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92-415: One sunny day, a young boy named Jo-kang meets a curious young girl dressed in a bright yellow raincoat. She tells everyone in school that she is an alien and whomever she touches will be harmed. Everyone in that school becomes afraid of her, except Jo-kang. Jo-kang befriends the girl, Ari, and falls instantly in love with her. The quirky Ari loves telling Jo-kang stories, and he believes everything she says and

184-422: A stem cell transplant , alkylating agents , or corticosteroid therapy , regardless of immunization status; travel to areas where measles commonly occurs or contact with travelers from such an area; and the loss of passive, inherited antibodies before the age of routine immunization. Once the measles virus gets onto the mucosa , it infects the epithelial cells in the trachea or bronchi. Measles virus uses

276-582: A billion people. Vaccination rates have been high enough to make measles relatively uncommon. Adverse reactions to vaccination are rare, with fever and pain at the injection site being the most common. Life-threatening adverse reactions occur in less than one per million vaccinations (<0.0001%). In developing countries where measles is common , the World Health Organization (WHO) recommends two doses of vaccine be given, at six and nine months of age. The vaccine should be given whether

368-453: A correlation between children who take aspirin and the development of Reye syndrome . The use of vitamin A during treatment is recommended to decrease the risk of blindness; however, it does not prevent or cure the disease. A systematic review of trials into its use found no reduction in overall mortality, but two doses (200,000 IU ) of vitamin A was shown to reduce mortality for measles in children younger than two years of age. It

460-441: A decrease in immunization. Symptoms typically begin 10–14 days after exposure. The classic symptoms include a four-day fever (the four Ds) and the three Cs— cough , coryza (head cold, fever, sneezing), and conjunctivitis (red eyes)—along with a maculopapular rash . Fever is common and typically lasts for about one week; the fever seen with measles is often as high as 40 °C (104 °F). Koplik's spots seen inside

552-442: A few weeks. A fever, sore throat, and fatigue may also occur. Joint pain is common in adults. Complications may include bleeding problems, testicular swelling , encephalitis, and inflammation of nerves . Infection during early pregnancy may result in a miscarriage or a child born with congenital rubella syndrome (CRS). Symptoms of CRS manifest as problems with the eyes such as cataracts , deafness , as well as affecting

644-754: A form of modified measles. Modified measles is characterized by a prolonged incubation period , milder, and less characteristic symptoms (sparse and discrete rash of short duration). Complications of measles are relatively common, ranging from mild ones such as diarrhea to serious ones such as pneumonia (either direct viral pneumonia or secondary bacterial pneumonia ), laryngotracheobronchitis (croup) (either direct viral laryngotracheobronchitis or secondary bacterial bronchitis), otitis media , acute brain inflammation , corneal ulceration (leading to corneal scarring ), and in about 1 in 600 unvaccinated infants under 15 months while more rarely in older children and adults, subacute sclerosing panencephalitis , which

736-474: A grassy lawn where she explains that crop circles are signs left by a UFO. Later that night, Ari falls sick and is admitted back to the hospital. Jo-kang stands outside the hospital, getting wet in the rain. But when Ari's uncle tells him to come inside, Jo-kang replies that he's obeying Ari's instruction not to cross her line on the ground. Jo draws designs on the grassy lawn, and takes Ari there against doctor's orders, telling her to fulfill her destiny to leave

828-691: A measles outbreak in the German capital of Berlin resulted in at least 782 cases. In 2017, numbers continued to increase in Europe to 21,315 cases, with 35 deaths. In preliminary figures for 2018, reported cases in the region increased 3-fold to 82,596 in 47 countries, with 72 deaths; Ukraine had the most cases (53,218), with the highest incidence rates being in Ukraine (1209 cases per million), Serbia (579), Georgia (564) and Albania (500). The previous year (2017) saw an estimated measles vaccine coverage of 95% for

920-412: A newly made virus. Within days, the measles virus spreads through local tissue and is picked up by dendritic cells and alveolar macrophages , and carried from that local tissue in the lungs to the local lymph nodes. From there it continues to spread, eventually getting into the blood and spreading to more lung tissue, as well as other organs like the intestines and the brain. Functional impairment of

1012-457: A patient. Filled with pain and confusion, Jo-kang visits Ari's uncle, a monk, and pours gasoline on himself, threatening to set himself on fire unless he learns the truth. He discovers that Ari is suffering from HIV/AIDS that was accidentally transmitted to her at a hospital where she was taken after an accident that caused the death of her father. Jo-kang goes to an exhibit where Ari's photographs are displayed, and afterwards he piggybacks her to

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1104-448: A population is vaccinated, more women may reach childbearing age without developing immunity by infection or vaccination, thus possibly raising CRS rates. Once infected there is no specific treatment. Rubella is a common infection in many areas of the world. Each year about 100,000 cases of congenital rubella syndrome occur. Rates of disease have decreased in many areas as a result of vaccination. There are ongoing efforts to eliminate

1196-414: A protein on its surface called hemagglutinin (H protein), to bind to a target receptor on the host cell, which could be CD46 , which is expressed on all nucleated human cells, CD150 , aka signaling lymphocyte activation molecule or SLAM, which is found on immune cells like B or T cells, and antigen-presenting cells, or nectin-4 , a cellular adhesion molecule. Once bound, the fusion, or F protein helps

1288-473: A second dose of the MMR vaccine is given, it will provide immunity in 99% of children. There is no evidence that the measles vaccine virus can be transmitted to other persons. There is no specific antiviral treatment if measles develops. Instead the medications are generally aimed at treating superinfections, maintaining good hydration with adequate fluids, and pain relief. Some groups, like young children and

1380-412: A short time after, the characteristic rash confirms the diagnosis. Rubella infections are prevented by active immunization programs using live attenuated virus vaccines . Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease. However, their use in prepubertal females did not produce a significant fall in the overall incidence rate of CRS in

1472-439: A surprise the next morning. She kisses him and Jo-kang catches the flu . Then Ari disappears once more, leaving Jo-kang devastated. Jo-kang becomes an adult, and one day Ari appears again in front of him and tells him to come with her. At first he ties her leg to a chair with shoelaces so she can't get away. Later that evening at his home, Ari explains to Jo-kang's father, a sushi chef, that people from NASA kidnapped her since

1564-445: A temple on a mountain that's actually a volcano, and that hot springs surround it. Jo-kang believes her when she tells him that her English got better after she was given lessons by an English ghost who visits her when she's naked. She also tells him that she plans to marry a banker so that she'll be able to rob his bank and leave the planet. Jo-kang travels all night to bring Ari her favorite dish from his home, presenting it to her as

1656-445: A week and the fever rarely rises above 38 °C (100.4 °F). The rash of rubella is typically pink or light red. The rash causes itching and often lasts for about three days. The rash disappears after a few days with no staining or peeling of the skin. When the rash clears up, the skin might shed in very small flakes where the rash covered it. Forchheimer spots occur in 20% of cases and are characterized by small, red papules on

1748-410: A year, primarily in the developing areas of Africa and Asia. It is one of the leading vaccine-preventable disease causes of death. In 1980, 2.6 million people died from measles, and in 1990, 545,000 died due to the disease; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000. Despite these trends, rates of disease and deaths increased from 2017 to 2019 due to

1840-772: A year. However, a 2007 outbreak in Argentina , Brazil , and Chile pushed the cases to 13,000 that year. On January 22, 2014, the World Health Organization (WHO) and the Pan American Health Organization declared and certified Colombia free of rubella and became the first Latin American country to eliminate the disease within its borders. On April 29, 2015, the Americas became the first WHO region to officially eradicate

1932-586: Is a highly contagious, vaccine-preventable infectious disease caused by measles virus . Other names include morbilli , rubeola , red measles , and English measles . Both rubella , also known as German measles , and roseola are different diseases caused by unrelated viruses. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever , often greater than 40 °C (104 °F), cough, runny nose , and inflamed eyes . Small white spots known as Koplik's spots may form inside

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2024-615: Is also recommended for children. Among cases reported in the U.S. between 1985 and 1992, death occurred in only 0.2% of cases, but may be up to 10% in people with malnutrition . Most of those who die from the infection are less than five years old. The measles vaccine is effective at preventing the disease, is exceptionally safe, and is often delivered in combination with other vaccines. Vaccination resulted in an 80% decrease in deaths from measles between 2000 and 2017, with about 85% of children worldwide having received their first dose as of 2017. Measles affects about 20 million people

2116-400: Is an infection caused by the rubella virus . This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days. It usually starts on the face and spreads to the rest of the body. The rash is sometimes itchy and is not as bright as that of measles . Swollen lymph nodes are common and may last

2208-466: Is available that can verify immunity. Diagnosis is confirmed by finding the virus in the blood, throat, or urine. Testing the blood for antibodies may also be useful. Rubella is preventable with the rubella vaccine with a single dose being more than 95% effective. Often it is given in combination with the measles vaccine and mumps vaccine , known as the MMR vaccine . When some, but less than 80%, of

2300-433: Is caused by the measles virus , a single-stranded, negative-sense , enveloped RNA virus of the genus Morbillivirus within the family Paramyxoviridae . The virus is highly contagious and is spread by coughing and sneezing via close personal contact or direct contact with secretions. Measles is the most contagious virus known. It remains infective for up to two hours in that airspace or nearby surfaces. Measles

2392-602: Is classically described as a generalized red maculopapular rash that begins several days after the fever starts. It starts on the back of the ears and, after a few hours, spreads to the head and neck before spreading to cover most of the body. The measles rash appears two to four days after the initial symptoms and lasts for up to eight days. The rash is said to "stain", changing color from red to dark brown, before disappearing. Overall, measles usually resolves after about three weeks. People who have been vaccinated against measles but have incomplete protective immunity may experience

2484-435: Is extremely infectious and its continued circulation in a community depends on the generation of susceptible hosts by birth of children. In communities that generate insufficient new hosts the disease will die out. This concept was first recognized in measles by Bartlett in 1957, who referred to the minimum number supporting measles as the critical community size (CCS). Analysis of outbreaks in island communities suggested that

2576-494: Is important for public health efforts. Measles is not known to occur in other animals. Once a person has become infected, no specific treatment is available, although supportive care may improve outcomes. Such care may include oral rehydration solution (slightly sweet and salty fluids), healthy food, and medications to control the fever. Antibiotics should be prescribed if secondary bacterial infections such as ear infections or pneumonia occur. Vitamin A supplementation

2668-455: Is included in the TORCH complex of perinatal infections. About 100,000 cases of this condition occur each year. The disease is caused by the rubella virus, in the genus Rubivirus from the family Matonaviridae, that is enveloped and has a single-stranded RNA genome. The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes . The virus is found in

2760-451: Is not ideal, as saliva contains many other fluids and proteins which may make it difficult to collect samples and detect measles antibodies. Saliva also contains 800 times fewer antibodies than blood samples do, which makes salivary testing additionally difficult. Positive contact with other people known to have measles adds evidence to the diagnosis. Mothers who are immune to measles pass antibodies to their children while they are still in

2852-796: Is progressive and eventually lethal. In addition, measles can suppress the immune system for weeks to months, and this can contribute to bacterial superinfections such as otitis media and bacterial pneumonia. Two months after recovery there is a 11–73% decrease in the number of antibodies against other bacteria and viruses. The death rate in the 1920s was around 30% for measles pneumonia. People who are at high risk for complications are infants and children aged less than 5 years; adults aged over 20 years; pregnant women; people with compromised immune systems, such as from leukemia , HIV infection or innate immunodeficiency; and those who are malnourished or have vitamin A deficiency . Complications are usually more severe in adults. Between 1987 and 2000,

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2944-443: Is recommended that all susceptible non-pregnant women of childbearing age should be offered rubella vaccination. Due to concerns about possible teratogenicity, use of MMR vaccine is not recommended during pregnancy. Instead, susceptible pregnant women should be vaccinated as soon as possible in the postpartum period . In susceptible people passive immunization , in the form of polyclonal immunoglobulins , appears effective up to

3036-462: Is recommended that children be immunized against measles at 12 months, generally as part of a three-part MMR vaccine (measles, mumps , and rubella ). The vaccine is generally not given before this age because such infants respond inadequately to the vaccine due to an immature immune system. A second dose of the vaccine is usually given to children between the ages of four and five, to increase rates of immunity. Measles vaccines have been given to over

3128-479: Is so contagious that if one person has it, 90% of non-immune people who have close contact with them (e.g., household members) will also become infected. Humans are the only natural hosts of the virus, and no other animal reservoirs are known to exist, although mountain gorillas are believed to be susceptible to the disease. Risk factors for measles virus infection include immunodeficiency caused by HIV/AIDS , immunosuppression following receipt of an organ or

3220-415: Is some indication that HLA-A1 or factors surrounding A1 on extended haplotypes are involved in virus infection or non-resolution of the disease. Rubella virus specific IgM antibodies are present in people recently infected by rubella virus, but these antibodies can persist for over a year, and a positive test result needs to be interpreted with caution. The presence of these antibodies along with, or

3312-480: Is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days, which is why it is often referred to as three-day measles. The facial rash usually clears as it spreads to other parts of the body. Other symptoms include low-grade fever, swollen glands (sub-occipital and posterior cervical lymphadenopathy ), joint pains , headache , and conjunctivitis . The swollen glands or lymph nodes can persist for up to

3404-446: Is the most common fatal complication of measles infection and accounts for 56–86% of measles-related deaths. Possible consequences of measles virus infection include laryngotracheobronchitis , sensorineural hearing loss , and—in about 1 in 10,000 to 1 in 300,000 cases — panencephalitis , which is usually fatal. Acute measles encephalitis is another serious risk of measles virus infection. It typically occurs two days to one week after

3496-442: Is unclear if zinc supplementation in children with measles affects outcomes as it has not been sufficiently studied. There are no adequate studies on whether Chinese medicinal herbs are effective. Most people survive measles, though in some cases, complications may occur. About 1 in 4 individuals will be hospitalized and 1–2 in 1,000 will die. Complications are more likely in children under age 5 and adults over age 20. Pneumonia

3588-414: Is willing to do anything for her. After he and Ari huddle together beneath her yellow raincoat one rainy day, Jo-kang becomes sick with measles . Soon afterwards, she disappears. Ten years later, Ari contacts Jo-kang, now in high school, and asks to meet again. Although they have not seen each other in a decade, they have a wonderful time together, and their love begins anew. Ari tells him that she lives at

3680-965: The American Red Cross , the United States CDC , the United Nations Foundation , UNICEF and the WHO. Globally, measles fell 60% from an estimated 873,000 deaths in 1999 to 345,000 in 2005. Estimates for 2008 indicate deaths fell further to 164,000 globally, with 77% of the remaining measles deaths in 2008 occurring within the Southeast Asian region. There were 142,300 measles related deaths globally in 2018, of which most cases were reported from African and eastern Mediterranean regions. These estimates were slightly higher than that of 2017, when 124,000 deaths were reported due to measles infection globally. In 2000,

3772-504: The magnetic force in her body attracts the UFOs . Jo-kang makes plans for the next day, but Ari tells him that she is leaving for the States. Upon leaving, Ari reminds Jo-kang not to cross the line she drew on the ground, something she constantly told him in their childhood. One of Jo-kang's friends gets into an accident and when Jo-kang visits his friend at the hospital, he sees Ari there as

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3864-422: The molecular structure of rubella was observed under electron microscopy using antigen-antibody complexes by Jennifer M. Best, June Almeida , J E Banatvala and A P Waterson. In 1969, a live attenuated virus vaccine was licensed. In the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced. By 2006, confirmed cases in the Americas had dropped below 3000

3956-472: The reverse transcription polymerase chain reaction assay. This method is particularly useful to confirm cases when the IgM antibodies results are inconclusive. For people unable to have their blood drawn , saliva can be collected for salivary measles-specific IgA testing. Salivary tests used to diagnose measles involve collecting a saliva sample and testing for the presence of measles antibodies. This method

4048-614: The Americas and Europe. In Japan , 15,000 cases of rubella and 43 cases of congenital rubella syndrome were reported to the National Epidemiological Surveillance of Infectious Diseases between October 15, 2012, and March 2, 2014, during the 2012–13 rubella outbreak in Japan. They mainly occurred in men aged 31–51 and young adults aged 24–34. Rubella was first described in the mid-eighteenth century. German physician and chemist, Friedrich Hoffmann , made

4140-617: The Americas drop. During the epidemic in the US between 1962 and 1965 , rubella virus infections during pregnancy were estimated to have caused 30,000 stillbirths and 20,000 children to be born impaired or disabled as a result of CRS. Universal immunisation producing a high level of herd immunity is important in the control of epidemics of rubella. In the UK , there remains a large population of men susceptible to rubella who have not been vaccinated. Outbreaks of rubella occurred amongst many young men in

4232-469: The CCS for measles is around 250,000. To achieve herd immunity , more than 95% of the community must be vaccinated due to the ease with which measles is transmitted from person to person. In 2011, the WHO estimated that 158,000 deaths were caused by measles. This is down from 630,000 deaths in 1990. As of 2018, measles remains a leading cause of vaccine-preventable deaths in the world. In developed countries

4324-487: The Mother , in 1941. He described a variety of problems now known as congenital rubella syndrome (CRS) and noticed that the earlier the mother was infected, the worse the damage was. Since no vaccine was yet available, some popular magazines promoted the idea of "German measles parties" for infected children to spread the disease to other children (especially girls) to immunize them for life and protect them from later catching

4416-574: The UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and were susceptible. Outbreaks still arise, usually in developing countries where the vaccine is not as accessible. The complications encountered in pregnancy from rubella infection (miscarriage, fetal death, congenital rubella syndrome) are more common in Africa and Southeast Asia at a rate of 121 per 100,000 live births compared to 2 per 100,000 live births in

4508-498: The UK. Reductions were only achieved by immunisation of all children. The vaccine is now usually given as part of the MMR vaccine . The WHO recommends the first dose be given at 12 to 18 months of age with a second dose at 36 months. Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus. The immunisation program has been quite successful. Cuba declared

4600-640: The United States and 3–5 years in Europe , mostly affecting children in the 5–9 year old age group. Since the introduction of vaccine, occurrences have become rare in those countries with high uptake rates. Vaccination has interrupted the transmission of rubella in the Americas : no endemic case has been observed since February 2009. Vaccination is still strongly recommended as the virus could be reintroduced from other continents should vaccination rates in

4692-467: The WHO established the Global Measles and Rubella Laboratory Network (GMRLN) to provide laboratory surveillance for measles, rubella , and congenital rubella syndrome . Data from 2016 to 2018 show that the most frequently detected measles virus genotypes are decreasing, suggesting that increasing global population immunity has decreased the number of chains of transmission. Cases reported in

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4784-420: The WHO. In November 2024, the WHO and CDC reported that that measles cases increased by 20% last year, primarily due to insufficient vaccine coverage in the world’s poorest and conflict-affected regions. Nearly half of the major outbreaks occurred in Africa, where deaths rose by 37%, the agencies noted. In 2023, approximately 10.3 million cases of the highly contagious disease were reported, up from 8.65 million

4876-497: The age of 5 years. In February 2024, the World Health Organization said more than half of the world was at risk of a measles outbreak due to Covid-19 pandemic-related disruptions in that month. All the world regions have reported such outbreaks with the exception of the Americas , though these could still be expected to become hotspots in the future. Death rates during the outbreaks tend to be higher among poorer countries but middle income nations are also heavily impacted, according to

4968-589: The area of the soft palate . Rubella can affect anyone of any age. Adult females are particularly prone to arthritis and joint pains. In children, rubella normally causes symptoms that last two days and include: In older children and adults, additional symptoms may be present, including Severe complications of rubella include: Coryza in rubella may convert to pneumonia , either direct viral pneumonia or secondary bacterial pneumonia , and bronchitis (either viral bronchitis or secondary bacterial bronchitis). Rubella can cause congenital rubella syndrome in

5060-449: The blood 5 to 7 days after infection and spreads throughout the body. The virus has teratogenic properties and is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them. During this incubation period, the patient is contagious typically for about one week before he/she develops a rash and for about one week thereafter. Increased susceptibility to infection might be inherited as there

5152-448: The brain may occur. Measles is an airborne disease which spreads easily from one person to the next through the coughs and sneezes of infected people. It may also be spread through direct contact with mouth or nasal secretions . It is extremely contagious: nine out of ten people who are not immune and share living space with an infected person will be infected. Furthermore, measles's reproductive number estimates vary beyond

5244-702: The case fatality rate across the United States was three deaths per 1,000 cases attributable to measles, or 0.3%. In underdeveloped nations with high rates of malnutrition and poor healthcare , fatality rates have been as high as 28%. In immunocompromised persons (e.g., people with AIDS ) the fatality rate is approximately 30%. Even in previously healthy children, measles can cause serious illness requiring hospitalization. One out of every 1,000 measles cases progresses to acute encephalitis , which often results in permanent brain damage. One to three out of every 1,000 children who become infected with measles will die from respiratory and neurological complications. Measles

5336-474: The child is HIV-infected or not. The vaccine is less effective in HIV-infected infants than in the general population, but early treatment with antiretroviral drugs can increase its effectiveness. Measles vaccination programs are often used to deliver other child health interventions as well, such as bed nets to protect against malaria , antiparasite medicine and vitamin A supplements, and so contribute to

5428-709: The common name of "German measles." Henry Veale, an English Royal Artillery surgeon, described an outbreak in India. He coined the name "rubella" (from the Latin word, meaning "little red") in 1866. It was formally recognised as an individual entity in 1881, at the International Congress of Medicine in London . In 1914, Alfred Fabian Hess theorised that rubella was caused by a virus, based on work with monkeys. In 1938, Hiro and Tosaka confirmed this by passing

5520-530: The day that they will meet each other again. Cho Seung-woo and Kang Hye-jung were a real-life couple when Love Phobia was filmed and released, but despite their combined star power, the movie did not become a commercial success at the box office, receiving a total of 397,913 admissions. The Korea Times review praised Jo and Kang's acting, but called the film "a standard melodrama." Measles Measles (probably from Middle Dutch or Middle High German masel(e) ("blemish, blood blister "))

5612-725: The disease eliminated in the 1990s, and in 2004 the Centers for Disease Control and Prevention announced that both the congenital and acquired forms of rubella had been eliminated from the United States . The World Health Organization declared Australia rubella free in October 2018. Screening for rubella susceptibility by history of vaccination or by serology is recommended in the United States for all women of childbearing age at their first preconception counseling visit to reduce incidence of congenital rubella syndrome (CRS). It

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5704-407: The disease globally. In April 2015, the World Health Organization declared the Americas free of rubella transmission. The name "rubella" is from Latin and means little red . It was first described as a separate disease by German physicians in 1814, resulting in the name "German measles". Rubella has symptoms similar to those of flu. However, the primary symptom of rubella virus infection

5796-462: The disease to children using filtered nasal washings from acute cases. In 1940, there was a widespread epidemic of rubella in Australia . Subsequently, ophthalmologist Norman McAllister Gregg found 78 cases of congenital cataracts in infants and 68 of them were born to mothers who had caught rubella in early pregnancy. Gregg published an account, Congenital Cataract Following German Measles in

5888-508: The disease was declared eliminated from the Americas in 2016. However, there were cases again in 2017, 2018, 2019, and 2020 in this region. In the United States, measles affected approximately 3,000 people per million in the 1960s before the vaccine was available. With consistent widespread childhood vaccination, this figure fell to 13 cases per million by the 1980s, and to about 1 case per million by 2000. Rubella Rubella , also known as German measles or three-day measles ,

5980-676: The disease when pregnant. The virus was isolated in tissue culture in 1962 by two separate groups led by physicians Paul Douglas Parkman and Thomas Huckle Weller . There was a pandemic of rubella between 1962 and 1965, starting in Europe and spreading to the United States. In the years 1964–65, the United States had an estimated 12.5 million rubella cases ( 1964–1965 rubella epidemic ). This led to 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. Of these, 2,100 died as neonates, 12,000 were deaf, 3,580 were blind, and 1,800 were intellectually disabled. In New York alone, CRS affected 1% of all births. In 1967,

6072-537: The disease. The last non-imported cases occurred in 2009 in Argentina and Brazil. The Pan American Health Organization director remarked, "The fight against rubella has taken more than 15 years, but it has paid off with what I believe will be one of the most important pan-American public health achievements of the 21st Century." The declaration was made after 165 million health records and genetically confirming that all recent cases were caused by known imported strains of

6164-478: The fifth day post-exposure. There is no specific treatment for rubella; however, management is a matter of responding to symptoms to diminish discomfort. Treatment of newborn babies is focused on management of the complications. Congenital heart defects and cataracts can be corrected by direct surgery. Management for ocular congenital rubella syndrome (CRS) is similar to that for age-related macular degeneration , including counseling, regular monitoring, and

6256-435: The first clinical description of rubella in 1740, which was confirmed by de Bergen in 1752 and Orlow in 1758. In 1814, George de Maton first suggested that it be considered a disease distinct from both measles and scarlet fever . All these physicians were German, and the disease was known as Rötheln (contemporary German Röteln ). ( Rötlich means "reddish" or "pink" in German.) The fact that three Germans described it led to

6348-539: The first dose and 90% for the second dose in the region, the latter figure being the highest-ever estimated second-dose coverage. In 2019, the United Kingdom, Albania, the Czech Republic, and Greece lost their measles-free status due to ongoing and prolonged spread of the disease in these countries. In the first 6 months of 2019, 90,000 cases occurred in Europe. As a result of widespread vaccination,

6440-466: The first three months of 2019, were 300% higher than in the first three months of 2018, with outbreaks in every region of the world, even in countries with high overall vaccination coverage where it spread among clusters of unvaccinated people. The numbers of reported cases as of mid-November is over 413,000 globally, with an additional 250,000 cases in DRC (as reported through their national system), similar to

6532-433: The frequently cited range of 12 to 18. The NIH quote this 2017 paper saying: "[a] review in 2017 identified feasible measles R 0 values of 3.7–203.3". People are infectious to others from four days before to four days after the start of the rash. While often regarded as a childhood illness, it can affect people of any age. Most people do not get the disease more than once. Testing for the measles virus in suspected cases

6624-463: The heart and brain. Problems are rare after the 20th week of pregnancy. Rubella is usually spread from one person to the next through the air via coughs of people who are infected. People are infectious during the week before and after the appearance of the rash. Babies with CRS may spread the virus for more than a year. Only humans are infected. Insects do not spread the disease. Once recovered, people are immune to future infections. Testing

6716-472: The immune system, which can cause deaths from other diseases. Suppression of the immune system by measles lasts about two years and has been epidemiologically implicated in up to 90% of childhood deaths in third world countries, and historically may have caused rather more deaths in the United States, the UK and Denmark than were directly caused by measles. Although the measles vaccine contains an attenuated strain, it does not deplete immune memory. Measles

6808-620: The increasing trends of infection reported in the earlier months of 2019, compared to 2018. In 2019, the total number of cases worldwide climbed to 869,770. The number of cases reported for 2020 is lower compare to 2019. According to the WHO, the COVID-19 pandemic hindered vaccination campaigns in at least 68 countries, including in countries that were experiencing outbreaks, which caused increased risk of additional cases. In 2022, there were an estimated 136,000 measles deaths globally, mostly among unvaccinated or under vaccinated children under

6900-796: The infected dendritic cells by the measles virus is thought to contribute to measles-induced immunosuppression. Typically, clinical diagnosis begins with the onset of fever and malaise about 10 days after exposure to the measles virus, followed by the emergence of cough , coryza , and conjunctivitis that worsen in severity over 4 days of appearing. Observation of Koplik's spots is also diagnostic. Other possible condition that can result in these symptoms include parvovirus , dengue fever , Kawasaki disease , and scarlet fever . Laboratory confirmation is, however, strongly recommended. Laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or detection of measles virus RNA from throat, nasal or urine specimen by using

6992-465: The main reason a vaccine for rubella was developed. 80–90% of mothers who contract rubella within the critical first trimester have either a miscarriage or a stillborn baby. If the fetus survives the infection, it can be born with severe heart disorders ( patent ductus arteriosus being the most common), blindness, deafness, or other life-threatening organ disorders. The skin manifestations are called "blueberry muffin lesions". For these reasons, rubella

7084-421: The measles rash breaks out and begins with very high fever, severe headache, convulsions and altered mentation. A person with measles encephalitis may become comatose , and death or brain injury may occur. For people having had measles, it is rare to ever have a symptomatic reinfection. The measles virus can deplete previously acquired immune memory by killing cells that make antibodies, and thus weakens

7176-606: The measles vaccine and autism ; this incorrect concern has reduced the rate of vaccination and increased the number of cases of measles where immunization rates became too low to maintain herd immunity . Additionally, there have been false claims that measles infection protects against cancer. Administration of the MMR vaccine may prevent measles after exposure to the virus (post-exposure prophylaxis). Post-exposure prophylaxis guidelines are specific to jurisdiction and population. Passive immunization against measles by an intramuscular injection of antibodies could be effective up to

7268-467: The mortality rate is lower, for example in England and Wales from 2007 to 2017 death occurred between two and three cases out of 10,000. In children one to three cases out of every 1,000 die in the United States (0.1–0.2%). In populations with high levels of malnutrition and a lack of adequate healthcare, mortality can be as high as 10%. In cases with complications, the rate may rise to 20–30%. In 2012,

7360-405: The mouth are diagnostic for measles, but are temporary and therefore rarely seen. Koplik spots are small white spots that are commonly seen on the inside of the cheeks opposite the molars. They appear as "grains of salt on a reddish background." Recognizing these spots before a person reaches their maximum infectiousness can help reduce the spread of the disease. The characteristic measles rash

7452-448: The mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression . Less commonly seizures , blindness , or inflammation of

7544-400: The newborn, this being the most severe sequela of rubella. The syndrome (CRS) follows intrauterine infection by the rubella virus and comprises cardiac, cerebral, ophthalmic, and auditory defects. It may also cause prematurity, low birth weight, neonatal thrombocytopenia, anemia, and hepatitis. The risk of major defects in organogenesis is highest for infection in the first trimester . CRS is

7636-480: The number of deaths due to measles was 78% lower than in 2000 due to increased rates of immunization among UN member states . Even in countries where vaccination has been introduced, rates may remain high. Measles is a leading cause of vaccine-preventable childhood mortality. Worldwide, the fatality rate has been significantly reduced by a vaccination campaign led by partners in the Measles Initiative :

7728-417: The planet. Ari passes the last moments of her life telling Jo-kang that she loves and pities him for believing everything she said. Jo-kang then sees a flying saucer appear in the night sky, signifying Ari's death. In the final scene, Jo-kang goes on with his life, narrating in voice-over that the scent of love that Ari left still lingers. He prefers to believe that she's living on another planet, waiting for

7820-704: The previous year. In England and Wales, though deaths from measles were uncommon, they averaged about 500 per year in the 1940s. Deaths diminished with the improvement of medical care in the 1950s but the incidence of the disease did not retreat until vaccination was introduced in the late 1960s. Wider coverage was achieved in the 1980s with the measles, mumps and rubella , MMR vaccine . In 2013–14, there were almost 10,000 cases in 30 European countries. Most cases occurred in unvaccinated individuals and over 90% of cases occurred in Germany, Italy, Netherlands, Romania, and United Kingdom. Between October 2014 and March 2015,

7912-423: The provision of low vision devices, if required. Rubella infection of children and adults is usually mild, self-limiting, and often asymptomatic. The prognosis in children born with CRS is poor. Rubella occurs worldwide. The virus tends to peak during the spring in countries with temperate climates. Before the vaccine against rubella was introduced in 1969, widespread outbreaks usually occurred every 6–9 years in

8004-553: The reduction of child deaths from other causes. The Advisory Committee on Immunization Practices (ACIP) recommends that all adult international travelers who do not have positive evidence of previous measles immunity receive two doses of MMR vaccine before traveling, although birth before 1957 is presumptive evidence of immunity. Those born in the United States before 1957 are likely to have been naturally infected with measles virus and generally need not be considered susceptible. There have been false claims of an association between

8096-404: The seventh day after exposure. Compared to no treatment, the risk of measles infection is reduced by 83%, and the risk of death by measles is reduced by 76%. However, the effectiveness of passive immunization in comparison to active measles vaccine is not clear. The MMR vaccine is 95% effective for preventing measles after one dose if the vaccine is given to a child who is 12 months or older; if

8188-416: The severely malnourished, are also given vitamin A , which acts as an immunomodulator that boosts the antibody responses to measles and decreases the risk of serious complications. Treatment is supportive , with ibuprofen or paracetamol (acetaminophen) to reduce fever and pain and, if required, a fast-acting medication to dilate the airways for cough. As for aspirin , some research has suggested

8280-410: The virus fuse with the membrane and ultimately get inside the cell. As the virus is a single-stranded negative-sense RNA virus , it includes the enzyme RNA-dependent RNA polymerase (RdRp) which is used to transcribe its genome into a positive-sense mRNA strand. After entering a cell, it is ready to be translated into viral proteins, wrapped in the cell's lipid envelope, and sent out of the cell as

8372-668: The virus. Rubella is still common in some regions of the world and Susan E. Reef, team lead for rubella at the CDC's global immunization division, who joined in the announcement, said there was no chance it would be eradicated worldwide before 2020. Rubella is the third disease to be eliminated from the Western Hemisphere with vaccination after smallpox and polio . From "rubrum" the Latin for "red", rubella means "reddish and small". "German" measles derives from "germanus" which means "similar" in this context. The name rubella

8464-442: The womb, especially if the mother acquired immunity through infection rather than vaccination. Such antibodies will usually give newborn infants some immunity against measles, but these antibodies are gradually lost over the course of the first nine months of life. Infants under one year of age whose maternal anti-measles antibodies have disappeared become susceptible to infection with the measles virus. In developed countries, it

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