Measles
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Measles

Measles is caused by the Measles virus. 


It is as an acute highly communicable viral disease, severe in infants and adults rather than in children. It can be complicated with otitis media, bronchopneumonia, laryngotracheobronchitis (croup), encephalitis and diarrhoea.


Mode of transmission
  • droplet spread 
  • direct nasal and throat secretions of infected persons

Reservoir
Humans.


Incubation period
7 - 18 days. Period of communicability is from slightly before the beginning of the prodromal period to 4 days after the appearance of the rash.


Signs and Symptoms
  • Cough
  • Koplik's spots on the buccal mucosa
  • Prodromal fever
  • Coryza
  • Conjunctivitis
  • A characteristic red blotchy rash appears around the third day of illness, beginning on the face and becoming generalised.


Diagnosis

  • History and clinical features.
  • Confirmatory tests: measles specific IgM antibodies that are present 3 - 4 days after the onset of the rash.

Treatment
Usually supportive, antipyretics given to control fever.


Control and Prevention
Routine childhood vaccination - at 15 months of age (Child Immunisation Schedule). Live attenuated vaccine is the agent of choice for vaccination. Especially recommended for children with congenital/acquired heart disease. Contraindications to vaccine:

  1. General: Acute febrile illness or during the course of any viral illness, pregnancy, patients receiving corticosteroids, antimitotics, and immunosuppressive therapy.
  2. Specific: Untreated active TB, hypersensitivity to egg protein, neomycin and polymycin.
  3. Relative: Children with the following should be given measles vaccine along with human normal Ig with a specific content of measles antibody:- children with a history of convulsions, family history of epilepsy, chronic disease of heart or lungs, seriously malnourished children.

Exclude from school children with rash, they can be sent back one week following the onset of rash.

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