The document provides information on measles, mumps, and rubella. It discusses the causative agents, modes of transmission, clinical features, complications, diagnosis, treatment, and prevention including vaccination recommendations for each disease. Measles, mumps and rubella are acute viral illnesses that mainly affect children and can spread through respiratory droplets. They typically cause mild to moderate symptoms but measles and congenital rubella syndrome can lead to more serious complications in some cases. Vaccination is the most effective way to prevent outbreaks of these contagious diseases.

2. GOVERNMENT AURVEDIC COLLEGE AND
HOSPITAL, PATIALA.
SESSION 2018-19
DEPARTMENT OF PEDIATRICS
COMPILTION ON: INFECTIOUS DISEASES (MEASLES,
MUMPS AND RUBELLA)
B.A.M.S.3RD
YEAR
SUBMITTED TO : SUBMITTED BY:
DR. K.K.CHOPRA MANDEEP KAUR
DR.SHALINI B.A.M.S.3RD
YEAR
DR.ASHWANI RANA ROLL NO:13920821

5. MEASLES
INTRODUCTION
 Measles which is also called rubeola ia the most common and
infectious of all the viral infections of childhood.
 It is a frequent cause of ill healthand morbidity, especially in the
undernourished infantsand children below the age of 3 years.
 One attack of this disease leads to life long immunity.
EPIDEMIOLOGY
 CAUSATIVE AGENT: Measles virus or morbilli virus which is a
RNA virus of paramyxoviridae family.
 MODE OF TRANSMISSION: By droplet spread from secretions of
nose and throat because it include catarrhal symptoms.Man is
the only reservior of this infection.
 PERIOD OF INFECTIVITY: 4 days prior to and 5 days after the
appearance of rash.
 INCIDENCE: This disease is common in pre school children.It may
occur in any season but its incidence is higher in winter and
spring.
PATHOLOGY
 The organism infest by invasion of respiratory epithelium.
 Here it undergo local multiplication which leads to viremia.
 Then it spreads to reticuloendothelial system.

6.  Then there is necrosis of cells which leads to secondary
viremia.
 Then there appears systemic symptoms.
Multinucleated giant cells can be demonstratedboth in
epidermis and oral epithelium by 7 to 11 days.
CLINICAL FEATURES
 INCUBATION PERIOD: 8 to 12 days.
 PRODROMAL PHASE/CATARRHAL PHASE:
 Onset is acute with moderate increase in temperature.
 Dry hacking cough.
 Running nose .
 Sneezing.
 Redness of eyes.
 Excessive lacrimation.
 KOPLIK’S SPOTS:

7.  These spots appear as greyish or bluish whiye grains of
sand surrounded by reddish areola on inner side of cheek
opposite second molars.
 They appear on 3rd
and 2nd
day of illness.
 They may be single or multiple.
 They increase in number for two to three days and
disappear by the end of 2nd
day of rash.
 ERUPTIVE PHASE:
This phase is approximately starting from 4th
day when
fever rise again.
RASH: Rashes appear in thus stage which are erythematous and
blenches on pressure. They first appear behind the ears, forehead,
face, neck and spresd to trunk, extremities-palms and soles within 3
days and become brownish and doesn’t fade on pressure.
PROGNOSIS
 Rash dissappeared to 4th
day in the order in which they appears.
 Fever and rash generally disappear within a week in
uncomplicated cases.
 It leaves browny desquamation after disappearance of rash.
COMPLICATIONS
 OTITIS MEDIA: It is the complication of respiratory tract, which
causes prolonged morbidity.
 BRONCHIECTASIS: Protracted in infection of lungs with delayed
resolution may be the cause of bronchiectasis.

8.  ENCEPHALITIS:Due to invasion of brain cells with measles virus
or may be autoimmune response.
 DIGESTIVE SYSTEM: Persistant diarrhoea is common or
appendicitis due to lymphoid tissue blocking the lumen of
appendix.
 MALNUTRITION: Malnutrition occurs severely as a complication
of this disease.
 There may be activation of tuberculosis.
 OTHERS: Depression of cell mediated immunity and energy.
DIAGNOSIS
 It is totally based on clinical features.
 Serological tests for confirmation.
 CBC
 Fluorescent antibody staining for measles antigen.
PREVENTION AND TREATMENT
 There is no specific tretment for this disease.
 Only symptomatic and supportive treatment is done.
Give bath to child daily.
Mouth is washed and teeth is brushed daily.
Give adequate amount of fluid to the child.
For fever paracetamol can be given.
Cough should not to be suppressed as it helps in clearing
mucus from lungs.

9. If child is vomiting then i/v fluids are given.
Vit A is given orally.
PROPHYLAXIS
 Administration of measles vaccine along with mumps and
rubella (MMR vaccine).
o 1st
dose at 9 to 12 months of age
o 2nd
dose at 15 to 18 months of age
o At a dose of 0.5 ml
o Site of injection is subcutaneously at right upper arm.
ROMANTIKA
 Measles can be correlated with ROMANTIKA in ayurveda.
 Acharya charak has described it in shotha chikitsadhyaya.
 Acharya Madhavakar has called it a type of “Masurika” and
described it.
 Vitiated Kapha and Pitta dosha doshas are the cause of this
disease.
NIDANA
According to Sushrut Nidanasthana chapter 5 , it is an Upsargajanya
vyadhi so its causes are similar to that which are:
 Contact with infected person’s body parts.
 Expiration or nih: shwasa which is its main cause.
 Eating , sitting and sleeping with infected person.
 Sharing clothes and articles with infected persons.

10. LAKSHANA
According to charaka chikitsa sthana chapter 9 the symptoms are:
 small red rashes all over the body (pidaka)
 fever (jwara)
 burning sensation (daha)
 excessive thirst (trishna)
 itching (kandu)
 anorexia (aruchi)
 common cold (pratishyay)
 redness of eyes (netra roga)
 tiredness (klama)
 depression (avsada)
 diarrhoea (atisara)
 photophobia (prakasha asahiyata)
 excessive weakness (daurbalya)
Jwara is the first symptom and all other symptoms appear after that.
At 3rd
to 4th
day the” PIDAKA” appear at forehear and near the
ears.and then it spreads all over the body. After spread fever recited
and the thin skin over the acne falls off.slowly all syptoms reside
within 15 to 20 days.
TREATMENT
 Tribhuvana kirti rasa: 30 to 60 mg with ardrakha rasa and honey.
 Pravala pishti: 30 to 60 mg with honey.
 Lakshami Narayana rasa+ Gorochana+ pravala pishti taken in
equal parts: 30 to 60 mg with honey or Patoladi kwatha.

11. MUMPS
It is an acute viral infection also called infectious parotitis or
epidemic parotitis. It is characterised bypainful swelling of salivary
glands especially the parotids and frequently by CNS involvement. The
majority of sufferers i.e. 80 % belong to pediatric age group. A single
attack leads to life long immunity.
EPIDEMIOLOGY
 CAUSATIVE ORGANISM: Mumps virus which is a single stranded
RNA virus belongs to paramyxoviridae family.
 RISK FACTORS: Mumps is endemic world over. May occur in any
age in either sex but most cases occur between 5 and 15 years
of age.infants are rarely involved due to transplacentally
acquired maternal mumps antibodies.
 INCIDENCE: Mumps can occur in any season but its incidence is
highr in winter and spring.
 TRANSMISSION: Direct contact by dropet infection. Direct
contact is through fomites contaminated by infected saliva.
Saliva ishighly infective in this case.
 PERIOD OF INFECTIVITY: 7 days prior to and 9 days after the
appearance of parotid and salivary gland swelling.
PATHOGENESIS
 Virus enters through nose or mouth.
 It proliferates in the parotid gland and respiratory mucosa.
 This is followed by viremia.

12.  Virus is localised in salivary glands and CNS and may be
recovered from saliva, blood, urine and CSF during acute stage of
illness.
CLINICAL FEATURES
 INCUBATION PERIOD: 2 to 4 weks with an average of 18 days.
 1/3rd
patients remain asymptomatic .
 Symptoms start with fever, headache, nausea, malaise, loss of
apetite.
 SALIVARY MANIFESTATIONS:
 Pain near the lobe of ear and difficulty in chewing within
24 hrs of onset .
 Parotid swelling and area behind angle of jaw appears full.
 Enlarged parotid obliterate mandibular angle
 Opening of stenson duct appear red
 Submaxillary and sublingual glands may also be enlarged.
 EXTRASALIVARY MANIFESTATION:
 Aseptic meningitis.
 Severe headache, vomiting, neck stiffness.

13. PROGNOSIS
 Prognosis is excellent .
 The disease begin unilaterally but involve other side also within
48-72 hrs in 75% cases.
 Fever and tenderness settle in 1-6 days.
 Swelling disappears in 6-10 days.
COMPLICATIONS
 Orchitis and epididymitis.
 Pancreatitis: uncommon and recover spontaneously within 5-7
days. It may lead to diabetes mellitus.
 In pregnancy: it may increase fatal mortality. Incidence of low
birth weight babies increases.
DIAGNOSIS
 It is based on clinical features.
 Blood count may show leucopenia.
 Compliment fixation test.
 In CSF there is increased pressure, increased proteins and cells.
TREATMENT
 symptomatic treatment is done
 paracetamol and aspirin is given for pain
 warm saline mouth washes

14.  Rest is usually advised to the child throughout the infection.
 Fluid diet is advised when there is difficulty in chewing.
 child should be isolated until parotid swelling has resolved
prophylaxis: administration of mmr vaccine
 1st
dose at the age of 9-12 months
 2nd
dose at the age of 15-18 months
subcutaneously at right upper arm.
RUBELLA
Rubella which is also called german measles is relatively less
contagious viral disease characterised by mild prodromal symptoms, a
typical eruption and enlargement of cervical lymph nodes. It is
primarily disease of older children and adults. Second attack of this
disease is rare. It isusually a mild illness. Most people who have had
rubella or the vaccine are protected againt the virus for the rest of
their lives. Because of routine vaccination against rubella since 1970,
rubella is now rarely reported.
EPIDEMIOLOGY
 CAUSATIVE ORGANISM: rubella virus which is a ss-RNA virus of
togaviridae family
 MODE OF TRANSMISSION: direct contact by droplet method
 PERIOD OF INFECTIVITY: 5 days prior to and 4 days after the
appearance of rash.

15.  INCIDENCE: rubella occurs worldwide with seasonal distribution.
Peak incidence of infection is in late winter or early spring. There
have been no major epidemics in the united states since vaccine
licencure in 1969 and the incidence increase by 99%. Continuous
cases of congenital rubella due to infection in unvaccinated,
susceptible young women.
CLINICAL FEATURES
 INCUBATION PERIOD: 14-21 days with an avg. 16 days
 PRODROMAL PHASE:
 it last for a few days
 slight malaise

16.  tender posterior cervical lymphadenopathy without catarrh.
This phase may be entirely absent or remain unnoticed.
 RASH :1st
visible sign.It is macule which spread from face to
trunk & extremities.Macules later blend.Eruption disappear by
3rd
day.
CONGENITAL RUBELLA SYNDROME
 Infants born to mother who had suffered from
rubella,paticularly in 1st
trimester of pregnancy may suffer from
multiple congenital defects and these are collectively known as
congenital rubella syndrome.
 This disease has three main symptoms:
 cataract
 Cardiac anomalies
 deafness

17.  other symptoms are:
 growth retardation
 mental retardation
 otitis media
 pancreatitis
 hepatospleenomegaly & hepatitis etc.
DIAGNOSIS
 viral isolation
 serological tests : neutralisation
compliment fixation
hemagglutination inhibition
fluorescent antibody studies
PREVENTION AND TREATMENT
 There is no specific treatment
 Treat complications if any
 Take proper rest
 Increase fluid intake
 PROPHYLAXIS: only reliable means of prevention is
administration of vaccine MMR.
 1st
dose at the age of 9-12 months
 2nd
dose at the age of 15-18 months
 0.5 ml subcutaneously at right upper arm