Measles is a highly infectious disease caused by a paramyxovirus. It is characterized by fever, cough, runny nose, and a red rash. The virus spreads through respiratory droplets and is contagious from 4 days before to 5 days after the rash appears. Complications can include pneumonia, eye inflammation, and neurological issues. Treatment focuses on relieving symptoms and preventing complications. Vaccination is the most effective prevention method.

1. ROMANTIKA (MEASLES)
Salina abdulmajid manek ,
3rd profession student of BAMS.

2. INTRODUCTION
• An acute highly infectious disease of
childhood caused by a specific virus of the
group myxoviruses.
• It is clinically characterized by fever and
cararrhal symptoms of upper respiratory tract
(coryza, cough) followed by typical eash.

3. AGENT FACTORS
• AGENT: Caused by RNA paramyxovirus.
• SOURCE OF INFECTION: Is a case of measles.
Carries are not known to occur.
• INFECTIVE MATERIAL: Scretion of nose, throat
and respiratory tract of case of measles during
the prodromal period and the early stage of the
rash.
• COMMUNICABILITY: 4 days before and 5 days
after the apperance of rash.
• SECONDARY ATTACK RATE: Infection confres life
long infectivity.

4. HOST FACTORS
• AGE: B/W 6 month and 3 years of age and other childeren
usually over 5 years.
• SEX: both sexes
• NIRITION: highly severe in malnourished child carring a
mortality upto 400 times highly than in well nourished
children.
• ENVIRONMENTAL FACTORS: virus can spread in any season
espicially a winter disease.
• Epidemics occurs in winter
• TXANOMISSION: Mainly by droplet nuclei from 4 days
brfore the onset of rash until 5 days there after.
• INCUBATION PERIOD: Commonly 10 days from exposure to
onset of fever, and 14 days to appearance of rash.

5. ETIOPATHOGENESIS
• Measles is caused by an RNA virus belongs to
the paramyxovirus family. The virus
transmitted by droplet spread from the
secretion of the nose and throat usually 4 days
befpre and 5 day after the rash.
• The disease is highly contagious with
secondary attack rates in susceptile household
contact exceeding 90%.

6. The portal of entry is the respiratory tract where
the virus multiples in the respiratory epithelium.
Primary viremia occurs resulting in infection of
the reticuloendothelial systemis followed by
secondary viremia, which results is systemic
symtoms.

7. PATHOGENESIS
• After entering the body through repiratory tract
by droplet infection, the virus quickly pass to the
nearest lymp node multipy there and leak into
the bloodstream, reaches R.E cells of liver, spleen
and bone marrow, where they multipy and
destroys cells and flow agai to blood stream in
sufficient number as to affect many tissue in body
mainly respiratory mucosa, alimentry mucosa,
conjuctiva and skin.
• The symptoms are mainly due to inflamatory
reaction in these areas.

8. EPIDEMIOLOGy
• Measles id endemic throughout the world.
• In the past, epidemics tented to occurs
irregularly. It is rarely subclinical.
• Prior to the use of measles vaccine, the pek
incidence was among childeen 5_10 yr of age.
• The WHO estimate that over 40 million cases
still occurs in worldwide contribution to
530000 deaths including 182000 in SEA region
as reported in 2003.

9. • Now measles mortality has been reduced
from 733000 in 2000 to 164000 in 2008
• In india measles is major cause of morbidity
and a significant contribution to childhood
mortality.
• Propr to the immunization were record every
third year.
• With immunization coverage the interval
etween cyclical peak incread and intensity
minimized.

10. THREE STAGES
1.PRODROMAL/ CATARRHAL STAGE
(FIRST 4 DAYS)
2.EXANTHEMATOUS STAGE (4TH TO
7TH DAY)
3.RECOVERS STAGE

11. 1. PREDROMAL
• Beging 10 days after infection and lasts untill 14
days.
• CHARACTEIZED:
1. Fever
2. Coryza
3. Sneezing
4. Nasal discharge
5. Cough
6. Redness of eye
7. Lacrimation
8. Often photophobia

12. • There may be vomiting or diarrhoea
• On 2nd day-pathognomonic- kopliks spots
apear in mucous membrane of mouth.
• Tiny whitish or bluish white spot, against a
reddish background, at level of upper 2nd
molar teeth
• Table salt crystal appear.

13. 2.) exanthematous (4th to 7th day)
• High rise of temprature , face puffy, headaches,
cough, photophobia, myalgia, lymph nodes may
enlarge, spleen- may be palpable.
• Rash – on 4th day, macilo papular
flppear first, on forcehead and
Behind the ears, at the downwards to whole of
trunk and limbs upto palms and soles
Initially- discrete, pink, blanch on pressure later
confluent.

14. 3.) RECOVERY STAGE
• Rapid, rashes fade away, leaving brownish
discoloration of skine and areas of
desquamation.

15. COMPLICATIONS
Laryngitis bronchitis, broncho, pneumonia, conjuctivitis, otitismedia,
albuminuria
Neurological co plication include febrile convulsion.
• In some cases vision loss has resulted in children infected with the
measles virus as it has caused damage to the cornea (the clear front
part of the eye) which becomes hazy and discolored in appearance.
• Known as measles keratitis, infected children may tear excessively
and need to avoid light due to extreme sensitivity. It is also noted
that children who have poor diets and are deficient in vitamin A are
at greater risk for more severe eye complications of measles. The
measles virus can also affect the back of the eye especially the
retina, which is the light-sensing part of the eye. “Measles virus can
cause inflammation of almost any part of the back of the eye
including the retina, blood vessels and optic nerve. Patients may
lose vision due to swelling or scarring of the retina,”

16. MANAGEMENT
• Isolation in well ventilated room
• Concurrent disinfection of nasal and throat
secretion
• Light and clean clothes
• Antipyretics to control fever
• Plety of water and fruit juice because of loss of
appetite
• Correction of malnutrition with high quality diet

17. • Prophylactic antibiotic can be given
• Attendants to use mask and gown
• Watch for complication
• Vitamin A for measles case management
Vitamin A supprmentation is required in all cases of
severe measles, a high dose of vitamin A ia give
after diagnosis and reapeated next daty.
AGE DAY1 follwing day
0-6 months- 50000IU -50000IU
6-11 months- 100000I -100000IU
≥12 months- 200000IU -200000IU

18. • MEASLES AND CHICKEN POX:
• In case of double infection the 1st infection may diminish the
severity of rash of the 2nd infection.
• PRVENTION OF MEASLES:
Achieving an immunization rate over 95% on going immunization against
measles through successive generation of childeren.

19. • MEASLES VACCINATIONS
• VACCINE: Tissue cultured vaccine either chick
embryo or human diploid cell line.
• AGE: 9 months
• ADMINISTRATION: subcutaneous does of 0.5ml
• REACTIONS: fvere
• IMMUNITY: develops 11-12 days after vaccination
• CONTRAINDICATION: pregnancy.
• ADVERSE EFFECT OF VACCINE- Toxic shock syndrome
(TSS) occurs when measles vaccine is contaminated
or the same vial is used for more than 1 session the
same day or the next day.

20. • Routine vaccination:
• Minimum age: 9 months or 270 completed days.
• Administer the primary dose of MMR vaccine at age 9
to 12 months, the second dose at age 15 through 18
months, and final (the 3rd) dose at age 4 through 6
years.
• The 2nd dose must follow in 2nd year of life. However,
it is given at anytime 4-8 weeks after the first dose
• There is no need to give a stand-alone measles vaccine.
•

21. • COMBIEND VACCINES: can be combiend with mumps
rubella (MMR) or MMRV varicella or MR
• IMMUNOGLOBINS: dose is 0.25 ml/body weight early in the
incubation period. Should be given 3-4 days of exposure.
• ERADICATION OF MEASLES: immunization by
only 1 dose has been developed which is more heat stable
• CONTROL MEASURES:
• ISOLATION:for 7 day after the onset of rash,
immunization of contact with I 2day of exposure.
• IMMUNIZATON: at the beginning of an epidemic is
essential to limitrd the spread.