Measles

Question 1

What’s the prodrome for Measles?

Answer 1

FFCC:
Fever, Fatigue
Cough, Conjunctivitis

Question 2

What’s the Incubation period?

Answer 2

10-14 days

Question 3

What is the R0 and transmission mechanism?

Answer 3

R0 9-18!??!!!+!!
15 minutes is enough time to contract it
90% of the unvaccinated will develop it

Question 4

What Clinical signs are found in full-blown measles?

Answer 4

• Rash: from behind ears down trunk. Palms and soles not affected
• Koplick spots; white mucosal lesions
• Conjunctivitis
• Maculopapular red rash in white childen, slightly raised rash with small discrete multilple lesions in black children. Desquamating in later stages.

Question 5

What are the ocular presentations?

Answer 5

• Conjunctivitis (usually mild)
• Secondary bacterial/viral conjunctivitis or keratitis (corneal) can cause scarring and blindness
• Exacerbates vitamin A deficiency! CAN CAUSE BLINDNESS AS WELL!
• Measles encephalitis can cause cortical blindness

Question 6

What are the 4 systemic clinical manifestations of measles?

Answer 6

1. Ocular: conjunctivitis
2. Respiratory: Primary viral penumonitis, Secondary Giant cell pneumonia
3. Gastrointestinal: Diarrhoea (worsens mortality)
   4 .Central nervous system (CNS) complications

Question 7

What are the Neurological complications of Measles?

Answer 7

1. Encephalitis occurs in approximately 1/1000 cases
   25% of children get neurodevelopmental sequelae,
   with a 15% mortality. Acute disseminated encephalitis occurs approximately 2 weeks after onset of exanthem (whole body rash)
2. Subacute Sclerosing Pan-Encephalitis (SSPE) is a
   neurodegenerative disease which occurs in
   approximately 1/10,000 cases. It is usually fatal

Question 8

Treatment of measles?

Answer 8

VITAMIN A is about it.
Fluids? (FEAST!!)
ORT
Abx for secondary infections

Question 9

Vaccination schedule for measles?

Answer 9

First dose at 9 months in endemic areas with second at 15 months.