http://www.who.

int/mediacentre/factsheets/fs286/en/
Measles
Fact sheet N286
Updated February 2014

Key facts

Measles is one of the leading causes of death among young children

even though a safe and cost-effective vaccine is available.

In 2012, there were 122 000 measles deaths globally about 330 deaths
every day or 14 deaths every hour.

Measles vaccination resulted in a 78% drop in measles deaths between

2000 and 2012 worldwide.

In 2012, about 84% of the world's children received one dose of

measles vaccine by their first birthday through routine health services up
from 72% in 2000.

Since 2000, more than 1 billion children in high risk countries were
vaccinated against the disease through mass vaccination campaigns about
145 million of them in 2012.

Measles is a highly contagious, serious disease caused by a virus. In 1980,

before widespread vaccination, measles caused an estimated 2.6 million deaths
each year.
It remains one of the leading causes of death among young children globally,
despite the availability of a safe and effective vaccine. Approximately 122 000
people died from measles in 2012 mostly children under the age of five.
Measles is caused by a virus in the paramyxovirus family. The measles virus
normally grows in the cells that line the back of the throat and lungs. Measles
is a human disease and is not known to occur in animals.
Accelerated immunization activities have had a major impact on reducing
measles deaths. Since 2000, more than one billion children in high risk

countries were vaccinated against the disease through mass vaccination

campaigns about 145 million of them in 2012. Global measles deaths have
decreased by 78% from an estimated 562 400 to 122 000.

Signs and symptoms

The first sign of measles is usually a high fever, which begins about 10 to 12
days after exposure to the virus, and lasts four to seven days. A runny nose, a
cough, red and watery eyes, and small white spots inside the cheeks can
develop in the initial stage. After several days, a rash erupts, usually on the
face and upper neck. Over about three days, the rash spreads, eventually
reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On
average, the rash occurs 14 days after exposure to the virus (within a range of
seven to 18 days).
Severe measles is more likely among poorly nourished young children,
especially those with insufficient vitamin A, or whose immune systems have
been weakened by HIV/AIDS or other diseases.
Most measles-related deaths are caused by complications associated with the
disease. Complications are more common in children under the age of five, or
adults over the age of 20. The most serious complications include blindness,
encephalitis (an infection that causes brain swelling), severe diarrhoea and
related dehydration, ear infections, or severe respiratory infections such as
pneumonia. As high as 10% of measles cases result in death among
populations with high levels of malnutrition and a lack of adequate health care.
Women infected while pregnant are also at risk of severe complications and the
pregnancy may end in miscarriage or preterm delivery. People who recover
from measles are immune for the rest of their lives.

Who is at risk?
Unvaccinated young children are at highest risk of measles and its
complications, including death. Unvaccinated pregnant women are also at risk.

Any non-immune person (who has not been vaccinated or was vaccinated but
did not develop immunity) can become infected.
Measles is still common in many developing countries particularly in parts of
Africa and Asia. More than 20 million people are affected by measles each
year. The overwhelming majority (more than 95%) of measles deaths occur in
countries with low per capita incomes and weak health infrastructures.
Measles outbreaks can be particularly deadly in countries experiencing or
recovering from a natural disaster or conflict. Damage to health infrastructure
and health services interrupts routine immunization, and overcrowding in
residential camps greatly increases the risk of infection.

Transmission
The highly contagious virus is spread by coughing and sneezing, close
personal contact or direct contact with infected nasal or throat secretions.
The virus remains active and contagious in the air or on infected surfaces for
up to two hours. It can be transmitted by an infected person from four days
prior to the onset of the rash to four days after the rash erupts.
Measles outbreaks can result in epidemics that cause many deaths, especially
among young, malnourished children. In countries where measles has been
largely eliminated, cases imported from other countries remain an important
source of infection.

Treatment
No specific antiviral treatment exists for measles virus.
Severe complications from measles can be avoided though supportive care that
ensures good nutrition, adequate fluid intake and treatment of dehydration with
WHO-recommended oral rehydration solution. This solution replaces fluids
and other essential elements that are lost through diarrhoea or vomiting.
Antibiotics should be prescribed to treat eye and ear infections, and
pneumonia.

All children in developing countries diagnosed with measles should receive

two doses of vitamin A supplements, given 24 hours apart. This treatment
restores low vitamin A levels during measles that occur even in well-nourished
children and can help prevent eye damage and blindness. Vitamin A
supplements have been shown to reduce the number of deaths from measles by
50%.

Prevention
Routine measles vaccination for children, combined with mass immunization
campaigns in countries with high case and death rates, are key public health
strategies to reduce global measles deaths. The measles vaccine has been in use
for 50 years. It is safe, effective and inexpensive. It costs less than one US
dollar to immunize a child against measles.
The measles vaccine is often incorporated with rubella and/or mumps vaccines
in countries where these illnesses are problems. It is equally effective in the
single or combined form.
In 2012, about 84% of the world's children received one dose of measles
vaccine by their first birthday through routine health services up from 72% in
2000. Two doses of the vaccine are recommended to ensure immunity and
prevent outbreaks, as about 15% of vaccinated children fail to develop
immunity from the first dose.

WHO response
The fourth Millennium Development Goal (MDG 4) aims to reduce the underfive mortality rate by two-thirds between 1990 and 2015. Recognizing the
potential of measles vaccination to reduce child mortality, and given that
measles vaccination coverage can be considered a marker of access to child
health services, routine measles vaccination coverage has been selected as an
indicator of progress towards achieving MDG 4.
Overwhelming evidence demonstrates the benefit of providing universal access
to measles and rubella-containing vaccines. Globally, an estimated 562 400

children died of measles in 2000. By 2012, the global push to improve vaccine
coverage resulted in a 78% reduction in deaths. Since 2000, with support from
the Measles & Rubella Initiative (M&R Initiative) over 1 billion children have
been reached through mass vaccination campaigns about 145 million of
them in 2012.
The M&R Initiative is a collaborative effort of WHO, UNICEF, the American
Red Cross, the United States Centers for Disease Control and Prevention, and
the United Nations Foundation to support countries to achieve measles and
rubella control goals.
In 2012, the MR Initiative launched a new Global Measles and Rubella
Strategic Plan which covers the period 2012-2020. The Plan includes new
global goals for 2015 and 2020:
By the end of 2015

To reduce global measles deaths by at least 95% compared with 2000

levels.

To achieve regional measles and rubella/congenital rubella syndrome

(CRS) elimination goals.
By the end of 2020

To achieve measles and rubella elimination in at least five WHO

regions.
The strategy focuses on the implementation of five core components:

1.

achieve and maintain high vaccination coverage with two doses of

measles- and rubella-containing vaccines;

2.

monitor the disease using effective surveillance, and evaluate

programmatic efforts to ensure progress and the positive impact of vaccination
activities;

3.

develop and maintain outbreak preparedness, rapid response to

outbreaks and the effective treatment of cases;

4.

communicate and engage to build public confidence and demand for

immunization;

5.

perform the research and development needed to support cost-effective

action and improve vaccination and diagnostic tools.
Implementation of the Strategic Plan can protect and improve the lives of
children and their mothers throughout the world, rapidly and sustainably. The
Plan provides clear strategies for country immunization managers, working
with domestic and international partners, to achieve the 2015 and 2020 measles
and rubella control and elimination goals. It builds on years of experience in
implementing immunization programmes and incorporates lessons from
accelerated measles control and polio eradication initiatives.
http://www.biofarma.co.id/?dt_portfolio=measles-vaccine
DESKRIPSI
Vaksin campak adalah vaksin virus hidup yang dilemahkan, merupakan vaksin
beku kering berwarna kekuningan pada vial gelas, yang harus dilarutkan hanya
dengan pelarut vaksin campak kering produksi PT Bio Farma yang telah
disediakan secara terpisah. Vaksin campak ini berupa serbuk injeksi.
KOMPOSISI
Tiap dosis (0,5 mL) vaksin yang sudah dilarutkan mengandung:
Zat aktif:
Virus Campak strain CAM 70 tidak kurang dari 1.000 CCID50*
* CCID50 = Cell Culture Infective Dose 50
Zat tambahan:
Kanamisin sulfat tidak lebih dari 100 mcg
Eritromisin tidak lebih dari 30 mcg
Pelarut mengandung :
Air untuk injeksi
INDIKASI
Vaksin digunakan untuk pencegahan terhadap penyakit campak.

CARA KERJA OBAT

Merangsang tubuh membentuk antibodi untuk memberi perlindungan terhadap
infeksi penyakit campak.
POSOLOGI
o

Vaksin dilarutkan dengan pelarut vak- sin campak kering produksi PT Bio
Farma sebanyak 5 mL pada setiap vial

10 dosis dan 10 mL pada setiap vial 20 dosis.

Imunisasi campak terdiri dari satu dosis tunggal 0,5 mL disuntikan secara
subkutan pada lengan bagian atas setelah dilarutkan dengan pelarutnya,
diberikan pada anak umur 9 bulan.

Dalam keadaan wabah imunisasi dapat diberikan mulai umur 6 bulan

disusul dengan suntikan ulangan 6 bulan kemudian dengan 1 dosis 0,5 mL
secara subkutan.

EFEK SAMPING
Vaksin campak dapat mengakibatkan sakit ringan dan bengkak pada lokasi
suntikan, yang terjadi 24 jam setelah vaksinasi.
Pada 5-15 % kasus terjadi demam (selama 1-2 hari), biasanya 8-10 hari setelah
vaksinasi.
Pada 2 % terjadi kasus kemerahan (selama 2 hari), biasanya 7-10 hari setelah
vaksinasi.
Kasus ensefalitis pernah dilaporkan terjadi (perbandingan 1/1.000.000 dosis),
kejang demam (perbandingan 1/3000 dosis ).
KONTRAINDIKASI
o

Terdapat beberapa kontraindikasi pada pemberian vaksin campak. Hal ini

sangat penting, khususnya untuk imunisasi pada anak penderita malnutrisi.

Vaksin ini sebaiknya tidak diberikan bagi; orang yang alergi terhadap dosis
vaksin campak sebelumnya, wanita hamil karena efek vaksin campak
terhadap janin belum diketahui; orang yang alergi berat terhadap kanamisin
dan eritromisin, anak dengan infeksi akut disertai demam, anak dengan
defisiensi sistem kekebalan, anak dengan pengobatan intensif yang bersifat

imunosupresif, anak yang mempunyai ke- rentanan tinggi terhadap protein

telur.
INTERAKSI OBAT
Tidak ada interaksi obat
PERINGATAN & PERHATIAN
o

Hindarkan vaksin dari sinar matahari langsung karena vaksin campak

sensi- tif terhadap sinar ultraviolet.

Vaksin hanya boleh disuntikkan secara subkutan, tidak boleh secara

intravena.

Bila anak telah diberikan imunoglobu- lin atau transfusi darah maka
imunisasi harus ditangguhkan paling sedikit 3 bulan.

Setelah imunisasi, tes tuberkulin pada anak harus ditangguhkan sampai 2

bulan karena mungkin terjadi reaksi negatif palsu.

Perhatikan petunjuk pemakaian vaksin (halaman 17).

PENYIMPANAN
o

Vaksin campak beku kering disimpan pada suhu antara +2C s/d +8C.

Vial vaksin dan pelarut harus dikirim bersamaan, tetapi pelarut tidak boleh
dibekukan dan disimpan pada suhu kamar.

Vaksin harus terlindung dari cahaya.

Waktu daluarsa 2 tahun.

Vaksin campak yang sudah dilarutkan, sebaiknya digunakan segera, paling

lambat 6 jam setelah dilarutkan, apabila masih bersisa maka harus
dimusnahkan.

KEMASAN
o

Dus : 10 vial @ 10 dosis + Pelarut Campak Dus @ 10 ampul @ 5 mL

Dus : 10 vial @ 20 dosis + Pelarut Campak Dus @ 10 ampul @ 10 mL

http://bestpractice.bmj.com/bestpractice/monograph/217/basics/pathophysiology.h
tml
Measles virus is transmitted via droplets and infects epithelial cells of the nose
and conjunctivae. Virus multiplies in these epithelial cells and then extends to the
regional lymph nodes. Primary viraemia occurs 2 to 3 days after infection, and
measles virus continues to replicate in epithelial and reticuloendothelial system
tissue over the next few days. Secondary viraemia occurs on days 5 to 7, and
infection becomes established in the skin and other tissues including the
respiratory tract on days 7 to 11. The prodromal phase, which lasts 2 to 4 days,
occurs at this time with fever, malaise, cough, coryza, and conjunctivitis. Koplik's
spots may develop on the buccal mucosa about 1 to 2 days before the rash and
may be apparent for 1 to 2 days after rash onset. The rash then develops at about
14 days after infection; at this time virus can be found in blood, skin, respiratory
tract, and other organs. Over the next few days, viraemia gradually decreases as
the rash coalesces and gradually resolves along with the other signs and
symptoms. Viraemia and presence of virus in tissue and organs ceases by days 15
to 17 corresponding to the appearance of antibody.