ME A S L E S

aka
RUBEOLA/ MORBILLI
Prepared by:
Lady Diane Cabriga.
DEFINITION
• Measles is an acute, contagious and exanthematous
disease that usually affects children who are
susceptible to upper respiratory tract infection (URTI).
This may be one of the most common and most
serious of all childhood diseases.

WOODGROVE 2
BANK
IDENTIFICATION
• Measles infection was distinguished from smallpox as
early as the 9th century by an Arab physician by the
name of Abu Becr Razi (the Doctor of Baghdad).
• However, there is no record of repeated epidemics
identified as measles until the 11th and 12th centuries.
• Measles was first mentioned as a childhood disease in
1224.
• The Danish physician Peter Panum is generally given
credit for illuminating the basic principles of measles
infection and epidemiology during his trip to the Faroe
Islands in 1846 during a measles epidemic.
https://www.nceas.ucsb.edu/~sjryan/PPP/lectures/Lecture%2015.pdf
WOODGROVE
BANK
• Estimated to have killed about 200 million worldwide
in the last 150 years.
• Disease caused by the measles virus is typically
marked by a prodrome of fever, conjunctivitis, coryza,
and cough which is followed by the development of a
rash of flat macules which first appear on the head and
then move to the chest, trunk, and limbs. These
macules typically fuse resulting in large blotches that
can be slow to fade.
• Children get complications like diarrhea

WOODGROVE 4
BANK
WOODGROVE 5
BANK
PATHOGNOMONIC SIGN
• Koplik’s sign – are pathognomonic of measles. These
are inflammatory lesions of the buccal mucous glands
with superficial necrosis.
1. They appear on the mucosa of the inner check opposite to
the second molars or near the junction of the gum and the
inner check.
2. They usually appear 1-2 days before measles rash.

WOODGROVE 6
BANK
CLINICAL MANIFESTATION
• Clinical manifestations come in three stages:
1. Pre-eruptive stage
a. Fever
b. Catarrhal symptoms (rhinitis, conjunctivitis, photophobia, coryza)
c. Respiratory symptoms start from common colds to persistent
coughing
2. Eruptive stage
a. A maculo-popular rash usually starts to appear late on the 4th day.
b. The maculo-popular rash appears firs on the cheeks, bridge of the
nose, temples, earlobes, or along the hairline.
c. The rash is fully developed by the end of the 2nd day and all
symptoms are at their most severe at this time.
d. High-grade fever comes on and off
WOODGROVE 7
BANK
CONTINUE..
e. Anorexia and irritability
f. Abdominal tympanism, pruritus, and lethargy
g. The throat is red and often extremely sore.
h. As fever subsides, coughing may diminish, but more often
it hangs on for a week or 2nand becomes looser and less
metallic.
3. Stage of convalescence
a. Rashes fade away in the same manner as they erupted.
b. The fever subsides as rashes start to fade.
c. When the rashes have faded, desquamation begins.
d. Symptoms subside and appetite is restored.

WOODGROVE 8
BANK
UNFAVORABLE SIGNS
1. Violet onset with high-grade fever
2. Fading eruption with rising fever
3. Hemorrhagic or black measles
4. Persistence of fever for 10 days or more
5. Slight eruptions accompanied by severe symptoms, especially
those of encephalitis.

WOODGROVE 9
BANK
ETIOLOGIC AGENT
• Filtrable Virus – which belongs to the genus
Morbilivirus of the family. Paramyxoviridae – is the
agent of measles.
• The measles virus us rapidly inactivated by heat,
ultraviolet light and extreme degrees of acidity and
alkalinity.

WOODGROVE 10
BANK
OCCURRENCE
• According to the World of Health Organization, the
yearly global incidence of measles is estimated to be
50 million cases, of which 1.5 million are fatal. –
Healthy populations 1 death per thousand cases –
Developing nations around 10% mortality – In
immunocompromised people upto 30% mortality.
• Two serious complications of measles infection are
acute post-infectious encephalitis, which occurs in
about 1 in every 1,000 cases (15% mortality), and
subacute sclerosing panencephalitis (SSPE), which
occurs in about 1 in every 300,000 cases (fatal).
https://www.nceas.ucsb.edu/~sjryan/PPP/lectures/Lecture%2015.pdf
WOODGROVE 11
BANK
OCCURRENCE
• The Philippines is now dealing with one of the worst measles outbreaks in
the world. Since January, the country has had more than 33,000 cases.
More than 450 people have died.
(https://www.npr.org/2019/05/19/724747890/measles-outbreak-in-the-Philippines)

• The outbreak has continued into February. Last week, a measles outbreak
was declared in Metro Manila – populated by 12 million people with many
living in poverty-stricken slums. This follows 196 reported cases in
January, compared to just 20 recorded in the same period last year. In
Manila, 55 children under the age of four have died of measles since the
beginning of the year.
• The department of health has subsequently also declared a “red alert”
outbreak in the regions of Luzon and parts of the Visayas.
(https://www.theguardian.com/world/2019/feb/12/measles-outbreak-in-philippines-kills-70-with-
vaccine-fear-mongering-blamed)

WOODGROVE
BANK
RESERVOIR
• The virus has been found in patient’s blood, as well as
in the secretions from the eyes, nose and throat.

WOODGROVE 13
BANK
MODE OF TRANSMISSION
1.The disease is transmitted through direct contact with
droplets spread through coughing or sneezing.
2.It can also be transmitted indirectly through articles
freshly contaminated with respiratory secretions of
infected patients.

WOODGROVE 14
BANK
INCUBATION PERIOD
• The incubation period is from 10 to 12 days ( the
longest is 20 days and the shortest is 8 days)
• A single attack conveys lifelong immunity.

WOODGROVE 15
BANK
PERIOD OF COMMUNICABILITY
• Measles usually lasts about 9-10 days measured from the
beginning of the prodromal symptoms to the fading of the
rash.
• The disease is communicable 4 days before and 5 days after
the appearance of rashes.
• The disease is most communicable at the height of the rash.

WOODGROVE 16
BANK
SUSCEPTIBILITY OF THE DISEASE
Being a young, unvaccinated child is the biggest risk factor for
contracting the measles virus and developing complications. If
you are exposed to the measles virus and you haven't been
vaccinated, your chance of getting it is 90 percent, no matter
your age. Risk factors for measles include:
• Being unvaccinated. If you haven’t received the vaccine for
measles. You’re much more likely to develop the disease.
• Travelling internationally. If you travel to developing
countries where measles is more common, you’re at higher
risk of catching the disease.
• Having a vitamin A deficiency. If you don’t have enough
vitamin A in your diet, you’re more-likely to contact
measles and to have more-severe symptoms.
WOODGROVE 17
BANK
METHODS OF CONTROL
1. Immunizations with anti-measles at the age of 9 months, as a
single dose. The 1st dose of the measles-mumps-rubella
(MMR) vaccine is given at 15 months old, with the 2nd dose
at 11 to 12 years old.
2. The measles should not be given to pregnant women or to
persons with active tuberculosis, leukemia, or lymphoma, or
those with depressed immune system.
3. Avoid overcrowded places to lessen the chances of
contracting the virus.

WOODGROVE 18
BANK
MODALITIES OF TREATMENT
1. Anti-viral drugs (Isoprinisone)
2. Antibiotics if with complication
3. Supportive therapy (oxygen inhalation, IV fluids)

WOODGROVE 19
BANK
 WOODGROVE
BANK

THANK YOU