Infection: Measles

Question 1

Why has there been a rise in cases?

Answer 1

Public anxiety about MMR

Question 2

Do older children or younger children have more severe disease?

Answer 2

Older

Question 3

For epidemiology tracking, what should be done?

Answer 3

PCR based or serology confirmation of clinical cases - blood or saliva

Question 4

What clinical features are there?

Answer 4

Prodrome: irritable, conjunctivitis, fever, cough

Kolpik spots followed by rash

Question 5

What are kolpik spots?

Answer 5

White spots on buccal mucosa

Question 6

Describe the rash

Answer 6

Starts behind the ears then to whole body
Discrete maculopapular rash becoming blotchy and confluent
May desquamate in the second week

Question 7

How is it spread?

Answer 7

Via droplets

Question 8

When is it infective?

Answer 8

from prodrome until 4 days after rash starts

Question 9

What complications can occur?

Answer 9

Otitis media = most common
Pneumonia = most common cause of death
Febrile convulsions
Diarrhoea
Myocarditis
Encephalitis - headache, lethargy, irritability, proceding to seizures and coma
Subacute sclerosing panencephalitis (SSPE)

Question 10

How is it treated?

Answer 10

Supportive
Children admitted to hospital should be isolated
In immunocompromised: ribavirin
Vitamin A in low income countries

Question 11

What should be done if a child not immunised comes into contact with someone with measles?

Answer 11

Offer the MMR - they will develop the antibody faster than following natural infection