Measles is a highly contagious viral infection that is transmitted through respiratory droplets. It causes a rash and fever and can lead to severe complications or death, especially in malnourished children. Before the widespread use of the measles vaccine in the 1960s, nearly all children contracted measles by age 10. Through vaccination campaigns and increased immunization rates, global measles deaths have declined significantly. However, ongoing efforts are still needed to achieve regional elimination goals and protect susceptible populations.
Smallest known DNA viruses.
Structure
Non-enveloped
18-26 nm diameter
Single-stranded DNA, 5.6 kb
Icosahedral
Parvovirinae (vertebrates)
Parvovirus
Erythrovirus
Dependovirus (requires helper virus, such as an adenovirus)
Bocavirus
Amdovirus
Densovirinae (invertebrates)`
B19 virus most common.
Diseases
Erythema infectiosum (cutaneous rash)
Polyarthropathy syndrome (acute or chronic)
Transient aplastic crisis (severe acute anemia)
Pure red cell aplasia (chronic anemia)
Hydrops fetalis (fetal anemia)
Simplest animal viruses infecting humans, responsible for - childhood exanthema - erythema infectiosum (fifth disease).
Smallest viruses (18–26 nm size)
Non-enveloped with icosahedral symmetry
Only DNA viruses - possess single-stranded DNA
Depend upon the host cell enzymes for replication
Transmission - Respiratory route, followed by blood transfusion and transplacental route.
Infects precursors of RBCs: Parvovirus B19 has a special tropism for erythroid progenitor cells present in adult bone marrow and foetal liver as it binds to blood group P antigen as receptors; which are present on the RBC surface.
This results in red cell destruction and inhibition of erythropoiesis
Erythema infectiosum (or fifth disease)
Transient aplastic crisis
Pure red cell aplasia
Non-immune hydrops fetalis
Papular-purpuric gloves and socks syndrome
Known to cause foetal loss through hydrops fetalis; severe anaemia, congestive heart failure, generalized oedema and foetal death
No evidence of teratogenicity.
Risk of foetal death highest when infection occurs during the second trimester of pregnancy (12%).
Molecular methods:
PCR - detects viral DNA (e.g. genes coding for VP1 and VP2) from serum, tissue or respiratory secretions.
Real time PCR - used for quantification of viral load in blood, during acute infections
Antibody detection: ELISA – detecting antibodies against VP1 and VP2 antigens. IgM appears early - recent infection and remains elevated for 2–3 months
Antigen detection: Immunohistochemistry - detect viral antigens in fetal tissues and bone marrow.
No antiviral drug is available
Symptomatic treatment is given
Immunoglobulins containing neutralizing antibodies to human parvovirus are available commercially
No antiviral drug is available
Symptomatic treatment is given
Immunoglobulins containing neutralizing antibodies to human parvovirus are available commercially
Measles is an acute, highly contagious childhood disease characterized by fever & respiratory symptoms, followed by typical maculopapular rash.
Transmission
Droplets inhalation over short distances and, less commonly,
Small-particle aerosols - remain suspended especially in schools, hospitals, and enclosed public places in the air for longer period.
Spread-The virus multiplies locally in the respiratory tract; then spreads to the regional lymph nodes → enter into the bloodstream in infected monocytes (primary viremia)→further multiply in reticuloendothelial system → spills over into blo
Smallest known DNA viruses.
Structure
Non-enveloped
18-26 nm diameter
Single-stranded DNA, 5.6 kb
Icosahedral
Parvovirinae (vertebrates)
Parvovirus
Erythrovirus
Dependovirus (requires helper virus, such as an adenovirus)
Bocavirus
Amdovirus
Densovirinae (invertebrates)`
B19 virus most common.
Diseases
Erythema infectiosum (cutaneous rash)
Polyarthropathy syndrome (acute or chronic)
Transient aplastic crisis (severe acute anemia)
Pure red cell aplasia (chronic anemia)
Hydrops fetalis (fetal anemia)
Simplest animal viruses infecting humans, responsible for - childhood exanthema - erythema infectiosum (fifth disease).
Smallest viruses (18–26 nm size)
Non-enveloped with icosahedral symmetry
Only DNA viruses - possess single-stranded DNA
Depend upon the host cell enzymes for replication
Transmission - Respiratory route, followed by blood transfusion and transplacental route.
Infects precursors of RBCs: Parvovirus B19 has a special tropism for erythroid progenitor cells present in adult bone marrow and foetal liver as it binds to blood group P antigen as receptors; which are present on the RBC surface.
This results in red cell destruction and inhibition of erythropoiesis
Erythema infectiosum (or fifth disease)
Transient aplastic crisis
Pure red cell aplasia
Non-immune hydrops fetalis
Papular-purpuric gloves and socks syndrome
Known to cause foetal loss through hydrops fetalis; severe anaemia, congestive heart failure, generalized oedema and foetal death
No evidence of teratogenicity.
Risk of foetal death highest when infection occurs during the second trimester of pregnancy (12%).
Molecular methods:
PCR - detects viral DNA (e.g. genes coding for VP1 and VP2) from serum, tissue or respiratory secretions.
Real time PCR - used for quantification of viral load in blood, during acute infections
Antibody detection: ELISA – detecting antibodies against VP1 and VP2 antigens. IgM appears early - recent infection and remains elevated for 2–3 months
Antigen detection: Immunohistochemistry - detect viral antigens in fetal tissues and bone marrow.
No antiviral drug is available
Symptomatic treatment is given
Immunoglobulins containing neutralizing antibodies to human parvovirus are available commercially
No antiviral drug is available
Symptomatic treatment is given
Immunoglobulins containing neutralizing antibodies to human parvovirus are available commercially
Measles is an acute, highly contagious childhood disease characterized by fever & respiratory symptoms, followed by typical maculopapular rash.
Transmission
Droplets inhalation over short distances and, less commonly,
Small-particle aerosols - remain suspended especially in schools, hospitals, and enclosed public places in the air for longer period.
Spread-The virus multiplies locally in the respiratory tract; then spreads to the regional lymph nodes → enter into the bloodstream in infected monocytes (primary viremia)→further multiply in reticuloendothelial system → spills over into blo
Epidemiology and control measures for CHICKENPOX {Varicella} AB Rajar
It is an acute, highly infectious disease caused by varicella-zoster(v-z) virus.
It is worldwide in distribution and occurs in both epidemic and endemic forms.
This ppt contains all information about epidemiology of Measles. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
human settlements/communities increased the possibility of a disease infecting many people at a time in a geographical area i.e known as an epidemic. And with time as communities mingled with each other either for trade, war, etc. they spread the diseases to new location fueling the pandemic.
Epidemiology and control measures for CHICKENPOX {Varicella} AB Rajar
It is an acute, highly infectious disease caused by varicella-zoster(v-z) virus.
It is worldwide in distribution and occurs in both epidemic and endemic forms.
This ppt contains all information about epidemiology of Measles. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
human settlements/communities increased the possibility of a disease infecting many people at a time in a geographical area i.e known as an epidemic. And with time as communities mingled with each other either for trade, war, etc. they spread the diseases to new location fueling the pandemic.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
epidofmeasles-180920162327.pdf
1.
2. Measles is a highly contagious respiratory infection
that's caused by a RNA virus- paramyxovirus that
infects only humans.
Also known as Rubeola meaning Red Spots.
Common among young chidren,transmitted by
respiratory droplets and direct contact with nasal or
throat secretions of infected persons.
3. It is an acute viral infection characterized by a
final stage with a maculopapular rash erupting
successively over the neck and face, trunk,
arms, and legs, and accompanied by a high fever.
Measles kills more children than any other
vaccine preventable disease. Before the
widespread use of vaccine, 90% of children had
contracted measles by the age of 10 years. An
effective vaccine has been available since the
1960s
4. Francis Home, a Scottish physician, demonstrated in
1757 that measles is caused by an infectious agent in
the blood of patients.
Panum Peter Ludwig (1820-1885) was a denish
physician ,who carried a classic study of
epidemiology of measles during an epidemic on the
faroe island in 1846.
5. Al-Razi (A Persian doctor)was the first physician in
history who described in details the symptoms and
signs of smallpox and measles based on clinical
examination.
In 1954, John F. Enders and Dr. Thomas C. Peebles
collected blood samples from several ill students
during a measles outbreak in Boston, Massachusetts,
they succeeded in isolating measles in 13-year-old
David Edmonston’s blood.
6. Measles is endemic throughout the world.
In the past, epidemics tended to occur irregularly .
it is rarely subclinical.
Prior to the use of measles vaccine, the peak
incidence was among children 5-10 yr of age.
7. The WHO estimated that over 40 million cases still
occurs in worldwide contributing to 530000 deaths
including 182000 in SEA region as reported in 2003.
Now Measles mortality has been reduced from
733000 in 2000 to 164000 in 2008
The coverage with measles vaccine has increased
from 1.3% in 1985 to 74% in 2009.However each
year about 15 % of 26 million infant remain
unimmunized and are at potential risk of measles
infection.
8. In India measles is a major cause of morbidity and a
significant contributor to childhood mortality.
Prior to the immunization programme ,cyclical
increase in the incidence were recorded every third
year
With immunization coverage the interval between
cyclical peak increased and intensity minimized
9. The retrospective data indicate declining trend of
measles in India
During 1987 about 2.47 lakh cases reported,whereas
after implementation of UIP the number came down
to 23348 with 33 deaths in 2014
However the estimates are much higher as large
number of cases go unreported
WHO estimates ,measles is responsible for about 2
percent of under-5 mortality in India
10. EPIDEMIOLOGICAL DETERMINANTS:-
AGENT FACTORS:-
A)AGENT:-Measles virus, the cause of measles, is an
RNA virus of the genus Morbillivirus in the family
Paramyxoviridae. Only one serotype is known.
It cannot survive outside the human body,and can be
easily destroyed by heat,acid and drying
It can retain infectivity when stored at sub zero
temperature,at 4-6 degree celcius ,it can survive for
6 months and at -20 degree celcius can survive for 2-
3 years.
11. B)Source Of Infection- The only source of infection is
the case of measles,No carrier state is known.
C)Infective Material-The secretion of nose,and
respiratory tract of a case of easles during prodormal
phase and early stages of the rash.
D)Communicability:-Highly infectious during the
prodormal period and at the time of eruption.
Communicability decreases with appearance of
rashes. The Period of communicability is 4 days
before and 4 days after the appearance of rashes
12. HOST FACTORS:
A)Age-Incidence is high among children between 6
months to 3 years in developing countries,Infant
below 6 months escapes because of maternal
antibodies ,they get through milk.
B)Sex- Equal in both sexes.
C)Immunity-No age is immune if there was no previous
immunity, One attack of measles confers lifelong
immunity .Immunity after vaccination is quite solid
and life long.
D)Nutrition-Malnutrition increases the susceptibility of
child, Mortality is 400 times higher in malnourished
child compared to healthy counterpart.
13. ENVIORNMENTAL FACTORS:
In temperte climates ,measles is common during
winter season and early spring(January to April)
because of overcrowding indoors,poor enviornmental
conditions,Poor housing ,and Overcrowding favours
the disease transmission.
14. After entering the body through respiratory tract by
droplet infection, the virus quickly pass to the
nearest lymph node multiply there and leak into the
bloodstream ,reaches R.E cells of liver, spleen and
bone marrow ,where they multiply and destroys
cells and flow again to blood stream in sufficient
number as to affect many tissue in body mainly
respiratory mucosa ,alimentary mucosa, conjunctiva
and skin.
The symptoms are mainly due to inflamatory
reaction in these areas.
15. Incubation period is commonly 10 days from
exposure to onset of fever ,14 days to
appearance of rashes, patients are infectious
from about 4 days before developing the rash
until 4 days after rash.
16. There are two stages of measles,
Prodromal Stage
Exanthematous Stage
17. This is also called as Pre-eruptive or catarrhal
stage,begins 10 days after infection and last
until day 14.
Characterised by
FEVER
CORYZA
NASAL DISCHARGE
COUGH
REDNESS OF EYES /PHOTOPHOBIA
18. KOPLIK SPOT-
One or two days before the appearance of rashes,
Koplik’s spot appear on the buccal mucous
membrane by side of the second molar tooth around
the orifice of the Stenson’s duct, lasting for about 3-
4 days.
(Pathognomonic of
measles.
Small bluish white spot
on a red base looking
like grains of salts)
19. Often cervical lymphadenopathy and febrile
convulsions occurs
The prodromal stage lasts for about 3 days.
20. Rashes appears on the 4th day of fever ,First
behind the ear,then on forehead ,face and
down the trunk,slowly taking 2-3 days to
progress to hands and lower extremities.
Rashes are pink in colour (dull red),valvety and
maculopapular ,they remain descrete but often
becomes confluent and blotchy
21.
22. From the 5th or 6th day the rashes begins to
disappear in the same order as they had
appeared.
Lesions disappears completely from face, but
on trunks they leave brownish discoloration,
which persist about 6-8 weeks.
The CFR varies from 5-30% depending upon
nutritional status and development of
complications
23. Post Measles Complications grouped into
following groups-
Respiratory Complications
Gastrointestinal Complications
Neurological Complications
Ophthalmic Complications
28. Isolation in well ventilated room
Concurrent disinfection of nasal and throat
secretions
Light and clean clothes
Antipyretics to control fever
Plenty of water and fruit juice because of loss
of appetite
Correction of malnutrition with high quality diet
29. Prophylactic Antibiotics can be given
Attendants to use mask and gown
Watch for complications
Vitamin A for measles case management
Vitamin A supplementation is required in all cases
of severe measles, A High dose of vitamin A is
given after diagnosis and repeated next day .
Age Day1 Following Day
0-6 months - 50000 IU - 50000 IU
6-11 months - 100000 IU- 100000 IU
> 12 months - 200000 IU 200000 IU
30. This is done by Active and Passive Immunization:-
Active Immunization-
Done by using live attenuated vaccine.
Two groups-
1.Single Antigen-
A)Aerosolized vaccine(Edmonston Zagreb Stain)
B)Heat stable vaccine(Schwartz/Moraten Stain)
31. 2.Measles vaccine of multiple antigen :
MMR(Measles,Mumps,Rubella vaccine)
Measles Vaccine-
Nature- live virus vaccine of single antigen in freeze
dried form
Diluent- Sterile distilled water
Dose- 0.5 ml
Route- Subcutaneous in the upper arm or
antrolateral aspect of thigh
Schedule-Two doses are recommended as per
NIP, one during 9-12 months, second during
16-24 months
32. Immunity –develops 10-12 days after
vaccination and last lifelong
Protective value-One dose confers 95%
protection
*IAP schedulde 2014 says,no need to use single
strand measles vaccine,It recommends to use
MMR1 at 9 months and MMR2 at 15 months.
33. This is done by human normal immunoglobulin
It is non specific
Given to those young children who came in contact
with case of measles and are not immunized.
Given within 1 week of exposure.
Dose-0.25-0.5 ml per kg body weight
(Approx 250 mg for infants ,500 mg for children
below 1 year)
Route-Intramascular
34. This was supported by WHO,UNICEF,and American
Red Cross by adopting strategies:
Catch Up Campaigns-To cover susceptible children
with second dose of measles vaccine to achieve
coverage of 90% with meticulous planning.
Follow Up Campaign- after 2-4 years in area covered
in catch up campaign to cover susceptible cohort
35. Goals and Objectives:
1.Reduce at least 90% mortality by 2013 as compared
to 2000.
2.Achieving at least 90% coverage with measles
vaccine
3.Collection of good quality epidemiological data
through active surveillance-IDSP(Integrated Disease
Surveillance Programme)
4.Elimination of measles by 2020 in India
36. Strengthining of routine Immunization
Surveillance of measles
Case Management
Second Opportunity
37. Park’s Textbook of Preventive and Social Medicine-24th
Edition
Textbook of Community Medicine by AH Suryakantha
4th Edition
Textbook of Community Medicine by Sunder Lal -5th
Edition
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