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Measles

Measles. introduction. Acute viral exanthematous fever Most contagious diseases known Leading cause of childhood deaths in developing countries. introduction. 6 million deaths of infants & children globally every year Measles vaccination marked decline

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Measles

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  1. Measles

  2. introduction • Acute viral exanthematous fever • Most contagious diseases known • Leading cause of childhood deaths in developing countries

  3. introduction • 6 million deaths of infants & children globally every year • Measles vaccination marked decline • Developed countries: estimated 20 million cases of measles resulted in 242,000 deaths in 2006

  4. Agent • Genus morbillivirus • Family paramyxoviridae • Negative sense single stranded RNA virus • There is only one serotype.

  5. Host • Susceptibility is universal • Most infections occur in 6months to 3years in developing countries • In india, >50% of cases were reported in children <5years of age

  6. Host • Serious form in adults. • No gender predilection • Mortality higher in females at all ages • Immunity lasts lifelong • Nutritional status critical to decide severity • Persons with malnutrition, especially VAD or advanced HIV infection are at increased risk of severe or fatal measles.

  7. Environment • In India, the peak incidence is in winter and early spring • In temperate countries most cases occur in winter months • Overcrowding favors transmission.

  8. Transmission • Person to person by direct contact • Droplets or airborne spread of secretions • SAR ~ 90% • Communicability: 2 days before prodrome to 4days appearance of rash

  9. Clinical Features • IP: ranges from 8 to13 days • 14 days from exposure to rash • Cough, coryza and conjunctivitis • Koplik’s spots: pathognomonic & towards the end of prodrome • Measles rash: 2 to 4 days after prodrome • First appears on the face and upper neck

  10. Koplik’s spots

  11. Complications • Severe Diarrhea Dehydration, • Ear Infections : Otitis Media • Pneumonia (MCC Death) • Measles Encephalitis • SSPE • CFR:1-5% & 25% in SAM

  12. Special Situations • Pregnancy: spontaneous abortion & premature delivery • May aggravate tuberculosis • Delay measles vaccination until after initiation of chemotherapy

  13. Treatment • General nutritional support and • Treatment of dehydration with oral rehydration • Antibiotics • Ribavirin • Oral vitamin A administration

  14. Prevention and Control • Active immunization is the primary method • Passive immunization: special circumstances. • General measures have little role

  15. Active Immunization • A live attenuated vaccine • Edmonston B strain • single dose of 0.5 ml SC • two doses are given • Contraindication: Severely immunocompromised and pregnancy

  16. Passive Immunization • Human Ig : 0.25 ml per kg • Within six days of exposure. • To susceptible household contacts like immunocompromised children

  17. General Measures • Respiratory isolation • Exclusion from school for 1week from appearance of rash • Hospital strict isolation of cases • Articles soiled by secretions or fluids from vesicles to be incinerated or treated with disinfectants

  18. Long Question : Discuss the epidemiology, treatment, prevention and control of Measles. • Short Note : (1) Complications of Measles (2) Measles vaccination

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