SlideShare a Scribd company logo
Measles, Mumps & Rubella
(MMR(
• Infections with measles, mumps and rubella
viruses are confined to man and occur worldwide.
• Spread primarily via the aerosol route.
• Each of these viruses exists as a single serotype
• MMR vaccine contains all three of these viruses
• .Measles & Mumps belong to family
Paramyxovirus
• RNA enveloped viruses
Measles & Mumps
MEASLES (RUBEOLA)
PATHOGENESIS AND DISEASE
• The word measles is derived from German word for
blister
• Respiratory droplet infection.
• Virus replicates in the upper/lower respiratory tract and
lymphoid tissues leading to viremia and then growth in
a variety of epithelial sites.
• The virus is very contagious: maximum contagiousness
is 2 to 3 days before onset of the rash.
• The disease develops 1 - 2 weeks after infection.
Clinical Features
• Measles is still a major killer in
underdeveloped countries
• Fever of 101o
F (38.3o
C) or above
• Running nose (coryza) and cough
• Conjunctivitis
• Koplik's spots on mucosal
membranes - small (1 - 3mm),
irregular, bright red spots, with
bluish-white speck at center.
• Maculopapular rash which extends
from face to the extremities.
• The infection is prostrating but
recovery is usually rapid
Clinical Features
Complications of Measles
• Secondary bacterial infections: otitis
media and bacterial pneumonia.
• Pneumonia accounts for 60% of deaths from
measles
• Encephalitis (1 in 1000 cases) a few days
after the rash disappears.
Subacute Sclerosing Pan encephalitis
• Very rare (7 in 1,000,000 cases)
• Develops 1 to 10 years after the initial infection.
• Behavioral changes.
• Impaired speech, vision and swallowing
• A progressive, usually fatal disease
• SSPE is associated with defective forms of the
virus in the brain
Complications of Measles
• Measles can cause temporary defects in
the immune response; e.g. tuberculin-
positive individuals may temporarily
give a negative response.
Complications of Measles
LAB DIAGNOSIS
• The clinical picture
• Serodiagnosis
o IgM & IgG levels
• Virus isolation in cell culture
o The large syncytia, or multinucleated
giant cells, result from fusion of cell
membranes
o Inclusion bodies, eosinophilic areas
of altered staining in the cytoplasm
EPIDEMIOLOGY
• Almost all infected individuals show signs
of disease.
• Only one serotype of measles and a single
natural infection gives life-long protection.
MMR Vaccine
• Is a live, attenuated combined vaccine to
prevent measles, mumps and rubella.
• Two doses are given to pre-school
children:
o The first dose at 12-15 months
o The second booster dose at 3-5 years
PREVENTION
PREVENTION & TREATMENT
• Immune serum globulin: for at risk
patients during an outbreak i.e. those <1 year
with impaired cellular immunity
o No antiviral therapy available for primary
disease. Complications should be treated
appropriately
MUMPS
• The name comes from the British
word "to mump", that is grimace
• Clinically, mumps is an acute
unilateral or bilateral parotid
gland swelling that lasts for more
than two days with no other
apparent cause.
 Other agents can also cause
parotitis
Mumps Pathogenesis
Mumps Epidemiology
Reservoir Human
Transmission Respiratory droplet infection
Communicability 7 days before to 9 days after
onset of active disease
• Worldwide distribution
•Many (30%) infections are sub-clinical
•No 'carrier state'.
Clinical Aspects of Mumps
• Fever
• Parotitis
• Meningitis & encephalitis
• Orchitis
• Pancreatitis
• Myocarditis
• Nephritis
• Arthritis
Mumps Complications
CNS involvement 15% of clinical cases
Orchitis 20-50% in
post-pubertal males
Pancreatitis 2-5%
Deafness 1/20,000
Death 1-3/10,000
MMR Vaccine
• Is a live, attenuated combined vaccine to
prevent measles, mumps and rubella.
• Two doses are given to pre-school
children:
o The first dose at 12-15 months
o The second booster dose at 3-5 years
PREVENTION & TREATMENT
Rubella (German Measles(
History
1881Rubella accepted as a distinct disease
1941Associated with congenital disease
Rubella virus first isolated 1961
1967Serological tests available
1969Rubella vaccines available
Rubella Virus
RNA enveloped virus
Member of the togavirus family
Spreads by respiratory droplets
In the pre-vaccination era, 80% of women
were already infected by childbearing age
Clinical Features
Rubella: Latin “little red”
Maculopapular rash
Lymphadenopathy
Fever
Arthropathy (up to 60% of cases(
Rash of Rubella
Risks of Rubella Infection
During Pregnancy
Preconception :Minimal risk
0-12weeks: 100% risk of fetus being congenitally
infected
 resulting in major congenital abnormalities.
Spontaneous abortion occurs in 20% of cases.
13-16weeks: Deafness and retinopathy 15%
After 16 weeks: Normal development, slight risk
of deafness and retinopathy
Congenital Rubella Syndrome
Classical triad consists
of:
Cataracts
Heart defects
Sensorineural deafness.
Transient
Low birth weight, hepatosplenomegaly,
thrombocytopenic purpura, meningoencephalitis,
hepatitis, haemolytic anemia, pneumonia,
lymphadenopathy
Permanent
Sensorineural deafness, Heart defects, Eye defects
(retinopathy, cataract, microopthalmia, glaucoma),
diabetes mellitis
Developmental
Sensorineural deafness, Mental retardation
Congenital Rubella Syndrome
Outcome
1/3rd will lead normal independent lives
1/3rd will live with parents
1/3rd will be institutionalised
The only effective way to prevent CRS is to
terminate the pregnancy
Laboratory Diagnosis
Diagnosis of acute infection
Presence of rubella-specific IgM
Rising titres of antibody (mainly IgG(
Typical Serological Events following
acute rubella infection
Note that in reinfection, IgM is usually absent or only present transiently at a low level
Prevention
Antenatal screening
Screening of all pregnant women attending antenatal
clinics for immune status against rubella.
Non-immune women are vaccinated in the immediate
post partum period.
Prevention
Since 1968, a highly effective live attenuated
vaccine has been available with 95% efficacy
Universal vaccination is now offered to all
infants as part of the MMR regimen in the
USA, UK and a number of other countries.
Vaccination of schoolgirls before they reach
childbearing age.

More Related Content

What's hot

Mycobacterium tuberculosis
Mycobacterium  tuberculosisMycobacterium  tuberculosis
Mycobacterium tuberculosis
Dr. Samira Fattah
 
Klebsiella Dr. Mahadi ppt
Klebsiella Dr. Mahadi pptKlebsiella Dr. Mahadi ppt
Klebsiella Dr. Mahadi ppt
Mahadi Hassan Mahmoud Abdallah
 
Pseudomonas
PseudomonasPseudomonas
Pseudomonas
Dr. Samira Fattah
 
Mycobacterium
MycobacteriumMycobacterium
Mycobacterium
Ashish Kelwa
 
paramyxovirus.ppt
paramyxovirus.pptparamyxovirus.ppt
paramyxovirus.ppt
NCRIMS, Meerut
 
Mycobacterium tuberculosis
Mycobacterium tuberculosisMycobacterium tuberculosis
Mycobacterium tuberculosis
Awaaz Batazoo
 
Paramyxovirus
ParamyxovirusParamyxovirus
Paramyxovirus
Noman-Hafeez khosa
 
KLEBSIELLA
KLEBSIELLAKLEBSIELLA
KLEBSIELLA
Maneesha M Joseph
 
Neisseria final.pptx
Neisseria final.pptxNeisseria final.pptx
Neisseria final.pptx
NCRIMS, Meerut
 
Neisseria meningitidis
Neisseria meningitidisNeisseria meningitidis
Neisseria meningitidis
Mosese HULKSTAH Tuapati JNR
 
Orthomyxovirus - Morphology and laboratory diagnosis
Orthomyxovirus - Morphology and laboratory diagnosisOrthomyxovirus - Morphology and laboratory diagnosis
Orthomyxovirus - Morphology and laboratory diagnosis
Ragya Bharadwaj
 
Haemophilus influenzae
Haemophilus influenzaeHaemophilus influenzae
Haemophilus influenzaecamanejotonto
 
Rhino virus notes
Rhino virus notesRhino virus notes
Rhino virus notes
Vamsi kumar
 
Herpes viruses
Herpes viruses Herpes viruses
Herpes viruses
sreenivasulu Reddy
 
Zygomycosis
ZygomycosisZygomycosis
Zygomycosis
Microbiology
 
Tetanus
TetanusTetanus
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps. Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
Eneutron
 
Orthomyxoviruses
OrthomyxovirusesOrthomyxoviruses
Orthomyxoviruses
İsa Badur
 

What's hot (20)

Neisseria Meningitidis
Neisseria MeningitidisNeisseria Meningitidis
Neisseria Meningitidis
 
Mycobacterium tuberculosis
Mycobacterium  tuberculosisMycobacterium  tuberculosis
Mycobacterium tuberculosis
 
Klebsiella Dr. Mahadi ppt
Klebsiella Dr. Mahadi pptKlebsiella Dr. Mahadi ppt
Klebsiella Dr. Mahadi ppt
 
Pseudomonas
PseudomonasPseudomonas
Pseudomonas
 
Mycobacterium
MycobacteriumMycobacterium
Mycobacterium
 
paramyxovirus.ppt
paramyxovirus.pptparamyxovirus.ppt
paramyxovirus.ppt
 
Mycobacterium tuberculosis
Mycobacterium tuberculosisMycobacterium tuberculosis
Mycobacterium tuberculosis
 
Paramyxovirus
ParamyxovirusParamyxovirus
Paramyxovirus
 
KLEBSIELLA
KLEBSIELLAKLEBSIELLA
KLEBSIELLA
 
Neisseria final.pptx
Neisseria final.pptxNeisseria final.pptx
Neisseria final.pptx
 
Klebsiella+proteus+uti
Klebsiella+proteus+utiKlebsiella+proteus+uti
Klebsiella+proteus+uti
 
Neisseria meningitidis
Neisseria meningitidisNeisseria meningitidis
Neisseria meningitidis
 
Orthomyxovirus - Morphology and laboratory diagnosis
Orthomyxovirus - Morphology and laboratory diagnosisOrthomyxovirus - Morphology and laboratory diagnosis
Orthomyxovirus - Morphology and laboratory diagnosis
 
Haemophilus influenzae
Haemophilus influenzaeHaemophilus influenzae
Haemophilus influenzae
 
Rhino virus notes
Rhino virus notesRhino virus notes
Rhino virus notes
 
Herpes viruses
Herpes viruses Herpes viruses
Herpes viruses
 
Zygomycosis
ZygomycosisZygomycosis
Zygomycosis
 
Tetanus
TetanusTetanus
Tetanus
 
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps. Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
Orthomyxoviruses & Paramyxoviruses, Influenza, Measles & Mumps.
 
Orthomyxoviruses
OrthomyxovirusesOrthomyxoviruses
Orthomyxoviruses
 

Viewers also liked

Lect 6 b rubella rmc
Lect 6 b rubella rmcLect 6 b rubella rmc
Lect 6 b rubella rmc
Dr. Riaz Ahmad Bhutta
 
Lect 3 - Herpes viruses hsv
Lect 3 - Herpes viruses hsvLect 3 - Herpes viruses hsv
Lect 3 - Herpes viruses hsv
Dr. Riaz Ahmad Bhutta
 
Lect 7 a enteroviruses-rmc
Lect 7 a enteroviruses-rmcLect 7 a enteroviruses-rmc
Lect 7 a enteroviruses-rmc
Dr. Riaz Ahmad Bhutta
 
Lect 4 - Varicella-zoster virus (vzv), cmv, ebv
Lect 4 - Varicella-zoster virus (vzv), cmv, ebvLect 4 - Varicella-zoster virus (vzv), cmv, ebv
Lect 4 - Varicella-zoster virus (vzv), cmv, ebv
Dr. Riaz Ahmad Bhutta
 
Diagnosis of viral disease
Diagnosis of viral diseaseDiagnosis of viral disease
Diagnosis of viral disease
Dr. Riaz Ahmad Bhutta
 
Introduction to virology
Introduction to virologyIntroduction to virology
Introduction to virology
Dr. Riaz Ahmad Bhutta
 
Lect 5 - Respiratory viruses
Lect 5 - Respiratory virusesLect 5 - Respiratory viruses
Lect 5 - Respiratory viruses
Dr. Riaz Ahmad Bhutta
 
Dengue in pakistan
Dengue in pakistanDengue in pakistan
Dengue in pakistan
Dr. Riaz Ahmad Bhutta
 
Lect 7 b diarrhoea viruses-rmc
Lect 7 b diarrhoea viruses-rmcLect 7 b diarrhoea viruses-rmc
Lect 7 b diarrhoea viruses-rmc
Dr. Riaz Ahmad Bhutta
 
Hep intro
Hep introHep intro

Viewers also liked (11)

Lect 6 b rubella rmc
Lect 6 b rubella rmcLect 6 b rubella rmc
Lect 6 b rubella rmc
 
Lect 3 - Herpes viruses hsv
Lect 3 - Herpes viruses hsvLect 3 - Herpes viruses hsv
Lect 3 - Herpes viruses hsv
 
Lect 7 a enteroviruses-rmc
Lect 7 a enteroviruses-rmcLect 7 a enteroviruses-rmc
Lect 7 a enteroviruses-rmc
 
Lect 4 - Varicella-zoster virus (vzv), cmv, ebv
Lect 4 - Varicella-zoster virus (vzv), cmv, ebvLect 4 - Varicella-zoster virus (vzv), cmv, ebv
Lect 4 - Varicella-zoster virus (vzv), cmv, ebv
 
Diagnosis of viral disease
Diagnosis of viral diseaseDiagnosis of viral disease
Diagnosis of viral disease
 
Introduction to virology
Introduction to virologyIntroduction to virology
Introduction to virology
 
Lect 5 - Respiratory viruses
Lect 5 - Respiratory virusesLect 5 - Respiratory viruses
Lect 5 - Respiratory viruses
 
Dengue in pakistan
Dengue in pakistanDengue in pakistan
Dengue in pakistan
 
Lect 7 b diarrhoea viruses-rmc
Lect 7 b diarrhoea viruses-rmcLect 7 b diarrhoea viruses-rmc
Lect 7 b diarrhoea viruses-rmc
 
Hep intro
Hep introHep intro
Hep intro
 
Mycology
MycologyMycology
Mycology
 

Similar to Lect 6 a measles, mumps and rubella

Mumps & Rubella.pptx
Mumps & Rubella.pptxMumps & Rubella.pptx
Mumps & Rubella.pptx
Rahul Netragaonkar
 
Rubella
RubellaRubella
Rubella
Angel Samy
 
5.Rubella-1.pptx for bsc nursing student
5.Rubella-1.pptx for bsc nursing student5.Rubella-1.pptx for bsc nursing student
5.Rubella-1.pptx for bsc nursing student
deepsinghraj50
 
Rubella slide
Rubella slideRubella slide
Rubella slide
ROMAN BAJRANG
 
Overview of medicine
Overview of medicineOverview of medicine
Overview of medicine
AnkitaKadam20
 
MEASLES.pptx4445544444444444444444444444
MEASLES.pptx4445544444444444444444444444MEASLES.pptx4445544444444444444444444444
MEASLES.pptx4445544444444444444444444444
samuellamaryk
 
Measles, Mumps and Rubella viruses
Measles, Mumps and Rubella virusesMeasles, Mumps and Rubella viruses
Measles, Mumps and Rubella viruses
Aman Ullah
 
Vaccine preventable diseases
Vaccine preventable diseasesVaccine preventable diseases
Vaccine preventable diseases
Dr. Eman M. Mortada
 
Rubella
RubellaRubella
AZU VIROLOGY LEC 4.pdf
AZU VIROLOGY LEC 4.pdfAZU VIROLOGY LEC 4.pdf
AZU VIROLOGY LEC 4.pdf
msalahabd
 
Measals and there management
Measals and there managementMeasals and there management
Measals and there management
Irfan Ahmed
 
German-Measles 355588092-German-Measles.ppt
German-Measles 355588092-German-Measles.pptGerman-Measles 355588092-German-Measles.ppt
German-Measles 355588092-German-Measles.ppt
Abdelrhman abooda
 
Fever with rashes, decribing various types of fever presenting with rash
Fever with rashes, decribing various types of fever presenting with rashFever with rashes, decribing various types of fever presenting with rash
Fever with rashes, decribing various types of fever presenting with rash
qjht4zgqzr
 
Common Pediatric Viral Exanthems
Common Pediatric Viral Exanthems Common Pediatric Viral Exanthems
Common Pediatric Viral Exanthems
Fatima Farid
 
Rubella, Togavirus
Rubella, TogavirusRubella, Togavirus
Rubella, Togavirus
Rahul Ratnakumar
 
Rubella (german measles)
Rubella (german measles)Rubella (german measles)
Rubella (german measles)
Mosese HULKSTAH Tuapati JNR
 
Rubella
RubellaRubella
Rubella
Pubali Biswas
 
Para.ppt
Para.pptPara.ppt
Para.ppt
JiyaMuhammad1
 
RUBELLA
RUBELLARUBELLA
RUBELLA
Aamir Ali
 
MEASLES - THEORY.ppt
MEASLES - THEORY.pptMEASLES - THEORY.ppt
MEASLES - THEORY.ppt
mousaderhem1
 

Similar to Lect 6 a measles, mumps and rubella (20)

Mumps & Rubella.pptx
Mumps & Rubella.pptxMumps & Rubella.pptx
Mumps & Rubella.pptx
 
Rubella
RubellaRubella
Rubella
 
5.Rubella-1.pptx for bsc nursing student
5.Rubella-1.pptx for bsc nursing student5.Rubella-1.pptx for bsc nursing student
5.Rubella-1.pptx for bsc nursing student
 
Rubella slide
Rubella slideRubella slide
Rubella slide
 
Overview of medicine
Overview of medicineOverview of medicine
Overview of medicine
 
MEASLES.pptx4445544444444444444444444444
MEASLES.pptx4445544444444444444444444444MEASLES.pptx4445544444444444444444444444
MEASLES.pptx4445544444444444444444444444
 
Measles, Mumps and Rubella viruses
Measles, Mumps and Rubella virusesMeasles, Mumps and Rubella viruses
Measles, Mumps and Rubella viruses
 
Vaccine preventable diseases
Vaccine preventable diseasesVaccine preventable diseases
Vaccine preventable diseases
 
Rubella
RubellaRubella
Rubella
 
AZU VIROLOGY LEC 4.pdf
AZU VIROLOGY LEC 4.pdfAZU VIROLOGY LEC 4.pdf
AZU VIROLOGY LEC 4.pdf
 
Measals and there management
Measals and there managementMeasals and there management
Measals and there management
 
German-Measles 355588092-German-Measles.ppt
German-Measles 355588092-German-Measles.pptGerman-Measles 355588092-German-Measles.ppt
German-Measles 355588092-German-Measles.ppt
 
Fever with rashes, decribing various types of fever presenting with rash
Fever with rashes, decribing various types of fever presenting with rashFever with rashes, decribing various types of fever presenting with rash
Fever with rashes, decribing various types of fever presenting with rash
 
Common Pediatric Viral Exanthems
Common Pediatric Viral Exanthems Common Pediatric Viral Exanthems
Common Pediatric Viral Exanthems
 
Rubella, Togavirus
Rubella, TogavirusRubella, Togavirus
Rubella, Togavirus
 
Rubella (german measles)
Rubella (german measles)Rubella (german measles)
Rubella (german measles)
 
Rubella
RubellaRubella
Rubella
 
Para.ppt
Para.pptPara.ppt
Para.ppt
 
RUBELLA
RUBELLARUBELLA
RUBELLA
 
MEASLES - THEORY.ppt
MEASLES - THEORY.pptMEASLES - THEORY.ppt
MEASLES - THEORY.ppt
 

More from Dr. Riaz Ahmad Bhutta

Stress Management
Stress ManagementStress Management
Stress Management
Dr. Riaz Ahmad Bhutta
 
Mental and Behavioral Disorders Due to General Medical Conditions
Mental and Behavioral Disorders Due to General Medical ConditionsMental and Behavioral Disorders Due to General Medical Conditions
Mental and Behavioral Disorders Due to General Medical Conditions
Dr. Riaz Ahmad Bhutta
 
Introduction to BHS
Introduction to BHSIntroduction to BHS
Introduction to BHS
Dr. Riaz Ahmad Bhutta
 
Genetics and Biochemistry of Behavior
Genetics and Biochemistry of BehaviorGenetics and Biochemistry of Behavior
Genetics and Biochemistry of Behavior
Dr. Riaz Ahmad Bhutta
 
Doctor-Patient Relationship
Doctor-Patient RelationshipDoctor-Patient Relationship
Doctor-Patient Relationship
Dr. Riaz Ahmad Bhutta
 
Depression in College Students
Depression in College StudentsDepression in College Students
Depression in College Students
Dr. Riaz Ahmad Bhutta
 
Child Psychiatry
Child PsychiatryChild Psychiatry
Child Psychiatry
Dr. Riaz Ahmad Bhutta
 
Aging, death & bereavement
Aging, death & bereavementAging, death & bereavement
Aging, death & bereavement
Dr. Riaz Ahmad Bhutta
 
Adolescence
AdolescenceAdolescence
Lecture 8a - HAV-HEV-HGV-RMC
Lecture 8a -  HAV-HEV-HGV-RMCLecture 8a -  HAV-HEV-HGV-RMC
Lecture 8a - HAV-HEV-HGV-RMC
Dr. Riaz Ahmad Bhutta
 
Lect 10 - HIV disease and aids
Lect 10 - HIV disease and aidsLect 10 - HIV disease and aids
Lect 10 - HIV disease and aids
Dr. Riaz Ahmad Bhutta
 
Misc - Congenital, zoonotic, arbo viruses
Misc - Congenital, zoonotic, arbo virusesMisc - Congenital, zoonotic, arbo viruses
Misc - Congenital, zoonotic, arbo viruses
Dr. Riaz Ahmad Bhutta
 
Shigella and Food Poisoning
Shigella and Food PoisoningShigella and Food Poisoning
Shigella and Food Poisoning
Dr. Riaz Ahmad Bhutta
 
Lect 2 laboratory diagnosis of viral infections
Lect 2 laboratory diagnosis of viral infectionsLect 2 laboratory diagnosis of viral infections
Lect 2 laboratory diagnosis of viral infections
Dr. Riaz Ahmad Bhutta
 
Lect 1 introduction to medical virology
Lect 1 introduction to medical virologyLect 1 introduction to medical virology
Lect 1 introduction to medical virology
Dr. Riaz Ahmad Bhutta
 
Superficial mycoses
Superficial mycosesSuperficial mycoses
Superficial mycoses
Dr. Riaz Ahmad Bhutta
 
Inate immunity
Inate immunityInate immunity
Inate immunity
Dr. Riaz Ahmad Bhutta
 
Humoral &amp; cellural immunity done
Humoral &amp; cellural immunity doneHumoral &amp; cellural immunity done
Humoral &amp; cellural immunity done
Dr. Riaz Ahmad Bhutta
 

More from Dr. Riaz Ahmad Bhutta (19)

Stress Management
Stress ManagementStress Management
Stress Management
 
Mental and Behavioral Disorders Due to General Medical Conditions
Mental and Behavioral Disorders Due to General Medical ConditionsMental and Behavioral Disorders Due to General Medical Conditions
Mental and Behavioral Disorders Due to General Medical Conditions
 
Introduction to BHS
Introduction to BHSIntroduction to BHS
Introduction to BHS
 
Genetics and Biochemistry of Behavior
Genetics and Biochemistry of BehaviorGenetics and Biochemistry of Behavior
Genetics and Biochemistry of Behavior
 
Doctor-Patient Relationship
Doctor-Patient RelationshipDoctor-Patient Relationship
Doctor-Patient Relationship
 
Depression in College Students
Depression in College StudentsDepression in College Students
Depression in College Students
 
Child Psychiatry
Child PsychiatryChild Psychiatry
Child Psychiatry
 
Aging, death & bereavement
Aging, death & bereavementAging, death & bereavement
Aging, death & bereavement
 
Adolescence
AdolescenceAdolescence
Adolescence
 
Lecture 8a - HAV-HEV-HGV-RMC
Lecture 8a -  HAV-HEV-HGV-RMCLecture 8a -  HAV-HEV-HGV-RMC
Lecture 8a - HAV-HEV-HGV-RMC
 
Lect 10 - HIV disease and aids
Lect 10 - HIV disease and aidsLect 10 - HIV disease and aids
Lect 10 - HIV disease and aids
 
Misc - Congenital, zoonotic, arbo viruses
Misc - Congenital, zoonotic, arbo virusesMisc - Congenital, zoonotic, arbo viruses
Misc - Congenital, zoonotic, arbo viruses
 
Shigella and Food Poisoning
Shigella and Food PoisoningShigella and Food Poisoning
Shigella and Food Poisoning
 
Lect 2 laboratory diagnosis of viral infections
Lect 2 laboratory diagnosis of viral infectionsLect 2 laboratory diagnosis of viral infections
Lect 2 laboratory diagnosis of viral infections
 
Lect 1 introduction to medical virology
Lect 1 introduction to medical virologyLect 1 introduction to medical virology
Lect 1 introduction to medical virology
 
Dengue
DengueDengue
Dengue
 
Superficial mycoses
Superficial mycosesSuperficial mycoses
Superficial mycoses
 
Inate immunity
Inate immunityInate immunity
Inate immunity
 
Humoral &amp; cellural immunity done
Humoral &amp; cellural immunity doneHumoral &amp; cellural immunity done
Humoral &amp; cellural immunity done
 

Recently uploaded

Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
Dr. Rabia Inam Gandapore
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Sapna Thakur
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
NEHA GUPTA
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
KafrELShiekh University
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
SumeraAhmad5
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
LanceCatedral
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
VarunMahajani
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
Swetaba Besh
 
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
DR SETH JOTHAM
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
Anurag Sharma
 

Recently uploaded (20)

Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
 
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
 

Lect 6 a measles, mumps and rubella

  • 1. Measles, Mumps & Rubella (MMR(
  • 2. • Infections with measles, mumps and rubella viruses are confined to man and occur worldwide. • Spread primarily via the aerosol route. • Each of these viruses exists as a single serotype • MMR vaccine contains all three of these viruses • .Measles & Mumps belong to family Paramyxovirus • RNA enveloped viruses Measles & Mumps
  • 3. MEASLES (RUBEOLA) PATHOGENESIS AND DISEASE • The word measles is derived from German word for blister • Respiratory droplet infection. • Virus replicates in the upper/lower respiratory tract and lymphoid tissues leading to viremia and then growth in a variety of epithelial sites. • The virus is very contagious: maximum contagiousness is 2 to 3 days before onset of the rash. • The disease develops 1 - 2 weeks after infection.
  • 4.
  • 5. Clinical Features • Measles is still a major killer in underdeveloped countries • Fever of 101o F (38.3o C) or above • Running nose (coryza) and cough • Conjunctivitis • Koplik's spots on mucosal membranes - small (1 - 3mm), irregular, bright red spots, with bluish-white speck at center.
  • 6. • Maculopapular rash which extends from face to the extremities. • The infection is prostrating but recovery is usually rapid Clinical Features
  • 7. Complications of Measles • Secondary bacterial infections: otitis media and bacterial pneumonia. • Pneumonia accounts for 60% of deaths from measles • Encephalitis (1 in 1000 cases) a few days after the rash disappears.
  • 8. Subacute Sclerosing Pan encephalitis • Very rare (7 in 1,000,000 cases) • Develops 1 to 10 years after the initial infection. • Behavioral changes. • Impaired speech, vision and swallowing • A progressive, usually fatal disease • SSPE is associated with defective forms of the virus in the brain Complications of Measles
  • 9. • Measles can cause temporary defects in the immune response; e.g. tuberculin- positive individuals may temporarily give a negative response. Complications of Measles
  • 10. LAB DIAGNOSIS • The clinical picture • Serodiagnosis o IgM & IgG levels • Virus isolation in cell culture o The large syncytia, or multinucleated giant cells, result from fusion of cell membranes o Inclusion bodies, eosinophilic areas of altered staining in the cytoplasm
  • 11. EPIDEMIOLOGY • Almost all infected individuals show signs of disease. • Only one serotype of measles and a single natural infection gives life-long protection.
  • 12. MMR Vaccine • Is a live, attenuated combined vaccine to prevent measles, mumps and rubella. • Two doses are given to pre-school children: o The first dose at 12-15 months o The second booster dose at 3-5 years PREVENTION
  • 13. PREVENTION & TREATMENT • Immune serum globulin: for at risk patients during an outbreak i.e. those <1 year with impaired cellular immunity o No antiviral therapy available for primary disease. Complications should be treated appropriately
  • 14. MUMPS • The name comes from the British word "to mump", that is grimace • Clinically, mumps is an acute unilateral or bilateral parotid gland swelling that lasts for more than two days with no other apparent cause.  Other agents can also cause parotitis
  • 16. Mumps Epidemiology Reservoir Human Transmission Respiratory droplet infection Communicability 7 days before to 9 days after onset of active disease • Worldwide distribution •Many (30%) infections are sub-clinical •No 'carrier state'.
  • 17. Clinical Aspects of Mumps • Fever • Parotitis • Meningitis & encephalitis • Orchitis • Pancreatitis • Myocarditis • Nephritis • Arthritis
  • 18. Mumps Complications CNS involvement 15% of clinical cases Orchitis 20-50% in post-pubertal males Pancreatitis 2-5% Deafness 1/20,000 Death 1-3/10,000
  • 19. MMR Vaccine • Is a live, attenuated combined vaccine to prevent measles, mumps and rubella. • Two doses are given to pre-school children: o The first dose at 12-15 months o The second booster dose at 3-5 years PREVENTION & TREATMENT
  • 20. Rubella (German Measles( History 1881Rubella accepted as a distinct disease 1941Associated with congenital disease Rubella virus first isolated 1961 1967Serological tests available 1969Rubella vaccines available
  • 21. Rubella Virus RNA enveloped virus Member of the togavirus family Spreads by respiratory droplets In the pre-vaccination era, 80% of women were already infected by childbearing age
  • 22. Clinical Features Rubella: Latin “little red” Maculopapular rash Lymphadenopathy Fever Arthropathy (up to 60% of cases(
  • 24. Risks of Rubella Infection During Pregnancy Preconception :Minimal risk 0-12weeks: 100% risk of fetus being congenitally infected  resulting in major congenital abnormalities. Spontaneous abortion occurs in 20% of cases. 13-16weeks: Deafness and retinopathy 15% After 16 weeks: Normal development, slight risk of deafness and retinopathy
  • 25. Congenital Rubella Syndrome Classical triad consists of: Cataracts Heart defects Sensorineural deafness.
  • 26. Transient Low birth weight, hepatosplenomegaly, thrombocytopenic purpura, meningoencephalitis, hepatitis, haemolytic anemia, pneumonia, lymphadenopathy Permanent Sensorineural deafness, Heart defects, Eye defects (retinopathy, cataract, microopthalmia, glaucoma), diabetes mellitis Developmental Sensorineural deafness, Mental retardation Congenital Rubella Syndrome
  • 27. Outcome 1/3rd will lead normal independent lives 1/3rd will live with parents 1/3rd will be institutionalised The only effective way to prevent CRS is to terminate the pregnancy
  • 28. Laboratory Diagnosis Diagnosis of acute infection Presence of rubella-specific IgM Rising titres of antibody (mainly IgG(
  • 29. Typical Serological Events following acute rubella infection Note that in reinfection, IgM is usually absent or only present transiently at a low level
  • 30. Prevention Antenatal screening Screening of all pregnant women attending antenatal clinics for immune status against rubella. Non-immune women are vaccinated in the immediate post partum period.
  • 31. Prevention Since 1968, a highly effective live attenuated vaccine has been available with 95% efficacy Universal vaccination is now offered to all infants as part of the MMR regimen in the USA, UK and a number of other countries. Vaccination of schoolgirls before they reach childbearing age.