About measles (chopsticks or Measles), rubella (German Measles (Rubella))
Report method of rubella changed from January 1, 2018! (PDF file opens when we click figure)
◎ To all of medical institutions
(PDF file 226KB)
When doctor diagnoses measles and rubella, based on "law about medical care for the patients with prevention of infectious disease and infectious disease," we are to report to the nearest public health center for less than 24 hours.
In addition, we are to have you report to public health center immediately when patient that measles and rubella are doubted even if it does not lead to diagnosis has a medical examination.
When there are reports, we investigate for prevention of infection spread quickly.
Please refer to this for contact information of flow of report and each ward Health and Welfare Center.
※ About conduct of examination of measles, rubella diagnosis in Yokohama-shi (flow) <January, 2018 revised edition> (PDF file 261KB)
◎ Let's be careful about the fashion in foreign countries
There was outbreak of patients with several measles from July through August in office in Chiba prefecture and Kansai Airport of Osaka in 2016.
Outbreak of measles continues abroad in Southeast Asia or Europe.
Measles develops in person who made a voyage to Southeast Asia after returning home, and, after January, 2017, examples to develop in the patient and person whom it touched in the country occur successively.
We catch measles by air infection, droplet infection and contact infection, and the following symptoms develop.
You wear mask, and please have a medical examination after calling, and having contacted medical institution beforehand by all means when we have suspicious symptom.
| <symptom of measles>
１．Fever more than 38 degrees Celsius
２．Cough, nasal mucus, conjunctival hyperemia
３．Red rash (bleatingly) of whole body
※If all 1-3 appears, measles is doubted.
※Particularly, one with a history of travel to foreign countries requires attention.
◎ March 27, 2015 measles exclusion country authorization!
Japan was recognized as "measles exclusion country" by the World Health Organization west Pacific secretariat.
But measles was not gone at all, and import example from foreign countries is seen, too, and there is report in Yokohama-shi. (about the number of the outbreak as for the details this "all quantity information (3-5 kinds infectious disease)")
Measles is infectious disease caused by measles virus.
Infection power is very strong, and immunity develops approximately 100% when person not to have infects. Severe complications develop and may be life-threatening.
We do not know when measles virus is brought in from foreign countries even if removed in Japan. It is important that each one has immunity.
Measles is not past disease! Let's be vaccinated to prevent measles!
What is measles?
Infection power is strong, and approximately 100% develop when person without antibody is infected. There is not special cure and may need hospitalization without complications and is heavy disease to take time before recovery.
- Measles is infection with measles virus. After the incubation period of approximately 10-12 days, heat and cough, symptom such as a cold including mucus come out when infected. High heat more than 38 degrees Celsius and red rash (bleatingly) of whole body develop for a few days when we do. White spot (Koplik spot) may be given to front and back where rash appears inside of cheeks.
- Without complications, main symptom is almost restored in 7-10 days, but rash becomes brown and stays for a while.
- Attention is necessary so that immunity decreases temporarily, and, meanwhile, reason does not suffer from other infectious diseases when we suffer from measles when we suffer for around one month before we recover.
Infection course of measles
We are infected by droplet infection, air infection, contact infection.
- We make infection (droplet infection and air infection) by breathing in air including measles virus including cough and sneezing. We may do contact infection.
- It is disease that infection is strong at all to be said to be when person of the circumference does not have immunity of measles when 12-14 people (for influenza 1-2) infect from one patient. When person without immunity is infected, approximately 100% develop.
- There is power to transmit to person of the circumference after the rash appearance until 4-5 days (after or defervescing 3rd) from one day ago (3-5 days ago of rash appearance) when symptoms such as heat or cough develop.
Complications of scary measles
We may be sometimes life-threatening when we develop complications. Complications are said to be complicated in approximately 30% of the whole. Of these, pneumonia and encephalitis become big cause of dying due to measles.
- Pneumonia…We occupy about half of complications, and, in the case of pneumonia due to measles virus, there are cases of pneumonia by bacteria.
- Encephalitis…It is merged in the ratio of approximately 0.5-1 of 1,000 patients. Approximately 60% completely recover, but we have aftereffects of the central nervous system for 20-40%, and case fatality rate is said to be approximately 15%.
- Subacute sclerosing panencephalitis (SSPE)…It is extremely rare (one of 100,000), but time passes 7-10 years after suffering from measles, and ttekara develops. Intelligence disorder, motor deficit gradually progress and are mortal disease from the onset in mean 6-9 months.
- In addition, it may merge otitis media (approximately 5-15%), croup syndrome (laryngitis, laryngopharynx bronchitis), myocarditis.
Why don't you come into contact with patients with measles?
* We measure temperature with patients with measles every day last for two weeks (up to three weeks) from day when we had contact, and let's observe health. When symptom such as measles appears, we inform medical institution of next beforehand, and let's have a medical examination according to instructions of medical institution by any chance.
- We convey symptom to medical institution over telephones before consultation.
"We had a fever from ● moon ● day, and blister appeared in whole body from ● day." to
- We talk about having had contact with patients with measles.
"We came into contact with patients with measles on ● moon ● day." to
- We confirm consultation method to medical institution.
"When should we have a medical examination where in hospital?" to
※ As we may transmit to other patients at the time of family and hospital consultation,
You note the precaution mentioned above, and you wear mask, and please have a medical examination to hospital.
We must take measures of measles…?
* It came to be demanded recently that we were vaccinated when it varied.
- When we participate in verge and club activities of entrance into a school of higher grade to university, we are vaccinated, or it becomes often demanded from cases to travel to foreign countries that we prove that antibodies (resistance) of measles are enough. Particularly, it is demanded that cases to enter overseas school confirm what they inoculate two times of Vaccinations into.
- We can receive blood test (examination for antibody titer) to check whether there is antibody of measles with medical institution (own expense).
- It is demanded from medical care and the welfare, education, immunity taking work that often contacts with weak or child including childcare relations that we vaccinate so that it is in the source of infection, and oneself does not open measles. In some companies, there is place to confirm Vaccinations career in the case of employment.
* When the patients with measles occur, there is such a thing, too. It is important to prevent not to suffer from measles.
- The patients with measles appeared at school, but after carrying out event (graduation ceremony or school excursion) on schedule, person who suffered from many measles appeared.
- When one suffered from measles, it developed in family in sequence, too.
※ Measles is very strong in infection power and may provide many infected people from patient of only one.
We can prevent infection and the onset, aggravation if vaccinated.
- It turned out that we suffered from measles during overseas travel, and we were isolated by local hospital. Person who attended, and went to hospital was isolated equally. In addition, all the suspected people who came into contact with patient received blood test to check whether there was antibody of measles. Therefore, returning home was postponed.
※ Endemic area of measles still exists abroad.
We confirm infectious disease fashion information of travel and, before travel, are vaccinated, or what there is antibody of measles or checks is necessary.
As for the rubella that raged, the fashion was not completely settled!
What is rubella?
It is fever, rash, infection with rubella virus characterized by lymphadenopathy. After the incubation period of approximately 14-21 days (an average of 16-18 days), symptom comes out.
It is disease favorable, but hospitalization may be necessary by complications such as arthralgia, joint pain, thrombocytopenic purpura or acute encephalitis basically.
Congenital rubella syndrome
When pregnant woman is infected with rubella virus in the pregnancy first half of the year, fetus is infected and, therefore, says obstacle to happen to child born with congenital rubella syndrome (congenital rubella syndrome: CRS).
Cataract, heart trouble, hearing loss (3 main symptoms) are seen.
- As there is subclinical infection not to appear of subjective symptoms around 15% even as for the adult in the case of rubella even if infected, CRS may occur even if mother is asymptomatic for the pregnancy period.
- Baby of congenital rubella syndrome lasts for long term (more than one year) after birth, and discharge of pharynx and rubella virus to urine may continue. Attention is necessary as the source of infection.
To prevent measles, rubella?
We can turn on immunity to measles, rubella by being vaccinated.
Applicable one can receive inoculation as routine immunization free next.
We confirm age and inoculation period, and let's receive inoculation.
- (the first) Please receive inoculation of measles, rubella mixture (MR) vaccine as soon as you became 1 year old.
- (the second) During one year before elementary school entrance to school, please be vaccinated for the second.
For more details, please see page of Vaccinations.
Approach of Yokohama-shi
For measles, rubella destruction, we are doing various approaches in Yokohama-shi.
- We carry out Vaccinations and examination of rubella of antibody
- Enlightenment of Vaccinations
- Virus genetic test of patients with measles
→Past test result is this
- Nine capital prefecture city rubella measures person in charge meeting
→About nine capital prefecture city combination rubella business the detailsThis
- Conduct (September 4, 2014) of congenital rubella syndrome workshop
- Negative conversion confirmation of CRS child
Achievement of 2015 measles exclusion!
As a result of devising "specific infectious disease prevention guideline about measles" in Ministry of Health, Labour and Welfare in 2008, and having strengthened measles measures, we received authorization of measles exclusion country. (reference: press release document (Ministry of Health, Labour and Welfare))
In Yokohama-shi, we revise "Yokohama-shi measles exclusion strategy" (PDF) in 2013 and carry out measures for measles exclusion. We will maintain state of measles exclusion in future.
For 2020 rubella exclusion!
"Specific infectious disease prevention guideline about rubella" is enforced in Ministry of Health, Labour and Welfare in April, 2014 and aims for rubella exclusion until 2020 in that.
We receive this and devise "Yokohama-shi rubella exclusion strategy" (PDF) in Yokohama-shi and strengthen measures for rubella exclusion.
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