This document provides information about measles (rubella), including: - It is an acute, highly communicable viral disease causing fever, conjunctivitis, cough and a characteristic red rash. - The measles virus is the infectious agent, which spreads through the air or direct contact with infected individuals. - Preventive measures include public education and immunization with live attenuated measles vaccines. Susceptible individuals include those who have not been vaccinated or had the disease. - Control involves reporting cases, isolating infected individuals, immunizing contacts, and comprehensive immunization programs for susceptible groups. International coordination is not required.

1. 3 a) MEASLES (Rubella or
German measles)
Allan R. Mbewe

2. 1. Identification
• Acute, highly communicable viral diseases with
prodromal fever, conjunctivitis, cough and spots on the
mucosa
• A characteristic red rash appears on the third to
seventh day, beginning on the face, becoming
generalized
 Rash may last 4 - 7 days
• The disease is more severe in infants and adults than in
children
• Complications may result from viral replication and
include otitis media, pneumonia, diarrhoea and
encephalitis

3. Cont.
• Diagnosis is usually made on clinical and
epidemiologic grounds although laboratory
confirmation is preferred

4. 2. Infectious agent:
• Measles virus
• 3. Occurrence: Prior to widespread
• 4. Reservoir: Humans
• 5. Mode of transmission: Airborne by droplet
spread, direct contact with nasal or throat
secretions of infected persons,
less commonly, by articles freshly soiled
with nose and throat secretions
• 6. Incubation period: About 10 days, varying
from 7 to 18 days

5. 7. Period of communicability
• Before the beginning of the prodromal period
to 4 days after appearance of the rash
• 8. Susceptibility and resistance: All persons
who have not had the disease
• All those who have not been successfully
immunized
• Acquired immunity after illness is permanent.
• Infants born to mothers who have had the
disease are immune for approximately the
first 6-9 months

6. A. Preventive measures
• Public education to encourage measles
immunization for all susceptible infants,
children, adolescents and young adults
• Immunization: live attenuated measles vaccine
is the agent of choice
• Mass measles immunization campaigns should
be considered in the following settings
• Vaccine shipment and storage: Both freeze-
dried (2o - 8°C) and reconstituted vaccine should
be protected from light, which may inactivate
the virus

7. Contraindications to the use of live-
virus vaccines
• Patients with immune deficiency diseases or
suppressed immune responses from leukaemia,
lymphoma or generalized malignancy
• Patients with severe acute illness with or without
fever
• People who cannot eat eggs because of
anaphylactic reactions
• Pregnancy. Vaccine should not be given to pregnant
women
• Vaccine should be given at least 14 days before
blood transfusion

8. B. Control of patient, contacts and the
immediate environment
• Report to local health authority: Early reporting
provides opportunity for control of outbreak
• Isolation: Children with measles should be kept
out of school for 4 days after appearance of the
rash
• Concurrent disinfection: None
• Quarantine: Usually impractical. Quarantine of
institutions, wards or dormitories can
sometimes be of value
• Immunization of contacts: live-virus vaccine

9. Cont.
• Investigation of contacts and source of
infection: A search for and immunization of
exposed susceptible contacts should be
carried out
Carriers are unknown
• Specific treatment: None

10. C. Epidemic measures
• Prompt reporting of suspected cases and
comprehensive immunization programs for all
susceptible
• In institutional outbreaks, new admissions should
receive vaccine
• If vaccine supply is limited, priority should be given
to young children for whom the risk is greatest
• D. Disaster implications: Introduction of measles
into refugee populations with a high proportion of
susceptible can result in devastating epidemics with
high fatality rates
• E. International measures: None

11. The end
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