over 39-40C, with drowsiness and decreased appetite. Second laboratory findings revealed normal leucocytes and reduced value of CRP. Two days after, she was hospitalised, still febrile, dehydrated, with drowsiness and presence of red maculopapular rash in the body, starting from the head through the corps. Girl wasn`t immunised with MMR vaccine.

Results: First laboratory findings revealed leucocytes 5,4x109/l (Ne69%,Ly24%), CRP 96mg/d (6). Second laboratory findings revealed leucocytes 4,0x109/l (Ne58%,Ly35%), CRP 24mg/dl (6). Test for Measles (IgM positive) confirmed the disease.

Conclusions: Varicella and measles are highly contagious infectious diseases. They are diseases that cause a big decline in immune system and can cause severe complications. Also, they are diseases that can be prevented by a vaccine. Therefore, it is recommended regular immunisation per calendar to prevent the occurrence of the diseases as well as to reduce the complications and mortality from these diseases, especially from the measles.