Measles presentation published from Lukupa college of nursing by a public health officer Conrad Miyanda, 2023 June 2.

1. MEASLES
Presenters;
Conrad Miyanda
Green Sikazwe
Joseph Mwansa
Maidy Kawimbe
Don Simpemba
Faith Mubanga

2. Introduction
 Measles is a highly contagious infection
caused by the measles virus (MeV).
 The MeV is transmitted from person-to-
person via respiratory droplets or
aerosolized small particles suspended in the
air as a result of sneezing or coughing .

3.  1 out of every 1000 people with measles
will develop brain swelling leading to brain
damage.
 Prior to the introduction of the measles
vaccine in the 1960s, measles was a leading
cause of childhood mortality, accounting for
2 million deaths globally each year.

4. Intro
 The number of measles deaths decreased
drastically due to the initiation of the
Expanded Program on Immunization in 1974
and subseque
 1to 3 out of 1000 people with measles will
die,even with best care.
LCN, 2022 intake rn and phn conrad miya

5. Definition;
 Measles is an acute highly contagious viral
disease caused by measles virus and it is
characterized by fever, URT catarrhal
inflammation, koplik’s spots and
maculopapules.
OR
 It is an acute viral disease characterized by
rash maculopopular eruption and
catarrhal inflammation of the conjunctive
and of the aorta passages.

7. Types of Measles
There are two types of measles which are;
 Rubeola measles
 Rubella measles
 The rubeola virus causes "red
measles,"also known as "hard measles"or
just “measles."Although most people
recover without problems, rubeola can
lead to pneumonia or inflammation of the
brain (encephalitis).

8.  The rubella virus causes "German
measles,"also known as "three-day
measles."This is usually a milder disease
than red measles. However, this virus can
cause significant birth defects if an infected
pregnant woman passes the virus to her
unborn child.

9. Cause of Measles
• It is caused by measles virus and it has been
classified as a paramyxovirus. Which is
spherical in appearance, measuring about
100~150nm in diameter. It has an outer
envelope composed of Mprotein, Hprotein,
Fprotein, and internal core is RNA.

10. Mode of spread
• Measles is spread through respiration
(contact with fluids from an infected
person's nose and mouth, either directly
or through aerosol transmission). And
therefore airborne precautions should be
taken for all suspected cases of measles.

11. INCUBATION
• The incubation period usually lasts for 4–12
days (during which there are no
symptoms). Infected people remain
contagious from the appearance of the first
symptoms until 3–5 days after the rash
appears.

12. Pathophysiology
 The measles is a highly contagious air
borne pathogen which spreads primarily
via the respiratory system.The virus is
transmitted in respiratory secretions, and
can be passed from person to person via
aerosol droplets containing virus particles,
such as those produced by a coughing
patient.

13. Cont'd
 Once transmission occurs, the virus infects
and replicates in the lymphatic system,
urinary tract, conjunctivae blood vessels
and central nervous system of its new
host.The role of epithelial cells is
uncertain,but the virus must infect them
to spread to a new individual.

14. Symptoms and Signs
Includes;
 Fever
 Runny nose
 Cough
 Red eyes (conjunctivitis)
 A run-down or lethargic feeling
 Loss of appetite
 And a generalised, maculopapular,
erythematous rush.

17.  Specific antibody IgM.
 Other Ag and multinucleated giant cells
 The separation ofvirus
 Measles virus can be isolated in tissues
culture;

18. Cont'd
Antibody titer;
 WBC is relative low
 Eye swab for m/c/s
Medical treatment
There is no specific treatment for measles.
Medical management is therefore
symptomatic.
• For fever administer analgesia e.g calpol
100mg to 200mg tds for 3 days.

19. • For conjunctivitis appropriate antibiotics
will be given such asTetracycline eye
ointment TDS.
• For itchy rash antihistamine e.g piriton
syrup or calamine lotion
• For cough safe cough remedies will be
given such as lemon tea, honey tea or
breast milk if breast fed.
• Antibiotic prophylaxis e.g Amoxycilline 125-
250mg TDS will be given

20. • Vitamin A supplementation for
preseevation of sight and also immune
booster will be given to the child. This will
be given 100000IU to 200000IU on day
1,2and day 8
• Sodium bicarbonate for mouth wash.
• Multivitamin will be administered to the
child.

21. Nursing Care
Aims:
To promote rest and comfort
To relieve symptoms
To prevent complications.

22. Environment.
• Measles is highly infectious therefore the
child will be nursed in isolation and infection
prevention protocols should be applied, for
example wearing of protective clothing such
as gloves, gowns.

23. • Visitors will be restricted to prevent spread
of infection.
• The environment should be dim lit as the
patient may have photophobia due to
conjunctivitis. The room should be cool
and humid to prevent intense itchy from
rush.

24. Observations
• Vital signs especially temperature which is
usually high and swinging about 38C° 40C°
should be observed to see if it is increasing
or reducing.

25. • If temperature continues to be high
interventions for fever management will be
employed such as tepid sponging, cool
environment, and remove excess line and if
this does not workout the prescribed
antipyretic will be administered to the child
such as calpol.
• Temperature will be observed vigilantly in order
to identify and prevent complications because if it
is swinging it may denote setting in of
complications.

26. • The child will be observed for hydration because
he/she is losing a lot of fluids through diarrhea,
sweating, coughing and sneezing, therefore there
is need to ensure good hydration to avoid
dehydration.
• The skin will be observed for rash to see the extent
of rash and the parts that are affected. The mouth
of the child will be observed for koplik spots which
might hinder with sucking/feeding to see if it is
increasing or reducing.

27. Psychological care
• Explain the disease process in order to
raise the knowledge levels and thereby
alley anxiety Encourage the patient’s
mother to ask questions and answer
accordingly. Refer those can’t answer to
the physician Explain all procedures to the
patient in order to gain cooperation and
allay anxiety Involve a successfully managed
case to come and talk to the patient in order to
allow the patient ask pressing questions and
get answers.

28. • Involve the loved ones in the care in order
not to feel neglected.Provide diversional
therapy like toys, TV and radio in order to
shift the patient’s mind from the hospital
routine and the conditionExplain to the
mother/caretaker that the health care
team is doing everything possible to
ensure that the patient gets better in order
to promote co-operation

29. Hygiene
• Offer baths to the patient in order to
remove dead epithelium and promote
comfort. Do hair care to promote self
esteem and also prevent pediculosis. Do
nail care to prevent auto infection. Do
mouth care to prevent halitosis Any soiled
linen and clothes will be changed PRN to
promote comfort and prevent infection.

30. Elimination
• Provide a lot of fluids and roughage to
prevent constipation Provide copious fluids
in order to promote renal wash out and
thereby prevent renal problemsRecord fluid
intake and out put to prevent fluid
overload.

31. Nutrition
• Provide energy giving foods to provide the
energy needed for the metabolic processes.
Provide foods rich in protein like fish and
beans to promote replacement of worn out
tissues Vegetables and fruits will be provided
to raise the immunity and promote skin and
mucous membrane integrity.

32. Cont'd
• Provide a lot of oral fluids to prevent
dehydration due to excessive
sweatingServe small frequent meals to
promote appetiteDo regular mouth
washes in order to promote appetite.
Exercise
• Do passive exercises like limb movement
and massage in order to prevent muscle
atrophy and promote blood circulation
Encourage the patient to do deep
breathing exercises in order to promote

33. • Encourage early ambulation as soon as
the condition permits in order to prevent
deep vein thrombosis and other
complications of immobility

34. Position
• Patient will be put in fowlers position to
promote lung expansion and relieve
dyspneaChange the patient’s position two
hourly to prevent development of pressure
soresAs the condition improves, let the
patient adopt any position of comfort to
promote rest

35. IEC
• Educate on the condition in order to
create awareness and prevent recurrence
of the condition Explain the need for
taking the medication in order to promote
compliance.Educate about the signs and
symptoms of the condition for early
diagnosis and treatment thereby
preventing complications

36. • Talk to the patient about the need to take a
balanced diet using locally available foods
in order to boost the immunity.
• Advise the mother to avoid over crowded
areas and exposure of her child to out
breaks of measles to prevent occurrence of
the disease.Advise the mother to ensure
that child is vaccinated against Measles.

37. Preventive measures
• The most effective way to prevent measles
is through vaccination against the disease
• Isolate all cases of measles
• Prompt reporting and management of
measles
• Increased surveillance of the disease

38. Complications
• Otitis media, croup
laryngotracheabronchitis, pneumonia
surgical emphysema, empyema.
• Bronchopneumonia is single most usual
complication.
• Malnutrition due to anorexia, stomatitis
and diarrhoea Corneal uclers

39. • Bleeding due to thrombocytopnaenic
purpura, vascular damage
• Myocarditis which may progress to CCF.
• Febrile convulsions
• Acute encephalitis may occur.
• Mental retardation or epilepsy.
• Blindness

40. Summary
• Measles is a highly infectious disease
Remains one of the major causes of
morbidity and mortality in developing
nations, Major symptoms include fever,
cough,coryza, conjuctivitis and rash.
Measles has no specific treatment Best
preventive measure against disease is by
vaccination