Measles is a contagious viral infection primarily affecting children, which is preventable through vaccination. The disease is characterized by respiratory transmission, incubation period of 10-12 days, and symptoms including fever, cough, conjunctivitis, and a distinctive maculopapular rash. Complications can arise, such as subacute sclerosing panencephalitis, with various methods available for diagnosis and prophylaxis recommended for children at specified ages.

1. T O P I C - M E A S L E S
Submitted by – Dikshit soni
2nd prof , Roll no- 8

2. INTRODUCTION
A Contagious viral infection that can be serious for small children but is easily
preventable by a vaccine.
• The disease spreads through the air by respiratory droplets produced from
coughing or sneezing by the infected person.
• It is a commonly childhood disease spread by respiratory secretions .Virus gains
access to the human body via the respiratory tract where it multiplies locally.

3. The infection then spreads to the regional lymphoid tissue:
where further multiplication occurs.
This leads to primary Viraemia.
This disseminates the virus, which then replicates in the
reticuloendothelial system. Followed by second viraemia.
It seeds the epithelial surfaces of the body, including skin,
respiratory tract, and conjunctiva where focal replication occurs.
Measles virus can replicate in certain lymphocytes.

4. Which aids in dissemi cells (Warghout the body Multinueleated giunt cell Warthin-Finket, cells) with
intranuelear inelusions are semi lymphoid tissues throughout the laks Aner an incubation period of 10-12
day.
• Develops upper respiratory tract infection with hip, fever, rhinitis, cough and conjunctivitis. Koplk, spots,
which are small, 1-3 mm in diameter, blush white spots surrounded by erythema can be seen on the
buccal mucosa during this stage and are pato gnomonic of measles. After 1-2 days, the acute
symptoms decline with the appearance of characteristic maculopapular rash which appear on the neck
and then spreads to the rest of the body, The rash is due to type IV hypersensitivity to vinl antigens. In
next 10-14 days, rash fades with considerable desquamation and sometimes by discoloration of the
skin. There is only one antigenic type of measles virus. Infection confers lifelong immunity.

5. In addition, acute post infections encephalitis and subacute sclerosing panencephalitis
(SSPE) may occur in 1 in 1000 and 1 in 300,000 cases of measles respectively.
• Subacute sclerosing panencephalitis (SSPE) is a rare and late complication of measles
infection. He disease begins insidiously(5-15 years after a case of measles. It is
characterized by progressive mental deterioration, involuntary movements.Muscular
rigidity, and coma.
• It is invariably fatal. Patients with SSPE exhibit high titres of measles antibody in
cerebrospinal fluid and serum, and defective measles virus in brain cells. With the
widespread use ol measles

6. P AT H O G E N E S I S
• The essential lesion of measles is to be found in the skin , the conjunctevate and
the mucous members of the nasopharynx ,bronchi and the intestinal tract.
• Serous exudate and proliferation of mononuclear cells and a few poly
mononuclear cells and capillaries.
•

7. 2. Direct microscopy
Giemsa-stained smears of nasal secretions show
multinucleated giant cells.
3. Immunofluorescence
The measles virus antigen can be detected in the
cells of nasal secretions by immunofluorescence.
4. Virus isolation
The measles virus can be isolated, though with
some difficulty, from throat washings, blood,
urinary sediment, etc.

8. For rapid diagnosis, both multinucleated giant
cells and viral antigens can be detected in the
cells aspirated from nasopharynx.
5. Serological diagnosis
Measles antibody in the patient serum can be
detected by IgM capture ELISA. Complement
fixation test can be carried out on acute and
convalescent sera. A rise in antibody titre is
diagnostic. Demonstration of high titres of
measles antibody in the CSF is diagnostic of
SSP method of diagnosis.

9. Demonstration of high titres of measles
antibody in the CSF is diagnostic of SSPE.
6. Polymerase chain reaction (PCR)
Reverse transcriptase PCR is a sensitive and
specific method of diagnosis.
Prophylaxis
Children of the age of 15 months are given
MMR vaccine, followed by a booster at the
age of 4-6 years.

10. C L I N I C A L M A N I F E S TAT I O N S
Measeles has 3 differever clinical stages:
1. An incubation stage
2. A prodromal stage with an enanthem and mild symptoms
3. A final stage with a Maclopapular rash accompanied by high febee

11. T R A N S M I S S I O N S
• Measles is highly contagious disease and approximately 90% of the household
acquires the disease .
• Maximial dissemination of virus occurs by droplet spray during the prodromal
period
• (catarrhal stage)

12. P AT H O G E N E S I S
• Hyperplasia of lymphoid tissue usually occurs , particularly in the appendix where
the multinuclear giant cells of upto 100 in diameter may be found .
• In the skin the reaction is particularly notable about the sebaceous glands and
the hair follicles.

13. D I A G N O S I S O F M E A S L E S
• Microscopy
• Immunofluouroscence
• Virus isolation
• Serology
• Fever + 3 c’s

14. T H A N K Y O U