Measles is an acute, highly infectious disease caused by a specific virus. It is characterized by fever, cough, and a rash. The virus spreads through respiratory secretions when infected individuals cough or sneeze. Measles is most common and severe in unvaccinated children between 6 months and 5 years old. Complications can include pneumonia and neurological issues. Prevention relies on achieving over 95% vaccination coverage through the measles vaccine, typically given at 9 months of age.

1. Respiratory infections
Measles
Rubeola
Vd Rakesh Shukla
Lecturer,
Dept of Swasthavritta
GAAC, Ahmedabad
Vd Rakesh Shukla, GAAC, Ahmedabad

2. • An acute highly infectious disease of
childhood caused by a specific virus of the
group myxoviruses.
• It is clinically characterized by fever and
catarrhal symptoms of upper respiratory tract
(coryza, cough) followed by typical rash.
Vd Rakesh Shukla, GAAC, Ahmedabad

3. Agent factors
Agent :caused by RNA paramyxovirus
Source of infection: is a case of measles. Carriers are not
known to occur.
Infective material: secretions of nose, throat and
respiratory tract of a case of measles during the
prodromal period and the early stages of the rash.
Communicability: 4 days before and 5 days after the
appearance of rash.
Secondary attack rate: infection confers life long infectivity.
Vd Rakesh Shukla, GAAC, Ahmedabad

4. Host factors
Age: between 6 months and 3 years of age and older
children usually over 5 years.
Sex: both sexes
Immunity: life long immunity
Nutrition: highly severe in malnourished child carring a
mortality upto 400 times highly than in well
nourished children.
Vd Rakesh Shukla, GAAC, Ahmedabad

5. Environmental factors: Virus can spread in any season
especially a winter disease.
Transmission – mainly by droplet nuclei from 4 days
before the onset of rash until 5 days there after.
Incubation period – commonly 10 days from exposure to
onset of fever, and 14 days to appearance of rash.
Vd Rakesh Shukla, GAAC, Ahmedabad

6. Clinical features
1. Prodromal stage: begins 10 days after infection and
lasts until 14 days. Characterized by fever, coryza
with sneezing and nasal discharge, cough, redness of
eyes, lacrimations, and often photophobia. There
may be vomiting or diarrhoea. A day or 2 before the
rash Koplik’s spots like table salt crystals appear on
the buccal mucosa opposite the 1st and 2nd lower
molars.
Vd Rakesh Shukla, GAAC, Ahmedabad

7. Clinical features
2. Eruptive phase: dusky red, macular or maculo-
papular rash which begins behind the ears and spreads
rapidly in a few hours over the face and neck.
3. Post measles stage: the child will have lost weight
and will remain weak for a no. of days. There may be
growth retardation and diarrhoea, cancrum oris,
pyogenic infections, candidiasis, reactivation of
pulmonary tuberculosis.
Vd Rakesh Shukla, GAAC, Ahmedabad

8. Complication – most often complications include
dirrhoea, pnemonia. Neurological complications
include febrile convulsions, encepahalitis, sub acute
pan encephalitis SSPE.
Measles and chicken pox - in cases of double infection
the 1st infection may diminish the severity of the rash
of the 2nd infection.
Prevention of measles – achieving an immunization rate
over 95%, on going immunization against measles
through successive generation of children.Vd Rakesh Shukla, GAAC, Ahmedabad

9. Measles vaccinations
Vaccine: tissue cultured vaccine either chick embryo or
human diploid cell line.
Age: 9 months
Administration: subcutaneous dose of 0.5 ml
Reactions: fever
Immunity: develops 11 -12 days after vaccination
Contraindications: pregnancy
Vd Rakesh Shukla, GAAC, Ahmedabad

10. Adverse effect of vaccine – toxic shock syndrome
(TSS)occurs when measles vaccine is contaminated
or the same vial is used for more than 1 session on the
same day or the next day.
Combined vaccine: can be combined with mumps,
rubella (MMR) or MMRV varicella or MR
Immunoglobins: dose is 0.25 ml /body weight early in
the incubation period. Should be given 3-4 days of
exposure.
Vd Rakesh Shukla, GAAC, Ahmedabad

11. Eradication of measles: immunization by only 1 dose
has been developed which is more heat stable.
Control measures:
• Isolation for 7 days after the onset of rash,
Immunization of contacts with in 2 days of exposure.
• Prompt immunization at the beginning of an
epidemic is essential to limit the spread.
Vd Rakesh Shukla, GAAC, Ahmedabad

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Vd Rakesh Shukla, GAAC, Ahmedabad