measles
MEASLES
Measles, also known as rubeola, is a highly contagious disease caused by the measles virus Morbillivirus.
It is characterized by generalized maculopapular rash, fever, cough, rhinitis and conjunctivitis. Transmission is through respiratory tract or conjunctivae following contact with droplet aerosols.
It is highly communicable from 4 days before the rash up to 4 days after its onset.
The incubation period from exposure to prodrome averages 7-21 days.

Prevention

Isolation

  • Isolation of household or school contacts solely is not effective in preventing transmission of infection; spread of virus occurs before the onset of symptoms
  • Isolation of infected individuals should be done for 4 days after the initial appearance of rashes

Measles Vaccine

  • May produce a mild, noncommunicable infection
  • Available as monovalent or combined w/ other vaccines (eg mumps, rubella); seroconversion rates same for both monovalent & combined vaccines
  • Advisory Committee on Immunization Practices (ACIP) recommends the use of measles-mumps-rubella (MMR) vaccine when any of the individual components is indicated
  • 1st dose of MMR vaccine is recommended at 12-15 mth, 2nd dose at 4-6 yr of age or <28 days after the 1st dose
  • MMRV may be given as the 2nd dose of measles vaccine at age 11-47 mth
    • May also be given as 1st measles vaccine for children aged >4-<14 yr, 2nd dose may be given w/in the same age range

Post-exposure Prophylaxis

  • May be protected either by Ig immunization or vaccine administration
  • Measles vaccine or MMR vaccine is effective if given w/in 72 hr of exposure
  • Ig is administered up to 6 days post-exposure
    • Indicated in susceptible contacts of measles patients eg infants <12 mth of age, immunocompromised individuals
    • For infants 6-11 mth of age, MMR should be used instead of Ig if given w/in 72 hr post-exposure
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