Measles has been in the news and is on the rise around the world; one Singapore mama shares her personal story about the importance of vaccines, and a doctor shares the latest stats and medical advice
My daughter Erin was 6 months old when she got sick. It started with a fever which kept creeping up on a Saturday night. I took her to the GP at our local clinic on that Sunday, and again on Monday, when our GP suggested that it would be better to go to the paediatrician to do further tests, as she was so young. So the following day we went to see the paediatrician, where she had a blood and urine test done, but the results came back negative. They did suspect roseola.
Nighttime was the worst; she was so tired and in so much pain, she’d scream and scream and just wanted to be held constantly.
By Wednesday night a rash appeared all over her head, but again it was in line with what the doctor had told me would happen if it was roseola.
On Thursday my husband called the clinic and informed them a rash had appeared, but they told him not to worry.
On Friday morning the paediatrician called me and had some questions about the rash and suggested we get the test for measles. He didn’t suspect it was measles but wanted to exclude it. When I got to the clinic, I asked the nurses if I should wait somewhere else, seeing we were coming for a measles test, but they said ‘No, just sit down.’ I raised this with the doctor too, as I really didn’t want other babies to get sick!
The day after (Saturday) I was supposed to get the results. Unfortunately there was delay at the lab or maybe between the 2 hospitals (I’m not exactly sure), so I didn’t get the results until Monday.
On the Monday, over a week later, my phone rang and the paediatrician said “Sorry, I don’t have good news, she has measles…”
MEASLES?! Why does my 6-month old have measles? MEASLES is a disease of the past! All because people think they don’t need to vaccinate they put my baby at risk (she’s up to date with all her vaccinations!).
I was – and still am – angry and so upset. I just couldn’t believe it!
Fortunately by the time we learned what she had she wasn’t contagious anymore, and was pretty much back to her normal, happy self. We can count ourselves lucky that it was a “mild” case of measles. We’ve tried to trace our steps but it’s impossible to figure out where she got it — the bus, the mall, the supermarket?
It’s so contagious, that someone with measles can be in a room and you can enter two hours later and still catch it! The following Monday afternoon I received a call from the Ministry of Health (as the paediatrician had to notify them). They asked me questions like Have you been traveling? and so on. The lady was really nice, apologetic that we had to go through this.
We had to give Erin Vitamin A, which came in 20(!) liquid capsules! (10 per day). The only thing we could do with them was to pop them in to her milk. We wished there was something more baby-friendly we could give her.
Please vaccinate, to protect your child, and other babies, and people that can’t be vaccinated yet!
Thank you for sharing your family’s story, Jessica. We also spoke with Dr Tsin Uin Foong, Deputy Medical Director of IMC Katong, to get the latest medical info and advice on Measles in Singapore.
What are the signs and symptoms of Measles?
The disease incubates for 8-12 days before symptoms appear. A high fever, runny nose, cough and eye inflammation (conjunctivitis) occur initially. 1 to 4 days later, spots may be noted on the cheek lining within the mouth – reddish with a white centre (Koplik’s spots). A doctor may be able to differentiate measles from other viral illnesses based on these. This is followed by a rash which starts from around the hairline, slowly spreading to the face and then the rest of the body including the palms and soles. The rash may appear to be flaky or peeling a few days later.
How does Measles spread, and how long is a patient contagious for?
Measles is highly contagious. It is spread through airborne droplets that are released into the air when coughing, breathing and sneezing and through contact with secretions of the nose or eyes. The virus can stay active for about two hours after being released into a room.
A patient is contagious from 4 days before onset of symptoms to 4-6 days after onset of the rash.
What should you do if you suspect your child has measles?
Bring your child to a doctor! Especially if the fever is reading high, and not responding in the usual way to fever medication. Be alert if your child seems more drowsy and confused during the illness. A widespread rash early on in the illness could also be unusual. Be alert if the fever is longer than a few days. Listen to your instinct if you think your child is more sick than just having a common cold.
Is the vaccination mandatory in Singapore? When should you get the vaccination?
Yes. MMR vaccination has been mandatory since 1985. In fact, as of February 2019, all foreign-born children less than 12 years old are expected to show proof of two doses of measles vaccination or immunity to obtain certain types of immigration passes (click here for more details).
The Singapore schedule recommends a MMR (measles, mumps and rubella) vaccine at 12 months, followed by a booster at 15-18 months of age. Two doses are required for complete protection. The MMR vaccination is available at polyclinics, private general practitioner clinics and private paediatric clinics. It is fully subsidised for children (Singapore Citizens) at polyclinics. MediSave can also be used at the private general practitioner and private paediatric clinics for both adults and children.
Teenagers or adults who are non-immune should be vaccinated. It is safe to do a vaccine if no records are available of previous vaccination.
Is there a Measles outbreak in Singapore?
The number of measles cases in Singapore in the first 11 weeks of 2019 was more than triple that of the same period last year (MOH). Nevertheless, the numbers are relatively small (116 cases of measles recorded in Singapore in 2019 as of 22 July) and the population has high immunization rates (there were two mini-outbreaks in July – at a residential facility for the intellectually disabled, and at a dormitory – that accounted for 17 cases). According to the MOH, of the 116 cases reported in 2019, 88 were local and 28 were imported from Bangladesh, Dubai, Malaysia, New Zealand, Phillippines, Thailand and Vietnam. Fortunately no deaths were reported in 2019 from the notified cases of measles.
What is the treatment for Measles in babies and children?
There is no specific medication necessary for curing measles; treatment is centred around relieving symptoms:
1. Treat any high fever with medications to bring the temperature down
2. Drink plenty of water, especially if the temperature is high
3. Treat sore eyes by cleaning away the crustiness with cotton wool soaked in water
4. Treat cold-like symptoms with the usual remedies applied to common colds, e.g. nose sprays, steam inhalation, medication to loosen mucous
Symptoms to watch out for which might indicate a more serious complication of measles: difficulty in breathing, chest pain, coughing up blood, drowsiness, confusion.
Complications are not common in measles, but worth being aware about it.
Thank you, Dr. Foong! If you’d like more information, be sure to call (+65) 6342 4440 or visit www.imc-healthcare.com
Lead image and image #3 via Getty