This document discusses the measles, mumps, and rubella viruses. It provides details on their morphology, genomes, hosts, and pathogenesis. For diagnosis, it recommends microscopy to detect viral antigens, virus isolation in cell culture, and serological tests like ELISA and complement fixation. It describes symptoms and complications for each virus. The mumps virus causes parotid gland inflammation. Measles causes rashes and pneumonia. Rubella can cross the placenta and cause fetal abnormalities. Vaccination with the live attenuated MMR vaccine provides protection.

1. Measales, Mumps,
Rubella (MMR)
Dr Kamlesh Patel
MBBS MD DCP
Asst Prof, Microbiology
www.jaailab.com

2. Paramyxovirus
• Enveloped virus
• ss RNA (-), Negative sense
• Single piece genome
• Spherical
• Large in size (100- 300 nm): Sometimes giant (800 nm)
• Some members show Haemagglutinin and Neuraminidase
activity (but HA and NA both present on single spike).

3. Paramyxovus:
Morphology
• Spherical particles
• Helical symmetry
• RNA genome (- ss RNA), Single pieces.
• Envelope:
– Inner protein layer ‘M’ protein (matrix)- Virus coded
– Outer lipids (Host cell membrane)
• Peplomers:
– HN Glycoprotein spikes: Possess both HA (Haemagglutinin) and NA
(Neuraminidase) activity.
– F Glycoprotein: Causes fusion of cell membrane and responsible for
Syncytial formation.

5. Paramyxovirus:
Various viruses of this group
• Paramyxovirus
• Measales Virus
• Mumps virus
• Respiratory syncytial virus (RSV)
• Rubella virus belongs to another group RUBIVIRUS group

6. Mumps Virus
• Enveloped.
• ss RNA (Negative sense)
• Human is only natural host.
• HN spikes: Possess both HA and NA activity.
• Lifelong immunity after single infection

7. Mumps virus:
Pathogenesis
• Mode of spread: Direct contact with aerosols or infected saliva.
• Incubation period: 16- 18 days
• Entry: Respiratory tract, after multiplying locally spread to salivary gland,
Ovaries, Pancrease, Testes, Kidney and Brain through blood stream.
• Characterstrict feature: Non-suppurative inflammation of Parotid gland (in
95% cases).
• Complications:
– Meningitis and Meningoencephalitis.
– Orchitis (Common in postpubertal male)
– Oophoritis
– Pancreatitis
– Nephritis

8. Mumps virus:
Lab diagnosis
Mostly clinical diagnosis, but sometimes lab diagnosis requires:
Sample collection:
– Saliva
– Throat swab
– Aspirate from lesion.
– Serum
– CSF
Diagnosis:
1. Microscopy:
Demonstration of viral antigens: Direct Immunofluorescence (IFA).
Rapid method.
2. Isolation (cultivation) of Viral particles: (Mostly for research purpose)
Useful in first 2 to 3 days of infection
i. Tissue culture: HEp 2 cell culture, Primary human or monkey kidney cell.
ii. Animal inoculation : Guinea pig

9. Mumps virus:
Lab diagnosis
3. Serology:
CFT (Complement fixation test)
ELISA
4. Molecular testing: RNA amplification followed by RT PCR ???
Prophylaxis:
• Live attenuated vaccine available.
• Administer as MMR with Measales and Rubella.
• C/I: Pregnancy, Immunodeficiency or hypersensitivity.

10. Measales Virus
• Genus Morbillivirus.
• Enveloped.
• ss RNA (Negative sense)
• Human is only natural host.
• Highly infectious childhood infection.
• HN spikes: Possess only HA activity.
• NA activity absent.
• Lifelong immunity after single infection

11. Measales virus:
Pathogenesis
• Mode of spread: Direct contact with respiratory secretions.
• Incubation period: 10- 12 days
• Entry: Respiratory tract, after multiplying locally spread to RE system through
blood stream. (Primary Viremia)
• After multiplying in RE system it spread to epithelial surfaces like skin,
respiratory epithelium or Conjunctiva through blood again. (Secondary
Viremia)
• Symptoms: Fever, cough, conjunctivitis, skin rashes, Koplik’s spot on buccal
mucosa (character strict feature)
• Rashes are due to type 4 hypersensitivity, faded after 10- 14 days.
• Complications:
– Otiti media and Brochopneumonia.
– Giant cell pneumonia.
– Post measales encephalitis and Subacute Sclerosing Panencephalitis
(SSPE)

12. Measales virus:
Lab diagnosis
Mostly clinical diagnosis, but sometimes lab diagnosis requires:
Sample collection:
– Saliva
– Throat washings
– Nasopharyngeal swab.
– Serum
– CSF
Diagnosis:
1. Microscopy:
– Demonstration of viral antigens: Direct Immunofluorescence (IFA).
– Giemsa stain to see giant body of virus.
2. Isolation (cultivation) of Viral particles: (Mostly for research purpose)
Useful in first 2 to 3 days of infection
i. Tissue culture: Primary human or monkey kidney cell look for the
Cytopathic changes.

13. Measales virus:
Lab diagnosis
3. Serology:
CFT (Complement fixation test)
ELISA (IgM antibody): In SSPE: Measales antibody titre is important.
4. Molecular testing: RNA amplification followed by RT PCR ???
Prophylaxis:
• Live attenuated vaccine available.
• Administer as MMR with Mumps and Rubella.
• Complication: SSPE.

14. Rubella Virus
• Group Rubivirus
• Causes German measales/ Rubella
• Clinical features are same as Paramyxovirus group)
• Pleomorphic/ Spherical shape
• Enveloped.
• ss RNA (Negative sense)
• 50- 70 nm size
• Human is only natural host.
• HN spikes: Possess only HA activity.
• NA activity absent.
• Lifelong immunity after single infection

15. Rubella virus:
Pathogenesis
• Mode of spread: Inhalation.
• Incubation period: 2- 3 weeks.
Postnatal Rubella:
• Symptoms: Fever, skin rashes (small, pink macules first arise on face later
spread to trunk and limbs)
• Short duration and self limiting illness.
Congenital Rubella:
• Can cross placental barrier.
• Responsible for fetal abnormalities or even death.
• Classic Rubella Triad: Cataract, Deafness and Patent Ductus Arteriosus
(PDA)

16. Rubella virus:
Lab diagnosis
Mostly clinical diagnosis, but sometimes lab diagnosis requires:
Sample collection:
– Throat washings
– Urine
– Serum
– CSF
Diagnosis:
1. Microscopy:
– Demonstration of viral antigens: Direct Immunofluorescence (IFA).
2. Isolation (cultivation) of Viral particles: (Mostly for research purpose)
Useful in first 2 to 3 days of infection
i. Tissue culture: Primary Rabbit kidney cell line.

17. Rubella virus:
Lab diagnosis
3. Serology:
ELISA (IgM and IgG antibody) detection (Part of ToRCH infection).
4. Molecular testing: RNA amplification followed by RT PCR ???
Prophylaxis:
• Live attenuated vaccine available.
• Administer as MMR with Mumps and Measales.
• s/c injection.
• First dose at 9 to 15 months age
• Booster dose at 4 to 5 years of age.

18. Thank you