Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Pulmonary TB is a bacterial infection of the lungs that can cause a range of symptoms, including chest pain, breathlessness, and severe coughing. Pulmonary TB can be life-threatening if a person does not receive treatment. People with active TB can spread the bacteria through the air.
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Chikungunya is an epidemic disease, broke out in Bangladesh in 2017. It was first identified in Tanzania 1953. From then it continuously rose as an epidemic disease after some interval in Asia, Africa and even in America.
measles is a important vaccine preventable disease in children and carries a high mortality in undernourishment children.it is also a candidate for eradication. proper diagnosis will go a long way in the control and eradication of measles
Pulmonary TB is a bacterial infection of the lungs that can cause a range of symptoms, including chest pain, breathlessness, and severe coughing. Pulmonary TB can be life-threatening if a person does not receive treatment. People with active TB can spread the bacteria through the air.
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Chikungunya is an epidemic disease, broke out in Bangladesh in 2017. It was first identified in Tanzania 1953. From then it continuously rose as an epidemic disease after some interval in Asia, Africa and even in America.
measles is a important vaccine preventable disease in children and carries a high mortality in undernourishment children.it is also a candidate for eradication. proper diagnosis will go a long way in the control and eradication of measles
Measles is a highly infectious disease of childhood caused by Measles virus. It is characterized by fever, catarrhal symptoms of the upper respiratory tract infections followed by typical rash.
Measles is defined as an acute and highly contagious viral disease characterized by fever, runny nose, cough, red eyes and a spreading skin rash.
Causative agent: Rubeola virus, a RNA virus of paramyxoviridae family
Reservoir: Human
Source: Infected Human
Period of Communicability: Approximately 4 days prior and 4 days after the appearance of the rash
Mode of Transmission:
Airborne transmission(virus remains active and contagious in the air or on infected surfaces for up to 2 hours)
Droplet transmission i.e. it is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions
Portal of entry: Respiratory tract and Conjunctiva
Incubation Period: 10-15 days
Host:
Children between age of 1 and 5 years
Older children
Malnourished children
Environment: Winter and spring month ,Low socio-economic status .
Clinical manifestations of measles are in three stages:
STAGE 1: Prodromal/ Catarrhal Stage:
starts after 10 days of infection and lasts up to 3-5 days-
- Fever
- Malaise
- Coryza
- Sneezing
- Nasal Discharge
- Brassy Cough
- Redness of eye
- Lacrimation
- Photophobia
- Lymphadenopathy
- Vomiting
- Diarrhea
- Koplik spot – grayish or bluish white spots, fine tiny grain like papules on a faint red base, smaller than the head of pin.
- Spots appear before the appearance of rash
- Found on buccal mucosa opposite to first and second molar
- Usually disappear after the rash, appears a day
Stage 2: Eruptive Stage:
- Typical irregular dusky red macular or maculopapular rash found behind the ears and face first, usually 3-5 days after the onset of disease
- Then it spread to neck, trunk, limbs, palms and soles in the next 3-4 days.
- Anorexia
-Malaise
-Cervical lymphadenopathy
-Fever and rash usually disappear in 4-5 days in the same order of appearance
- Fine shedding of superficial skin of face, trunk and limbs leaving brownish discoloration that persists 2 months or more
Stage 3: Convalescent or Post- Measles Stage:
-Fever and rash disappear
-Child remains sick for number of days and lose weight
- Gradual deterioration into chronic illnesses due to bacterial or viral infections, nutritional and metabolic disturbances or other complications.
prevention- Active Immunization with live attenuated vaccines 0.5 ml subcutaneously in single dose at 9-12 months of age.
management,nursing management, nursing diagnosis
how does measles present, approach, signs and symptoms, treatment in the developing countries like nepal and vaccination program, its scenario after earthquake
A brief discussion on different Viral ex anthems especially measles. In a simple and easy manner, the measles virus is explained with its clinical features, treatment, investigations, and vaccination. Helpful for clinicians, dermatologists and pediatricians. Helpful for exam preparation for FCPS, MCPS, MRCP and USMLE in the field of dermatology. Also helpful for med students and nurses.
Coronavirus is the largest known RNA virus responsible for a range of respiratory illnesses in man. 7 Known coronaviruses have been identified with 4 causing mild infections and 3 severe diseases. The severe diseases are SARS, MERS and COVID-19
There is presently an ongoing epidemic of the disease in China which has gradually spread across the continent.
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.
Abbott Diagnostics
Hematology
Educational Services
Intended Audience
This Learning Guide is intended to serve the basic educational needs of health care
professionals who are involved in the fields of laboratory medicine. Anyone associated with
the testing of the formed elements of the blood will find this monograph of special interest.
The monograph features basic information necessary to understand and appreciate the
importance of hematology testing in the laboratory and is intended for those who use
the hematology laboratory services, including, but not limited to, laboratory technicians,
laboratory technologists, supervisors and managers, nurses, suppliers, and other
physician office and laboratory support personnel.
Blood diseases cover a wide spectrum of illnesses, ranging from the anaemias, leukaemias and congenital coagulation disorders.
Haematological change may occur as a consequence of disease affecting any system and measurement of haematological parameters is an important part of routine clinical assessment.
A myeloprolifrative stem cell disorder resulting in
Proliferation of all haematopoietic lineages but
manifestation Predominantly in the granulocytic series.
The disease occurs chiefly between 30 and 80 years, with
A peak incidence at the 55 years.
*accounts for 20% of all leukaemis.
*found in all races.
*the aetiology is unknown.
Systematic (non-random) error that results in an incorrect estimate of the association between exposure and risk of disease.
Can occur in all stages of a study
Not affected by study sample size
Difficult to adjust for afterwards, but can be reduced by adequate study design.
•Can never be totally avoided, but we must be aware of it and interpret our results accordingly
Tropic = shape response. [from Middle English tropik, Old French tropique, Latin tropicus, Greek tropikos, turn]
Viral tropism = the way the virus responds to external stimulus in order to attach to and infect cells
Medical college of wasit
Department of medicine
Case sheet history
Thing to remember :-
1) Stand on the right side of the patient with good confidence .
2) Introduce yourself as a medical student not as a doctor . ( you may face difficult question ).
3) Talk the patient gently with clear comprehensible words .
4) Remember don’t hurt the patient in your speak & touch .
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3. MEASLES (RUBEOLA)
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough,
coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it
was estimated that measles caused between 5
million and 8 million deaths worldwide each year.
Definition
6. The first systematic description of measles, and its
distinction from other exanthematous diseases
(smallpox and chichenpox) is credited to
the Persian physician Rhazes (860–932),
who published
The Book of:
Smallpox and Measles
7. In 1529, a measles outbreak in Cuba killed two-
thirds of those natives who had previously survived
smallpox.
Two years later, measles was responsible for the
deaths of half the population of Honduras,
and it had ravaged (destroyed) Mexico, Central
America and Inca civilization
8. Measles killed 20 percent of Hawaii's
population in the 1850s. In 1875, measles killed
over 40,000 Fijians, approximately one-third of
the population
10. Measles is caused by Measles virus.
Measles virus is a spherical, single-stranded RNA
virus with diameters of 100-250 nm.
The family of Paramyxoviridae.
The genus of Morbillivirus
Etiology
11. Measles virus
The virus was first isolated in 1954 by Nobel Laureate John
F. Enders and Thomas Peebles
12. Measles virus
Although RNA viruses typically have high
mutation rates, measles virus is considered to
be an antigenically monotypic virus;
Measles virus is killed by ultraviolet light and
heat.
13. Measles virus
The measles virus has two envelope
glycoproteins on the viral surface—
hemagglutinin (H) and membrane fusion
protein (F).
These proteins are responsible for host cell
binding and invasion.
15. Measles virus is one of the most highly contagious
directly transmitted pathogens.
Outbreaks can occur in populations in which <10% of
persons are susceptible
Chains of transmission are common among household
contacts, school-age children, and health care workers.
There are no latent or persistent measles virus
infections that result in prolonged contagiousness, nor are
there animal reservoirs for the virus.
16. In temperate climates, annual measles
outbreaks typically occur in the late
winter and early spring.
17. Persons with measles are infectious (Measles Virus
is communicable) for several days before (3-5
days) the rash. It remains communicable up to 4
days after the appearance of rush, when levels of
measles virus in blood and body fluids are highest
Measles Virus is communicable ……..
18. Who are at risk?
• Unvaccinated young children are at highest risk of measles
• Unvaccinated pregnant women are also at risk
• Measles is still common in many developing countries –
particularly in parts of Africa and Asia
• Measles outbreaks can be particularly deadly in countries
experiencing or recovering from a natural disaster or
conflict.
• Damage to health infrastructure and health services, interrupts
routine immunization, and greatly increases the risk of infection.
20. The way of transmission
The Measles is an airborne disease.
The virus spreads easily through the coughs
and sneezes.
It may also be spread through contact with saliva
or nasal secretion.
21. • Infection is initiated when measles virus is deposited
on epithelial cells in the respiratory tract, oropharynx,
or conjunctivae.
• During the first 2–4 days after infection, measles virus
proliferates locally in the respiratory mucosa and
spreads to lymph nodes.
• Virus then enters to the bloodstream in infected
leukocytes (primarily monocytes), producing the
primary viremia that disseminates infection
throughout the reticuloendothelial system.
22. Further replication results in secondary
viremia that begins 5–7 days after infection and
disseminates measles virus throughout the body.
24. • Fever
• Dry cough
• Coriza
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red
background called Koplik's spots
• A skin rash: maculopapular rush (flat blotches (spots)
that often flow into one another)
Main symptoms of measles
25. • Incubation period (Phase)
• Prodromal period (Phase)
• Exanthem period (Phase)
• Reconvalencence period (Phase)
The Disease has 4 Phases
27. Prodromal period (Phase):
lasts 2-4 days and is marked by fever (39-40 C),
malaise, cough, coryza, conjunctivitis and
pharyngitis
Disease has 4 Phases
Koplik’s spots develop on the buccal mucosa
during this phase, 2 days before the rash appears.
Koplik’s spots seen inside the mouth
are pathognomic (diagnostic) for measles, but are
temporary and therefore rarely seen
30. Koplik’s spots are pathognomonic of measles
and consist of bluish white dots ~1 mm in
diameter surrounded by erythema.
The lesions appear first on the buccal mucosa
opposite the lower molars but rapidly increase in
number to involve the entire buccal mucosa.
They fade with the onset of rash.
31. Exanthem period (Phase)
The Disease has 4 Phases
The erythematous maculopapular rash first appears behind
the ears and on the neck. The rash progresses to cover face,
trunk, arms, with involvement of the legs and feet within 72
h. The fever peaks on the 2nd
or 3rd
day of the rash.
The rash usually begins to clear in the same order of
progression as it appeared, usually beginning on the third or
fourth day after onset.
Exanthem period (Phase) begins after prodromal phase:
2 weeks after exposure
37. Reconvalencence period (Phase)
The Disease has 4 Phases
After 10-12 days Resolution of the rash may
be followed by desquamation leaving transient
hyperpigmented areas .
39. • The differential diagnosis of measles includes
other causes of fever, rash, and conjunctivitis,
including:
• rubella,
• Kawasaki disease,
• infectious mononucleosis,
• scarlet fever,
• Rocky Mountain spotted fever,
• enterovirus or adenovirus infection,
• drug sensitivity
41. Measles is easily diagnosed based on clinical
symptoms by clinicians familiar with the
disease, particularly during outbreaks
Koplik’s spots are especially helpful because
they appear early and are pathognomonic.
The Centers for Disease Control and Prevention case definition
for measles requires
(1) a generalized maculopapular rash of at
least 3 days’ duration;
(2) fever of at least 38.3 o C, and
(3) cough, coryza, or conjunctivitis.
42. Serology is the most common method of
laboratory diagnosis.
The detection of measles virus–specific IgM in a single specimen of
serum or oral fluid is considered diagnostic of acute infection.
Also, a fourfold or greater increase in measles virus–specific IgG
antibody levels between acute- and convalescent-phase serum
specimens.
Measles virus–specific IgM antibodies may not be detectable
until 4–5 days or more after rash onset and usually fall to
undetectable levels within 4–8 weeks of rash onset.
We should remember that
43. Measles also can be diagnosed by detection of
measles virus RNA
by reverse-transcriptase polymerase chain reaction
(RT-PCR) from clinical specimens
45. There is no specific antiviral therapy for
measles
Treatment consists of general supportive measures,
such as:
• hydration
• Bed rest
• administration of antipyretic agents.
46. Secondary bacterial infections are a major cause of
morbidity and death following measles.
Prompted antibiotic treatment is necessary for patients who
have clinical evidence of bacterial infection, including
pneumonia and otitis media.
Streptococcus pneumoniae and Haemophilus influenzae
type b are common causes of bacterial pneumonia
following measles;
47. Vitamin A is effective for the treatment
of measles and can markedly reduce
rates of morbidity and mortality.
The World Health Organization recommends administration
of once-daily doses of 200,000 IU of vitamin A for 2
consecutive days to all children with measles who are > 12
months of age.
Lower doses are recommended for younger children: 100,000
IU per day for children 6–12 months of age and 50,000 IU
per day for children <6 months old.
51. • Passive Immunization by specific
Measles immunoglobulin
• Active Immunization by Vaccine
Prophylaxis
52. Prophylaxis
Passive Immunization by specific Measles immunoglobulin
immunoglobulin given shortly after exposure can attenuate (reduce)
the clinical course of measles. In immunocompetent persons,
administration of immunoglobulin within 72 h of exposure usually
prevents measles infection.
Administered up to 6 days after exposure, immunoglobulin
will still prevent or modify the disease.
Prophylaxis with immunoglobulin is recommended for
susceptible household and nosocomial contacts who are at risk of
developing severe measles, particularly children <1 year of age,
immunocompromised persons (including HIV-infected persons) and
pregnant women.
54. Licensed vaccines (by Merck) to prevent
the disease became available in 1963
American Microbiologist
Maurice Hilleman developed the first successful vaccine.
55. Measles vaccine is life attenuated vaccine
The Moraten (“more attenuated”) strain, was licensed in 1968 and is
used in the United States,
Measles vaccines are often combined with other live attenuated virus
vaccines, such as:
• for mumps and rubella (MMR)
• for mumps, rubella, and varicella (MMR-V).
56. Active Immunization by Vaccine
The recommended age of first vaccination varies from 6
to 15 months
Antibodies first appear 12–15 days after vaccination
and peak at 1–3 months.
The duration of vaccine-induced immunity is at least
several decades if not longer.
57. In developing countries where measles is
highly endemic, WHO doctors recommend two
doses of vaccine be given at six and nine months of
age
In developed countries, children are immunized
against measles at 12 months, generally as part of a
three-part MMR vaccine.
WHO recommendations: