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.

Introduction

  • Also known as rubeola, is a highly contagious viral disease characterized by fever, an enanthem, cough, coryza & a distinct exanthem

Etiology

  • Measles virus is a paramyxovirus, genus Morbillivirus
  • Transmission is through resp tract or conjunctivae following contact w/ droplet aerosols
  • Highly communicable from 4 days before the rash up to 4 days after its onset
  • Incubation period from exposure to prodrome averages 7-21 days

Signs and Symptoms

Typical Measles

  • Prodrome begins w/ fever followed by conjunctivitis w/ photophobia, coryza, cough; cough usually lasts for 10 days
  • Koplik spots found on the inner aspects of the cheeks at the level of the premolars, may also spread in the labial mucosa, hard & soft palate & gingiva
    • Appear as punctate bluish white spots on an erythematous base
    • Pathognomonic for measles
  • Erythematous maculopapular rash initially appears around the forehead or posterior occipital area, spreads downward & outward
    • Begins at the peak of resp symptoms, about 2-3 days after emergence of Koplik spots
    • May become confluent on the face & upper trunk
    • Rash diminishes in the same progression as it appeared, followed by fine desquamation
  • Generalized lymphadenopathy esp prominent in the cervical & occipital areas
  • Gastrointestinal symptoms may occur eg diarrhea, loss of appetite, vomiting, abdominal pain

Atypical Measles

  • Occurs in patients who received inactivated or killed measles vaccine
  • Characterized by fever, pneumonia, pleural effusions & edema
  • Rash may be maculopapular, petechial, urticarial, purpuric or vesicular & it appears initially on the wrists or ankles

Black Measles or Severe Hemorrhagic Measles

  • High-grade fever
  • Seizures
  • Changes in mental status

Modified Measles

  • An attenuated form of measles that may occur in patients who were previously given immunoglobulin (Ig) as post exposure prophylaxis to measles
  • Signs & symptoms are milder than those of typical measles
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