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RUBEOLA
OR
MORBILLI
DEFINITION
ETIOLOGY
EPIDEMIOLOGY
1.Source of infection
The patients are the only source of infection.
2 .Routes of transmission
air-borne
3. Susceptibility of population
3.1 All age person is susceptible; 90% of
contact people acquire the disease.
3.2 The permanent immunity acquire after
disease.
4. Epidemic features
season:winter and spiring
age:6 months to 5 years old
MPS(multiply)
PATHOLOGY
CLINICAL MANIFESTATIONS
Typical type
1.Incubation period is approximately
6~18days,10days is the most common.
(3-4weeks)
2 .predromal phase
3~4 days.
2 .1 Fever;
2 .2 Catarrhal inflammation of URT;
2 .3 Kopliks spots;
2 .4 Transient prodromal rashes.
3. Eruption stage
3 .1. Time: the3~5 days after fever;but the 4th
day is most common;
3 .2 . Shape:maculopapular
3.3. Seuence:behind the earalong the
hairlinefaceneckchestbackabdomen
limbshand and feet(palm,sole)
3 .4 . The temperature rise continously and
companied with the toxic symptoms exaggerate
4 . Convalescent stage
brown staining.
fine branny desquamation.
course:10-14 days
Atypical measles
1 . mild measles;
2 . severe measles (toxic and shock type
measles);
3. hemorrhagic measles;
4 . variant measles.
COMPLICATIONS
1 .Bronchopneumonia;
2 .Myocarditis;
3 .Laryngitis;
4 .Neurologic complications:
Encephalitis and SSPE .
0.1-0.2%
1-4/m
2-6days
2-17ys
viral encephalitis retrograde change
early-viral
mutation
late crossed immune
LABORATORY FINDINGS
Blood routine
Serum Ab measurement
complement combining antibody;
hemagglutinin inhibiting antibody;
neutralizing antibody;
specific antibody IgM.
Other Ag and multinucleated giant cells
The separation of virus
DIAGNOSIS
1 .Epidemiologic data;
2 .Clinical manifestations;
3. Laboratory findings:
. 3 .1 .Multinucleated giant cells are
detected in nasopharyax mucosa
secretions;
3 .2 .Measles virus can be isolated in
tissues culture;
. 3 .3 . Antibody titer;
3 .4 . WBC is relative low .
DIFFERENTIAL DIAGNOSIS
1 .Rubella (German measles) ;
2 .Roseola infantum (infant
subitum,exanthem subitum)
3. Drug rashes.
*the early stage definite diagnosis is:
*the early stage clinical diagnosis is:
*the clinical diagnosis is:
treatment
PREVENTION
1 .Control source of infection;
2 .Interruption of transmissions ;
3 .Protection of the susceptible person:
3.1 . Active immunization
Lived attenuated measles vaccine.
plan immune:8m,7j
epidemic stage:before 2 m
contactor:with in 2 days
Contraindications:pregnancy et al
3.2 . Passive immunization
placenta globulin or gamma globulin.
<5 days
prevent onset
>5 days
relieve symptoms