Measles, Mumps and Rubella - vaccines Flashcards
measles epidemiology:
* — reservoir
* Transmission: — , —,—
* Seasonality: peak in late — /—in
temperate —
* Incubation period: — days. Exposure to rash onset — days (mean – days)
* Infectious period: – days before to –days after rash onset
human
airborne droplet fomite
late winter/spring
climates
10-12
7-21
14 days
4
4
measles is — contagious
* — inoculum - A very large number of viral particles is shed from the infected —
* — infecting dose - — virions required to lead to infection
- So infection can follow —
– Especially in a — and poorly —
environment
-Measles R0 = 12-18, COVID-19 Delta R0= 5
highly
high
respiratory tact
low
not too many
brief exposure
crowded n poorly ventilated
pathogenesis of measles:
* Invasion and replication in the —
and —-
* Day 2-3 — occurs
* Further viral replication occurs in— and — reticuloendothelial sites
* Day 5-7 —- occurs
– May be infection of the respiratory tract and other organs
respiratory tract n regional lymph node
primary viraemia
regional n distal
2ndary viraemia
neurological complications:
* Measles inclusion body — (MIBE) 2/1000
– Appears within a few days of rash
– 15% rapidly progress to —
* — disseminated encephalomyelitis (ADEM) 1/1000
– 1-2 weeks after rash, —-
– 15% fatality
* — sclerosing panencephalitis (SSPE)
– — 4-11 per 100,000 – — disease
– ? active measles in brain, diagnosis — in CSF
– Onset 7 years (average) post measles (1 mo– 27 years)
– Deterioration in behaviour and cognition, ataxia, myoclonic seizures, and death
encephalitis
fatality
acute
post-infectious autoimmune
subacute
rare
degenerative CNS
IgM
1- other measles complications:
* — – most common
* — – 5-10%
*— – commonest cause of death
* — complications
* — – 0.1-0.2%
2- lab diagnosis:
* — for measles RNA
– Oral fluid/swab
* Serology
– — on buccal swab,
or
– — fold rise in – titre on serum samples from acute and convalescent phase of illness
3- measles:
- Fine — particles with the virus
suspended in air over — and — and inhaled
*airborne infection — room
* Respiratory protection; use — respirator mask respirator mask
4- prevention:
* – Public Health immediately about any suspected cases
* Childhood — programme
* Contacts:
* — within — of exposure.
* HNIG – Human Normal — : If vaccine contraindicated or outside 72 hour window
* Hospital:
* — isolation with airborne, and —
precautions
diarrhoea
otitis media
pneumonia
neurological
death
NAAT
IgM
4 folds
IgG
airborne
distance n time
isolation
FFP2/N95
notify
vaccination
vaccination within 72 hours
immunoglobin
single room
standard
rubella:
* — reservoir
* Transmission: —
* Seasonality: peaks in late — in
temperate—
* Incubation period: — days (mean – days)
* Infectious period: – days before to – days after rash onset
clinical features:
* Prodrome:— grade fever, malaise, anorexia
* Rash:
* — maculopapular
* Non-blanching
* Starts — and moves down
* Does not — (unlike measles)
* Arthritis/Arthralgia
* Lymphadenopathy (Head & Neck)
- Can be difficult to see on darker skin tones but rash may feel — or — , as it is maculopapular
human
droplet spread
late winter/spring
regions
12-23
14
7
7
low
geenrlaised
face
coalesces
rough or bumpy
congenital rubella syndrome CRS:
* Due to — in a – mother
* Rare in countries with established immunisation programmes
* May affect – organs
* May lead to – death or – delivery
* Severity of the damage to the
foetus depends on the
gestational –
– Up to 85% of infants will be
affected if infected during
the — trimester
– No documented risk after —
-‘Blueberry muffin’ skin
lesions
Triad:
1. –
2. –
3. – defects
infection
non immune
all
feotal death or premature
age
first
20 weeks
cataracts
deafness
heart defects
lab diagnosis for rubella :
1. — for Rubella RNA:
* Oral fluid
* Urine
* Blood
* Respiratory secretions
2. Serology:
* — on buccal swab
Or
* – fold rise in – titre on serum samples
from acute and convalescent phase of illness
prevention:
1. — Public Health immediately about any suspected case
2. Childhood —
3. Immunity—:
* Antenatal and healthcare staff
* Immunization of non-immune adults
4. Hospital precautions:
* – room & – plus standard
NAAT
IgM
four
IgG
notify
vaccination
immunity sceeeninf
single room
droplet
mumps:
— reservoir
Transmission: –
Seasonality: late — in temperate —
Incubation: — days
Infectious Period:– days before to – days after symptom onset
clinical features:
* Fever
* — flu-like prodrome:
headache, malaise, myalgia, anorexia
* Earache
* Sudden onset of — (25%) or — parotid swelling (parotitis)
* Can affect other – glands also
* Up to 20% cases are —
human
respiratory droplet
winter/spring
zones
14-18
3
5
nonspecific
unilateral or bilateral
salivary
asymptomatic
- NOTE EVEN IF FULLY VACCINATED DON’T EXCLUDE MUMPS ON THAT BASIS ALONE
mumps complications:
— involvement → 10% of mumps parotitis cases
(but <50% cases mumps meningitis have parotitis)
— → 20-50% of clinical cases in post-pubertal
males, decreased fertility common, infertility is rare
—- → 2-5%
— → 1/20,000
— → 1-3/10,000
lab diagnosis: - — for mumps RNA:
- Oral fluid
- Buccal swabs
- Urine
- CSF
Serology:
*— on buccal swab
Or - — fold rise in — titre on serum samples
from acute and convalescent phase of illness
CNS
orchitis
pancreatitis
deafness
death
NAAT
IgM
four
IgG
prevention:
— Public Health immediately about any suspected cases
Childhood —
Catch up — vaccinations for adolescents and young adults
Hospital precautions:
* — precautions
notify
vaccination
booster
droplet
summary:
* In pre-vaccination era, measles, mumps and rubella were endemic — diseases
* Measles, Mumps & Rubella are- —- preventable infections still associated with significant morbidity & mortality worldwide (major global public health issue!)
* — is a potentially severe multisystem illness with a
characteristic —
* Mumps and rubella are generally — URTI-like illnesses with some characteristic features
* Complications are important & may be fatal
childhood
vaccine
measles
rash
mild
