Measles is caused by a RNA virus from the paramyxoviridae family. It spreads through respiratory droplets during the prodromal phase which starts 4 days before and lasts 5 days after the rash appears. The rash starts on the head and neck and spreads downward over the body. Complications can include pneumonia, encephalitis, and SSPE. Measles can be prevented through administration of the live attenuated vaccine at 9 months of age, which provides 95% protection.

2. Measles
Etiology
-RNA virus
-Paramyxoviridae family
-Morbillivirus genus
Infectivity/ Mode of spread:
-Droplet spray during prodromal phase
-Infective period
-4days before & 5 days
after the appearance of rash

3. Pathology:
- Essential lesion found in
skin
Mucous membrane
Conjunctiva
- Serous Exudate and proliferation of
mononuclear cells
-Lymphoid hyperplasias---Giant cells
-Interstitial Pneumonitis
-Encephalomyelitis
-SSPE

4. Eradicable disease ( like small pox)
Distinctive rash
No animal reservoir
No vector
Seasonal occurrence with disease free intervals
No transmissible latent virus
One Serotype
An Effective vaccine
> 90% Immunization coverage
produces disease free zones
Unusual before 6 month of age

5. Clinical Features:
Incubation period 10-12 days
prodromal phase 3-5 days
low to moderate fever
Hawking cough
Coryza
Conjunctivitis & photophobia
Koplik spots ( pathogonomic sign)
Transverse line of conjunctival inflammation

6. Stage of Maculopapular Rash
(day 4-5)
-Temp. rises abruptly as the rash appears (104-105 F)
-Starts on upper lateral part of neck,
-Behind the ear, posterior part of check
-24hr upper chest
-Next 24hr Back, Abdomen
-On 3rd day reaches legs/feet and starts fading from
face
- Hemorrhagic, black Measles-confluent
rash, ecchymosis.
-Brawny desquamation and brownish discoloration –
called post measles staining-disappears 7-10 days

7. Diagnosis:
-Clinical
-Virus can be isolated
-Diagnostic rise in antibodies

8. Treatment:
-Supportive care
-Antipyretics
-Treatment of bacterial infection
-Nutritional support
-Vitamin A 100,000 units (6-12 months)
200,000 units (above 12 months)

9. Prevention:
Active Immunization
Live attenuated vaccine
Given at 9 months of age
95% protection
Prevents Measles if given within
three days of Exposure
Passive Immunization
Gamma Globulins 0.25 ml/kg IM
within 5 days after exposure

10. Different Diagnosis:
-Roseola Infantum
-Rubella
-Meningococcemia
-Drug Rash
-Scarlet Fever
-Infectious Mononucleosis
-Echo & Coxsackie

11. Complication:
-Otitis Media
-Pneumonia
-Encephalitis
-Post Measles Diarrhea
-Anergy to Tuberculin
-Hemorrhagic Measles
-Myocarditis
-SSPE