measles

1. MEASLES [RUBEOLA]
Dr. Sushrit A. Neelopant
Assistant Professor,
Department of Community Medicine
RIMS, Raichur
10/2/2020

2. • An acute highly infectious disease of childhood
caused by - A - myxovirus
• ‘Rubeola’ = red spots
• Endemic in all parts of the world
• Before availability of vaccine, it killed 7-8M children a
year, today it still kills about 1m people
10/2/2020

3. • Clinical:
– Fever, coryza, cough  Rash
• Developing countries
– morbidity & mortality high
• Types of Measles:
– Purpuric measles
– Haemorrhagic measles
– Atypical measles
– Modified measles
10/2/2020

4. • > 30 million people are affected each year by
measles
• It is a leading killer among
– vaccine preventable diseases of childhood
10/2/2020

5. 10/2/2020

6. • Single stranded RNA virus - paramyxovirus group
• Survival outside human body- Subzero
• Sensitive- acid conditions, drying
• Source of Infection: a case of measles (carriers known)
• Infective material : secretions of nose, throat, resp. tr
• Communicability: 4 days before & 4 days after
• Secondary Attack Rate : 90% - unimmunized contacts
• Infection life long immunity
10/2/2020

7. 1) Vulnerable age: 6 months – 3yrs
2) Gender: Both - equally affected
3) Immunity: no age is immune if there is no previous
immunity
– One attack - life long immunity, second attacks rare
– Maternal antibodies protect - up to 6 months of age
– Immunity after vaccination long lasting
4) Nutrition: severe disease in malnourished
– mortality up to 400 times higher
10/2/2020

8. • Can spread in any season
• Increased transmission during winter
• Poor socio-economic conditions- favour attack
10/2/2020

9. Environmental
Factors
• Can spread in
any season
• More- winter
• Poor socio-
economic
conditions
Mode of
transmission
• Droplet inf.
• 4 & 4 days
• Entry-
– Resp. tr.
– Conjunctiva
Incubation
period
• Fever- 10 days
• Rash- 14 days
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10. 1. PRODROMAL STAGE
2. ERUPTIVE STAGE
3. POST-MEASLES STAGE
10/2/2020

11. • Begins 10 days after infection
– fever, sneezing, cough, coryza, conjunctivitis,
lacrimation, photophobia
• Koplik’s spots - buccal mucosa
– opposite the I and II upper molars
– a day / two before appearance of rash → they are small,
bluish – white spots on a red base
– pathognomonic
10/2/2020

12. • Rash- dusky red, macular/ maculopapular → face
(at hair line/forehead) → neck → extends down the
body in 2–3 days → to lower extremities
• Disappears in 3 – 4 days → fades in the same order
of the appearance end of disease
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13. Rashes
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17. 10/2/2020

18. Chicken pox rashes and Measles rashes
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19. • child has lost weight remains weak
• failure to recover 
• gradual deterioration into chronic illness 
• susceptible to other bacterial and viral infection,
diarrhoea, pyogenic inf, reactivation of pulmonary
tuberculosis, growth retardation
10/2/2020

20. • The risk of complications and death- highest in
young children and adults
• The most common complications of measles are
otitis media, diarrhoea and pneumonia
• Less common complications-
– sinusitis, mastoiditis, myocarditis, keratoconjunctivitis,
mesenteric adenitis, hepatitis, and thrombocytopenic
purpura
10/2/2020

21. • Measles infection during pregnancy is
associated with spontaneous abortion
and with delivery of low birth weight
infants
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22. • In addition to the acute complications, measles virus
can cause a degenerative disorder of the central
nervous system known as Subacute Sclerosing
PanEncephalitis (SSPE)
• The reported risk of SSPE ranges from 1 case per
100,000 measles cases in persons infected after four
years of age to 18 cases per 100,000 measles cases in
persons infected in infancy
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23. Prevention
10/2/2020

24. • Measles,Mumps,Rubella
(MMR) vaccine
• MMR I/M, 0.5 ml at 12
and 18 months
• MMR is a reconstituted
vaccine and hence must
be discarded at the end
of immunization session
i.e. after 6 Hours
10/2/2020

25. • Measles vaccine is contraindicated in persons with
immunodeficiency or immuno suppression
• However, it should be administered to persons with
asymptomatic human immunodeficiency virus (HIV)
infection since measles disease may be severe or
fatal in such persons
• Severely immunocompromised persons with HIV
infection should not be vaccinated
10/2/2020

26. • Passive immunity against measles disease can be
induced by the administration of commercially
prepared immune globulin (IG) (formerly called
immune serum globulin [ISG]), which typically has a
high measles antibody titer
• Administration of 0.25 mL of IG per kilogram
(maximum dose 15 mL) can modify or prevent the
development of measles in the exposed person
10/2/2020