Some aspects of Measles with homoeopathic mode of treatment -

Measles is an acute, highly infectious disease of childhood occurring worldwide and is caused by measles virus, a RNA virus belonging to the family of paramyxoviruses. The virus is antigenically uniform. Humans are the only natural hosts. One attack confers solid immunity and second attacks are uncommon. Introduction of aggressive immunization has dramatically reduced the incidence of the disease in the developed countries but it is still now a very common disease of childhood in the developing countries. Although it is a relatively mild disease in the healthy child, it carries a high mortality in the malnourished as well as in those with other diseases. In the nonimmune, infection almost always causes clinical manifestation.

Age- Peak incidence is in young children between 1-5 years of age. It is rare in first six months of life due to the presence of maternal antibody.

Season- Epidemics occur mostly in late winter and early spring, with a peak in April.

Spread of infection- This infection spreads by droplet during the prodromal stage and in early eruptive stage. Infectivity is maximum at the prodrome and diminishes rapidly with the appearance of rash. It starts from 3 days prior to the onset of symptoms and lasts until the rash desquamates.

Pathogenesis-The virus enters the body through the respiratory tract or the conjunctiva and multiplies locally as well as in the adjoining lymph nodes. The virus spreads to the reticuloendothelial system via blood where it multiplies and then a secondary viraemia carries the virus to the epithelial surfaces including the skin, mouth, respiratory tract and conjunctiva.

Incubation Period- 8-14 days.

Clinical Features- The course of the disease is divided into two distinct phases-

(1) The infectious pre-eruptive and catarrhal stage-
This is the stage of viraemia and viral dissemination and lasts for about 4 days. There are sudden onset of malaise, acute fever, rhinorrhoea, cough, conjunctivitis, photophobia and hoarseness of voice. The cough is hacking and occasionally painful. After 3-4 days of prodromal illness, the rash which is a characteristic of the next stage appears and a day or two before the onset of rash, the pathognomonic Koplik’s spots develop. Koplik’s spots are tiny whitish irregular spots against a reddish background characteristically around the opening of the parotid duct opposite the second molar teeth. Koplik’s spots may occasionally develop on the conjunctiva and the intestinal mucosa. On the 3rd day the temperature usually comes down to a low level and is so known as day of remission.

(2) The non-infectious eruptive or exanthematous stage- This stage is characterized by the appearance of a maculopapular rash which appears usually on the 4th day and initially occurs on the face, mainly on the forehead and behind the ears at the junction of skin and hair. It then spreads rapidly to involve whole of the body, including palms and soles. Initially they are discrete, pink in colour, blanch on pressure but later it become confluent and patchy, particularly on the face and neck. It fades in about a week in the same sequence, leaving behind a brownish discolouration of skin and areas of desquamation. The rash represents an immune reaction between T lymphocytes and cells in which viral replication is going on. During this stage, there is again a high rise of temperature with puffiness of face, headache, cough, photophobia and myalgia. Lymph nodes may also enlarge.

Complications- Although most patients recover uneventfully, a few may develop complications which are due to secondary bacterial infection or to the virus itself and are found in those who are malnourished or have other diseases. Complications include bacterial pneumonia, bronchitis, otitis media and gastroenteritis. Rarely the virus may cause fatal giant cell pneumonia. Less common complications are myocarditis, hepatitis and encephalomyelitis. A rare late complication is subacute sclerosing panencephalitis. Protracted diarrhea may also occur as a complication in children in poor countries. Maternal measles may cause spontaneous abortion and premature delivery.

Laboratory Investigations-

(1) Blood examination -Blood examination shows leucopenia or normal count. Leucocytosis may be seen with secondary bacterial infection.

(2) Immunofluorescence-Detection of measles virus antigen by immunofluorescence in multinucleated giant cells which may be demonstrated in Giemsa stained smears of nasal secretions may be used to confirm the diagnosis. This is very simple and may be used a diagnostic test even before the appearance of rash.

(3) Serological tests- Serological tests like complement fixation test( CFT), haemagglutination inhibition test etc may also be used to confirm the diagnosis. High titre measles antibody if can be demonstrated in CSF is diagnostic of subacute sclerosing panencephalitis, a rare and late complication of measles.

(4) Virus culture- Virus culture may also be used to confirm the diagnosis.

Prophylaxis-Normal human gammaglobulin administered within 5 days of exposure can prevent or modify the disease. This is particularly valuable in previously unimmunized children below the age of 3 years, children with immunodeficiency, during pregnancy and others at special risk. Active unimmunization may be done with single antigen measles vaccine or with combined vaccine, MMR.

Treatment- Bry. ( Bryonia) 30, Kalibich. (Kali bichromicum) 6 or 30, Puls. (Pulsatilla) 30 etc are some of the medicines used most frequently. The dose administered and the frequency maintained depends on the state of condition and the severity of the disease. Bryonia is the prime medicine. It is especially useful in fever with dry cough as well as in fever with internal heat. If there is associated cough, Kalibi is to be added. If there is any abdominal distress or diarrhoea, Pulsatilla should be used in addition to Bryonia.

Labels-Abortion, Antibody , CFT, Epidemics, Gammaglobulin, Giemsa Stain, Haemagglutination, Inhibition Test, Immunodeficiency, Immunofluorescence, Serological Test, Viraemia, Bry. ( Bryonia), Kalibich. (Kali bichromicum) , Puls. (Pulsatilla), Sclerosing panencephalitis, CCF , Otitis media, Gastroenteritis, Peumonia, Bronchitis, Giant Cell, Myocarditis, Hepatitis, Encephalomyelitis.

IN SHORT-Measles, an acute, highly infectious disease of childhood is caused by measles virus, a RNA virus & begins with sudden onset of malaise, acute fever, rhinorrhoea, cough, conjunctivitis, photophobia and hoarseness of voice. The disease is characterized by the appearance of the pathognomonic Koplik’s spots which is soon followed by the appearance of a maculopapular rash. The disease may be associated with some complications which are due to secondary bacterial infection or to the virus itself. Prevention may be done with active unimmunization with single antigen measles vaccine or with combined vaccine, MMR. Treatment is as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Influenza with homoeopathic mode of treatment -

Influenza is an acute infectious disease of the respiratory tract which occurs in sporadic, epidemic and pandemic forms. It is caused by the Influenza virus which is a RNA virus and belongs to the family of Orthomyxovirus and has the unique ability to undergo antigenic variation. The route of entry is the respiratory tract. Though the disease is generally confined to the respiratory tract, very rarely it may spread to some other organs. The virus is classified into three serotypes, A, B and C, based on the antigenic nature of the ribonucleoprotein antigen. Influenza B is associated with localized outbreaks of milder nature such as in camps, whereas Influenza A is the cause of worldwide pandemics and epidemics. Influenza C rarely produces disease in humans. Influenza also occurs in animals and birds in nature. But isolates from nonhuman hosts belong to type A. Influenza viruses belonging to B and C types are exclusively human viruses and have not been found to be associated with infection in animals and birds. The unique ability of the virus to cause epidemics and pandemics is due to the frequent antigenic variations in it. Major shifts in the antigenic structure of influenza A form the essential conditions for pandemics. On the other hand, minor shifts in the virus results in less severe epidemics. A major reservoir of influenza virus is believed to exist in animals and birds and the source of infection is usually a clinical case or a sub-clinical case.

Spread of infection- Spread is mainly by droplet infection but fomites and direct contact may also be the cause.

Incubation Period-1-3 days.

Onset- Sudden.

Clinical Features- Most of the cases are sub-clinical. The disease varies in severity from a mild coryza to fulminating and rapidly fatal pneumonia. There is high rise of temperature all on a sudden with shivering and generalized aching in the limbs. This is associated with severe headache, soreness of the throat and a persistent dry cough that may last for several weeks. Abdominal pain and vomiting may also occur, especially in type B infection in children. There may be mild conjunctivitis and nasal congestion may or may not be present. During acute stage of the disease there may be flushing of the face and the pulse shows tachycardia. But all these symptoms usually disappear within a few days, an uncomplicated case usually resolving within 2-7 days, except asthenia which persists for several days or weeks.

Complications- Secondary bacterial infection, particularly with Strep.pneumonia and H. influenza is often found. The most important one is pneumonia which is rarer and is caused by Staph.aureus or very rarely by the virus itself. Cardiac complications like congestive cardiac failure (CCF) or myocarditis and postinfectious encephalomyelitis may also rarely occur after infection with this virus.

Prophylaxis- Protection by influenza vaccine is not always successful and is of short duration, lasting for about a year. The major problem is the frequent change in its antigenic make up. Hence new vaccines are to be prepared each time to cover each change in antigenicity of the virus which is a great hindrance to the fight against an outbreak of influenza at the very beginning.

Treatment- Besides bed rest, the following homeoeoathic medicines may be used-
Bry (Bryonia) 30, Bell ( Belladonna) 6, Rhus tox ( Rhus Toxicodendron) 30, Eup.perf (Eupatorium Perfoliatum) 6 or 30 should be used separately one after another at an interval of usually ½ to 1 hour several times in a day depending on severity and nature of the condition. Bryonia is especially useful in fever with pain stitching and or tearing in nature as well as in fever with dry cough. Belladonna is particularly useful in a high feverish state with mild or no signs of toxaemia. It may also be used effectively when there is distension of superficial blood vessels. Rhus tox 30 acts better in chill with dry cough and or restlessness. It is particularly useful when the bowels are loose. Eupatorium Perfoliatum is particularly useful in fever with much frontal ache but without thirst during chill and also in bone pains. For high fever, Ferrum Phos 6x should be used repeatedly in between the above four medicines. If there is any chest congestion, Antim. tart ( Antimonium tartaricum) 6 may be used several times depending on severity of the condition. Lach. ( Lachesis) may be tried in presence of hot flushes and hot perspiration.

Labels-Antim. tart ( Antimonium tartaricum), CCF, Encephalomyelitis, Eup.perf (Eupatorium Perfoliatum), Lach. ( Lachesis), Myocarditis, Pandemic, RNA., Sporadic, Staph.aureus, Ferrum Phos, Chill, Toxaemia, Bry (Bryonia) , Bell ( Belladonna) , Rhus tox ( Rhus Toxicodendron) , Chest, Congestion, Blood vessel, Strep.pneumonia, H. influenza, Orthomyxovirus, Serotype, Epidemic, Ribonucleoprotein, Antigen.

IN SHORT-Influenza is an acute infectious disease of the respiratory tract caused by the Influenza virus which is manifested by a sudden high rise of temperature with shivering and generalized aching in the limbs & is also associated with severe headache, soreness of the throat and a persistent dry cough that may last for several weeks. It may be complicated by secondary ingection. Protection by influenza vaccine is not of much value due to the frequent change in its antigenic make up. Treatment is as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Herpes Zoster infection ( shingles) with homoeopathic mode of treatment-

This infection usually represents the re-emergence of varicella zoster virus (VZV) from posterior nerve roots in the spinal cord or cranial nerves into the skin, the original infection having been acquired in an attack of chicken pox many years previously usually in the childhood. VZV is a DNA virus that infects only humans and produces two distinct diseases in man- varicella ( chicken pox) and herpes zoster ( shingles) among which chicken pox is the primary infection occurring usually in the childhood. Chicken pox is the primary infection in the non-immune host. It almost never occurs twice in the same individual. The virus then remains latent in the dorsal root and cranial nerve ganglia for the rest of the life. If immunity is impaired which occurs in elderly persons, the virus replicates and migrates along the sensory nerves to the skin or eye causing the lesions of zoster. Shingles is never the direct result of a primary infection. Patients with chicken pox or shingles are infective, the virus being spread from fresh skin lesions by direct contact or airborne transmission and causing chicken pox in susceptible individuals.The disease affects individuals in their middle years or old age. Factors causing re-emergence of the virus are often ill understood and probably may represent changes in the immune state of the host.
In the cranial nerves herpes zoster has a predilection for the fifth and seventh nerve.

Age- Old age, being common after the age of fifty years.

Incubation Period- About two weeks.

Clinical Features- It produces an identical skin lesion to chicken pox, although classically it is unilateral and restricted to a sensory nerve (dermatomal) distribution, thus respecting the midline. But inflammatory oedema may cross the midline, giving the erroneous impression of bilaterality. General symptoms include fever, malaise, swelling of lymph nodes etc, which may precede the development of pain. The first specific symptom is pain in the segmental distribution of the nerves involved and is burning or shooting or cutting in character associated with hyperaesthesia or hyperalgesia over the affected cutaneous segments. Within a few days this is followed by appearance of erythema initially and later on vesicles containing clear fluid and papules or bullous lesions. These eruptions are distributed over the cutaneous segments of the affected nerves. The vesicular eruption is accompanied with much swelling and tenderness. The lesions vary in distribution, density and severity. They may be small, discrete and scattered or large, confluent and deep with haemorrhagic bullae. In course of time the vesicles are dried up leaving behind permanent scars on the skin. Unusual site of involvement such as sacral nerve disease may give rise to visceral changes which may lead to, for example, bladder dysfunction.

Clinical variants-

(1) Zoster of the limbs and trunk-This is the usual type where the posterior root ganglia of the spinal nerves are involved.

(2) Geniculate zoster- This is herpes zoster of the geniculate ganglion causing facial palsy identical to Bell’s palsy with herpetic vesicles on the external auditory meatus, pinna and sometimes on the soft palate. Deafness may also be there.

(3) Ophthalmic zoster- This involves the ophthalmic division of the fifth cranial nerve. There may be keratitis, anterior uveitis, conjunctivitis, scleritis, episcleritis, acute retinal necrosis. There may be cranial nerve palsies of which third nerve palsy is the most common but palsies of fourth, sixth and seventh cranial nerves, though uncommon, may occur.

(4) Generalised zoster- In rare cases there may be scattered eruptions all over the body.

Complications- These are secondary infection, very rarely purpura and necrosis in the affected segment and postherpetic neuralgia.
Postherpetic neuralgia - Postherpetic neuralgia is intractable pain in the zone of the previous eruption after the subsidence of the vesicles. It occurs in some 10% of patients who are often elderly. It is a burning, continuous pain responding poorly to any treatment and depression is almost always associated with.

Treatment- There are lots of medicines for herpes zoster. A few of them are described below-
Dolich ( Dolichos puriens ) may be used in case of intense itching. It is particularly useful in postherpetic neuralgia. Croton tig (Croton tiglium) 6 or 30 potency is useful especially in pustular eruptions on face where there is intense itching but scratching is painful. It is also useful in herpes with eye symptoms. Semperv.t (Sempervivum Tectorum) is also recommended for herpes zoster. But Cantharis 6 may be recommended as the drug of choice if there is burning sensation with or without itching. And in general Rhus.tox ( Rhus Toxicodendron) 30 should be used. Locally cantharis ointment or lotion may be used.

Labels-Croton tig (Croton tiglium), Dolich ( Dolichos puriens ), Keratitis, Postherpetic neuralgia, Purpura, Rhus.tox ( Rhus Toxicodendron), Semperv.t (Sempervivum Tectorum), Cantharis, Ointment, Lotion, Conjunctivitis, Scleritis, Episcleritis, Retinal necrosis, Uveitis, Geniculate ganglion, External auditory meatus, Pinna, Soft palate, Segment, Facial palsy, Purpura, Hyperaesthesia, Hyperalgesia .

IN SHORT- Herpes Zoster is a viral disease usually occurring in old man due to the re-emergence of varicella zoster virus (VZV) from posterior nerve roots in the spinal cord or cranial nerves into the skin. It usually occurs in persons who had chicken pox several years earlier. General symptoms include fever, malaise, swelling of lymph nodes etc followed by pain burning or shooting or cutting in character restricted to a sensory nerve (dermatomal) distribution and associated with hyperaesthesia or hyperalgesia over the affected cutaneous segments. Within a few days this is followed by appearance of skin eruptions which are usually unilateral and confined to the area supplied by a single sensory ganglion. The commonest sites are the areas innervated by spinal cord segments from third thoracic to second lumber and the trigeminal nerve, particularly its ophthalmic branch. The eruptions heal in about two weeks but pain and paresthesia of the affected area may persist for weeks or months. Of the complications, postherpetic neuralgia is very important. Treatment is as mentioned.

But in every case a doctor should be consulted. Signs including swelling of the eyelid, conjunctivitis or blistering at the site of the nose should seek the attention of an ophthalmologist.