Signs & Symptoms
Measles, also known as rubeola, is a highly contagious viral disease characterized by fever, an enanthem, cough, coryza & a distinct exanthem
- 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 & Symptoms
- 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
- 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
- Changes in mental status
- 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
Refer to Symptoms for more information
- Patients are provided w/ supportive therapy
- Oxygen therapy
- Hydration & nutrition
- Vitamin A
- Parents are advised to
- Isolate the child 4 days after the initial appearance of rashes
- Immunize the child w/ measles vaccine
- Give post-exposure prophylaxis to susceptible contacts of measles patients
Refer to Treatment for more information
Below is the overview of the disease management of MEASLES:
Version: 7 Aug 2015
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- Communicable Diseases Network Australia (CDNA). Measles: national guidelines for public health units. Australian Government Department of Health website. http://www.health.gov.au/internet/main/publishing.nsf/Content/BD2AD79FD34BFD14CA257BF0001D3C59/$File/Measles-SoNG-final-April2015.pdf. Feb 2015. Accessed 06 Aug 2015.
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- Maldonado YE. Rubeola virus (measles and subacute sclerosing panencephalitis). In: Long SS, Pickering LK, Prober CG. Principles and practice of pediatric infectious diseases. 3rd ed. Philadelphia, PA: Elsevier; 2008.
- Marin M, Broder KR, Temte JL, Snider DE, Seward JF, Centers for Disease Control and Prevention (CDC). Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010 May;59(RR-3):1-12. http://www.cdc.gov/mmwr/pdf/rr/rr5903.pdf. PMID: 20448530
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