3C Fever to Scaly Rash, Recognize the Three Stages of Measles Symptoms to Watch Out for

JAKARTA - The Chairman of the Indonesian Pediatric Association (IDAI) West Java, Anggraini Alam, reminded parents to be aware of the three stages of measles symptoms that often appear in children.

In a media seminar which was attended online from Jakarta, recently, he explained that this disease has a typical clinical pattern and is easy to recognize if understood well.

According to him, the first stage is the prodromal stage or the initial phase. At this stage, children usually experience high fever accompanied by symptoms known as "3C", namely coryza (cold), cough (cough), and conjunctivitis (red eyes).

"It starts to hurt, the fever goes up high, there are 3C coryza, conjunctivitis, typical cough, this is 3 to 5 days. If the doctor will check whether there are koplik's spots before the appearance of the typical rash of measles," said Prof. Anggraini. Koplik's spot itself is a small white spot in the oral cavity that is an early marker before the rash appears.

After the prodromal phase, the patient enters the eruption stage. This stage is characterized by the appearance of a reddish rash on the skin that spreads gradually. He explained that measles is often referred to as the first disease because of the pattern of the rash's spread, which is usually starting from the area around the hairline or behind the ear, then spreading to the face, trunk, to the arms and legs.

The last stage is the convalescent stage or recovery period. At this stage, the rash changes color to darker, then dries and peels off until it looks scaly. "Characteristic of measles in the convalescent stage, he changes the more he collects the rash, darkens, then disappears with a scaly appearance," he explained.

He also emphasized that measles is a disease that is very easy to spread because it is spread through the air (airborne), not just direct contact. The virus can spread through coughing, sneezing, even when talking, and can survive in the air for more than two hours. Dense, humid, and poorly ventilated environments increase the risk of transmission.

"So the transmission of measles is not a joke. It is similar to tuberculosis, imagine from one it can be 18," he said.

The incubation period of the measles virus can last up to three weeks. During this period, the virus is already in the body but has not caused symptoms, so the sufferer often does not realize that he is infected. Symptoms generally appear in the form of fever, followed by a rash a few days later. A person is no longer contagious after the rash dries and darkens.

Measles is known to have a very high transmission rate. To prevent extraordinary events (KLB), herd immunity coverage of at least 94 percent is required in an area. If the immunization rate is below this threshold, the risk of an outbreak will increase.

"Because in order not to have KLB, we need people around us to be protected by immunity against measles. Once vaccinated against measles, it is said to prevent measles with a wide range, 84 to 93 percent," he explained.

Prof Anggraini added, the government has set a schedule for measles immunization as many as three times, namely when the child is 9 months old, 18 months old, and when sitting in the 1st grade of elementary school. The measles vaccine is a live attenuated vaccine so it requires repeated administration according to the schedule so that optimal antibodies are formed.

"Try to make sure that every toddler is fully immunized before entering PAUD, let's catch up if it's late. One measles can spread anywhere," he reminded.