Measles

Question 1

Measles Virus

Answer 1

-Morbillivirus

Question 2

Measles Infectious Period

Answer 2

-Infectious from when symptoms first appear to four days after onset of rash

Question 3

Measles Presentation

Answer 3

• Rash for at least five days
• Fever for at least one day and one of cough, coryza, conjunctivitis
• Prodrome of fever, cough, runny nose, mild conjunctivitis and diarrhoea lasts 2-4 days
• Koplik spots
• Morbilliform rash
• First seen on forehead and neck and spreads to trunk and limbs over 3-4 days
• Often high fever

Question 4

Measles Investigations

Answer 4

• Clinical diagnosis is unreliable
• Swab or serum sample for measles-specific IgM
• RNA detection in salivary swab
• Best to test oral fluids

Question 5

Measles Differentials

Answer 5

• Rubella
• Parvovirus
• Enterovirus
• Scarlet fever

Question 6

Measles Management

Answer 6

• Usually supportive, patients should remain at home to disease spread
• Inform public health

Question 7

Measles Complications

Answer 7

• Otitis media
• Bronchopneumonia accounts for most deaths (secondary infection usually from Staph aureus or viral)
• Giant cell pneumonitis can occur 2-3 weeks following if immunocompromised
• Acute demyelinating encephalitis within 2 weeks
• Subacute subsclerosing panencephalitis 5-10 years afterwards
• Diarrhoea
• Eyes if vitamin A deficient
• More severe in pregnancy

Question 8

Measles Post-Exposure Prophylaxis

Answer 8

• Within 24 hours of exposure

- Vaccine will not exacerbate symptoms