Measles

Question 1

Measles overview

Answer 1

Highly contagious disease endemic throughout the world
RNA Paramyxovirus

Incubation 10-14 days
Infectious until 4 days after development of rash

Laboratory Diagnosis - Serology looking for measles IgM 3-5 days after onset of rash.
- Nasopharyngeal aspirate for PCR (No medicare rebate so must discuss cost with patient)

Lifelong immunity after infection

Question 2

Clinical stages and features of measles

Answer 2

Prodromal stage (Lasts 3-4 days)
- Fever, malaise, anorexia, diarrhoea, 3C’s (Cough, coryza, conjunctivitis)
Exanthema (Rash) Stage (Lasts 4-5 days)
- Blotchy, bright erythematous, blanching maculopapular eruption
- Progression - Behind ears -> Face -> Trunk -> Limbs
- Koplik spots (Tiny white spots like grains of salt) found opposite molars on buccal mucosa.
Convalescent Stage (Lasts 7-10 days)
- Rash fades leaving brownish staining.
- Cough may persist but usually good health and appetite.

Question 3

Complications of measles

Answer 3

Otitis Media
Pneumonia
Diarrhoea
Encephalitis
- 1-2/1000 infected will die, usually from pneumonia.
- In Pregnant women - Miscarriage, premature delivery

Question 4

Management of Measles

Answer 4

Non-pharmacological
- Rest
- Avoid bright lights
- Vaccination to non-immunised children over 12 months identified as close contacts. (Note: Do not use MMRV if child >= 14 years. Only use 2x MMR
- Isolation until 4 days after development of rash.
- Notify Public health unit