THE RELEVANCE OF MEASLES TODAY

Urgench branch of Tashkent Medical Academy, Urgench, Uzbekistan✓ ResumeThis article outlines the main issues related to the etiology, epidemiology and pathogenesis of measles infection, taking into account the data of the last outbreak of this disease in 2023-2024. The classification of measles, the features of its clinical course in children in the age aspect are presented, the characteristics of the clinical forms of the disease with central nervous system damage are given, and the complications of measles are described. The features of the formation of immunity in measles are shown. The issues related to the laboratory and differential diagnosis of this infection are outlined, modern approaches to the treatment and specific prevention of measles are presented in detail, and the need for vaccination within the framework of the National Calendar of Preventive Vaccinations is emphasized. The requirements for antiepidemic measures in the measles outbreak and dispensary monitoring of children who have had measles infection are considered.Keywords: complication, vaccination, contagiousness, age, rash, common, prevention.Introduction. Measles is a highly contagious acute viral disease that is transmitted by airborne droplets and can lead to serious complications and death. Between 2000 and 2021, measles vaccination prevented 56 million deaths. Despite the availability of a safe and cost effective vaccine, an estimated 128,000 measles deaths were reported worldwide in 2021, mostly among unvaccinated or under-vaccinated children under the age of 5. In 2022 About 83% of children in the world received one dose of measles vaccine during the first year of life as part of planned public health care, which is the lowest rate since 2008. Prior to the introduction of the measles vaccine in 1963 and the widespread use of measles vaccination, major epidemics were recorded approximately every two to three years and led to approximately 2.6 million deaths annually.Measles is an acute infectious viral disease with a very high level of contagiousness, the causative agent of which is the measles virus. It is characterized by high fever (up to 40.5 C), inflammation of the mucous membranes of the oral cavity and upper respiratory tract, conjunctivitis and a characteristic spotted papular rash of the skin, general intoxication. According to the World Health Organization, in 2018, about 140 thousand people died from measles worldwide, most of them children under the age of five. Measles remains one of the prominent causes of child mortality in developing countries. The number of measles cases in the world increased dramatically in 2017. Due to gaps in vaccination coverage, measles outbreaks have been observed in all regions.Etiology. The causative agent of measles is an RNA virus of the morbillivirus genus of the paramyxovirus family, which has a spherical shape. The virus consists of a nucleocapsid — minus-an RNA strand, three proteins and an outer shell formed by a matrix protein and two surface glycoproteins: one of them is hemagglutinin, the other is a "fusion" protein. The virus remains active in the air and on surfaces for up to 2 hours, it is poorly resistant in the external environment, quickly dies outside the human body from the effects of various chemical and physical factors (irradiation, boiling, treatment with disinfectants). There is a hypothesis about the origin of the measles virus from the bovine plague virus during the emergence of animal husbandry. Despite the instability to the external environment, there are cases of the virus spreading over considerable distances with the flow of air through the ventilation system — in the cold season in one single building. Weakened strains of the measles virus are used to produce a live measles vaccine.Epidemiology. The success of immunization made it possible to classify measles as "outgoing" infections included in the National Measles Elimination Program (Order No. 192 of the Ministry of Health of the Republic of Uzbekistan dated April 24, 2003), the purpose of which was to eliminate this disease in our country by 2020. The program included several stages: at the first stage, it was planned to achieve widespread stabilization of measles incidence rates at a sporadic level in all regions of the country, at the second — to create conditions for preventing the occurrence of measles cases and complete eradication of measles infection in the Republic of Uzbekistan, at the third (2018-2020) — certification of measles-free territories. However, in 2019-2023, the situation changed dramatically: the incidence of measles in the Republic of Uzbekistan increased. The first cases of the disease were imported from countries such as the United Kingdom, Germany, Italy, France, Finland, Russia, India, Malaysia, and China. According to the WHO Regional Office for Europe and ECDC (European Centre for Disease Prevention and Control), in 2011, more than 31,000 cases of measles were reported i