Measles

( Rubeola )
Measles (Rubeola)
It is an acute viral infection characterized by a
final stage with a maculopapular rash erupting
successively over the neck and face, trunk, arms,
and legs, and accompanied by a high fever.

It is a viral infection of the respiratory system. It

is a very contagious disease that can spread
through contact with infected mucus and saliva.
An infected person can release the infection into
the air when they cough or sneeze.
 Causative Agent:
Measles is caused by an RNA of the genus
Morbillivirus in the family paramyxovirus.

Mode of Transmission:
It is spread by droplets in the air or by direct contact. The measles virus can live
on surfaces for several hours. As the infected particles enter the air and settle on
surfaces, anyone within close proximity can become infected.

The virus infects the respiratory tract , grows in the cells of the back of the
throats and lungs, then spreads throughout the body. Measles is a human
disease and is not known to occur in animals.
Pathogenesis:
Attach to primary
Infected Healthy Inhaled
site: Respiratory
People People
Nasal/Throat Epithelium of the
Secretion, airborne nasopharynx
transmission

2-3 days later

Virus Multiply,
replicates in replication,
the lymph Invasion to regional
nodes lymph nodes.

5-7 days
Skin, after initial
viscera,
Secondary infection
Primary viremia +
subsequent infection
kidney, Viremia of the Respiratory
bladder
System
Signs and Symptoms
Its symptoms always include fever and at least one of the three Cs:

Cough Conjunctivitis
Coryza,
or runny nose
The First Sign
Within seven to 14 days after
getting infected with the measles,
your first symptoms will appear.
The earliest symptoms feel like a
cold or the flu, with a fever, cough,
runny nose, and sore throat.
Often the eyes get red and runny.
Three to five days later, a red or
reddish-brown rash forms and
spreads down the body from head
to foot.
Kopliks Spots
There will be very small grayish-
white spots with bluish-white
centers in the mouth, insides of
cheeks, and throat.
It spread rapidly in the Buccal
Mucosa.
Kopliks spots should fade as the
other measles symptoms
disappear.
Measles
Rash
Red or reddish-brown in color. It
starts on the face and works its way
down the body over a few days:
from the neck to the trunk, arms,
and legs, until it finally reaches the
feet.
Eventually, it will cover the entire
body with blotches of colored
bumps.
The rash lasts for five or six days in
total. Immunocompromised people
might not have the rash..
Other Signs and Symptoms:
Dry hacking cough
Watery eyes

Photophobia, or sensitivity to light

Sneezing

Generalized body aches

Complications:
Complications are more common in children under the age of 5, or adults
over the age of 20.
The most serious complications include:
- Blindness
- Encephalitis (an infection that causes brain swelling)
- Severe diarrhea and vomiting
- Ear Infections
- Bronchitis, Laryngitis
- Pneumonia
- Convulsion
Risk Factors:
1. Being unvaccinated. If you haven't received the vaccine for measles,
you're much more likely to develop the disease.

2. Having a vitamin A deficiency. If you don't have enough vitamin A in

your diet, you're more likely to contract measles and to have more-
severe symptoms.

3. Traveling to countries where measles is prevalent.

Diagnosis:
The doctor can diagnose the patient by examining
the rash.

Typically, there will be white spots in the buccal

mucosa (Kopliks spots) which is an infection of the
endothelial cells results in an Enanthem (Koplik
Spots). These lesions are said to be a prodromic
viral enanthem (mucus membrane eruption) of
measles.

If it is hard to diagnose virtually, a blood test can be

done to check/verify for the presence of measles
virus.
Diagnostic Test:
MMR Titer
- Blood test that checks if you are immune to Measles, Mumps and Rubella. It
measures your antibody levels to get a sense for whether your immune
system has the capability to respond to an infection with one of these
diseases.
- For Measles: If IgM antibodies are present, it may mean you have an active
measles infection.
- If you have been exposed to the rubeola virus, the body may have made this
antibody.
Treatment:
Post-exposure vaccine: Receiving the measles vaccine 72
hours after exposure to the virus may help in
prevention, or lead to a milder form of the disease.
(MMR Vaccine Measles, Mumps, and Rubella Vaccine)
Vitamin A supplement: Vitamin A supplementation can
help reduce measles symptoms and deaths in patients
with nutritional deficiency.
Antipyretics (acetaminophen or ibuprofen, paracetamol)
for fever Aspirin should not be given.
Treatment:
Antibiotics can be given if the patient suffers
from bacterial infection like ear infection or
pneumonia. Penicillin, Oxacillin
Humidifier - may alleviate symptoms of
laryngitis or an excessively irritating cough
Patients with photophobia should be
protected from exposure to strong light.
Adequate bed rest to help boost the immune
system.
Prognosis:
Measles has a low death rate in healthy children and adults, and
most people who contract the measles virus recover fully. The risk
of complications is higher in children and adults with a weak
immune system.

You cannot get measles more than once. After youve had the
virus, you are immune for life.
Prevention is better than cure
Immunizations can help prevent a measles outbreak.

MMR Vaccine is a safe and effective

combined vaccine that protects against three
separate illnesses measles, mumps and rubella
(German measles) in a single injection. The full
course of MMR vaccination requires two doses.
First Dose: 12-15 months of age
Second Dose: 4-6 years of age (may be given earlier,
if at least 28 days after the 1st dose)