Infectious Diseases: Measles

Measles is an acute exanthematous disease. It is caused by meales virus, a member of Paramyxoviridae. The desease is common in preschool and junior school children but recently it is rare due to widespread of effective immunization. The explosive outbreaks may occur if measles is introduced to unexposed and non-immune communities.

Pathogenesis:

• Measles spread follow airborne droplet transmission from the respiratory tract of patient with active measles
• No other reservoir of infection
• The invasion of upper respiratory tract is followed by lymphoid tissues multiplication and viraemia.

Signs and Symptoms:

1. Koplik's spot as white spots on buccal mucosa (3 days after a high fever)
2. Maculopapular rash, spreads from the head downward
3. Low-grade fever with cough, coryza, and conjunctivitis
4. Erythematous

Complication of Measles:

• Obstructive laryngitis and dysentery
• Secondary bacterial otitis media
• Appendicitis
• Giant cell pneumonitis
• subacute slerosing panencephalitis
• Allergic encephalomyelitis

Management of Measles:

• Commonly the management is symptomatic
• No effective antiviral therapy for acute complications
• Erythrocin, clarithromycin or azithromycin, or co-amoxiclave for bacterial complication
• Steroids are used in allergic encephalitis

How to prevent measles:

1. Active immunization: using combined meales, mumps, rubella (MMR) vaccine is geven between 12-18 months of age. Mild febrile reactions are expected in 3% of vaccines
2. Passive Immunization: It is given within 72 hours of exposure and especially useful in immunocompromised non-immune children