1) Measles is a highly infectious disease caused by a paramyxovirus that is spread through respiratory droplets. 2) It causes a prodrome of fever and cough followed by a characteristic rash. Complications can include pneumonia, diarrhea, and encephalitis. 3) Measles is prevented through widespread vaccination with two doses of the MMR vaccine, which has significantly reduced global measles deaths.

1. MEASLES [RUBEOLA]
Dr. Sushrit A. Neelopant
Assistant Professor,
Department of Community Medicine
RIMS, Raichur
10/2/2020

2. • An acute highly infectious disease of childhood
caused by - A - myxovirus
• ‘Rubeola’ = red spots
• Endemic in all parts of the world
• Before availability of vaccine, it killed 7-8M children a
year, today it still kills about 1m people
10/2/2020

3. • Clinical:
– Fever, coryza, cough  Rash
• Developing countries
– morbidity & mortality high
• Types of Measles:
– Purpuric measles
– Haemorrhagic measles
– Atypical measles
– Modified measles
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4. • > 30 million people are affected each year by
measles
• It is a leading killer among
– vaccine preventable diseases of childhood
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5. 10/2/2020

6. • Single stranded RNA virus - paramyxovirus group
• Survival outside human body- Subzero
• Sensitive- acid conditions, drying
• Source of Infection: a case of measles (carriers known)
• Infective material : secretions of nose, throat, resp. tr
• Communicability: 4 days before & 4 days after
• Secondary Attack Rate : 90% - unimmunized contacts
• Infection life long immunity
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7. 1) Vulnerable age: 6 months – 3yrs
2) Gender: Both - equally affected
3) Immunity: no age is immune if there is no previous
immunity
– One attack - life long immunity, second attacks rare
– Maternal antibodies protect - up to 6 months of age
– Immunity after vaccination long lasting
4) Nutrition: severe disease in malnourished
– mortality up to 400 times higher
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8. • Can spread in any season
• Increased transmission during winter
• Poor socio-economic conditions- favour attack
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9. Environmental
Factors
• Can spread in
any season
• More- winter
• Poor socio-
economic
conditions
Mode of
transmission
• Droplet inf.
• 4 & 4 days
• Entry-
– Resp. tr.
– Conjunctiva
Incubation
period
• Fever- 10 days
• Rash- 14 days
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10. 1. PRODROMAL STAGE
2. ERUPTIVE STAGE
3. POST-MEASLES STAGE
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11. • Begins 10 days after infection
– fever, sneezing, cough, coryza, conjunctivitis,
lacrimation, photophobia
• Koplik’s spots - buccal mucosa
– opposite the I and II upper molars
– a day / two before appearance of rash → they are small,
bluish – white spots on a red base
– pathognomonic
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12. • Rash- dusky red, macular/ maculopapular → face
(at hair line/forehead) → neck → extends down the
body in 2–3 days → to lower extremities
• Disappears in 3 – 4 days → fades in the same order
of the appearance end of disease
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13. Rashes
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17. 10/2/2020

18. Chicken pox rashes and Measles rashes
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19. • child has lost weight remains weak
• failure to recover 
• gradual deterioration into chronic illness 
• susceptible to other bacterial and viral infection,
diarrhoea, pyogenic inf, reactivation of pulmonary
tuberculosis, growth retardation
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20. • The risk of complications and death- highest in
young children and adults
• The most common complications of measles are
otitis media, diarrhoea and pneumonia
• Less common complications-
– sinusitis, mastoiditis, myocarditis, keratoconjunctivitis,
mesenteric adenitis, hepatitis, and thrombocytopenic
purpura
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21. • Measles infection during pregnancy is
associated with spontaneous abortion
and with delivery of low birth weight
infants
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22. • In addition to the acute complications, measles virus
can cause a degenerative disorder of the central
nervous system known as Subacute Sclerosing
PanEncephalitis (SSPE)
• The reported risk of SSPE ranges from 1 case per
100,000 measles cases in persons infected after four
years of age to 18 cases per 100,000 measles cases in
persons infected in infancy
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23. Prevention
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24. • Measles,Mumps,Rubella
(MMR) vaccine
• MMR I/M, 0.5 ml at 12
and 18 months
• MMR is a reconstituted
vaccine and hence must
be discarded at the end
of immunization session
i.e. after 6 Hours
10/2/2020

25. • Measles vaccine is contraindicated in persons with
immunodeficiency or immuno suppression
• However, it should be administered to persons with
asymptomatic human immunodeficiency virus (HIV)
infection since measles disease may be severe or
fatal in such persons
• Severely immunocompromised persons with HIV
infection should not be vaccinated
10/2/2020

26. • Passive immunity against measles disease can be
induced by the administration of commercially
prepared immune globulin (IG) (formerly called
immune serum globulin [ISG]), which typically has a
high measles antibody titer
• Administration of 0.25 mL of IG per kilogram
(maximum dose 15 mL) can modify or prevent the
development of measles in the exposed person
10/2/2020