MORBILIVIRUS (MEASLES)

Question 1

Measles is what kind of pathogen?

Answer 1

Virus (morbilivirus)

Question 2

What is another name for Measles infection?

Answer 2

Rubeola

Question 3

What is the epidemiology of measles?

Answer 3

-Can be spread 5 days before rash
-infects all ages
-Life long immunity with immunocompetent patients
-incubation time of 6-21 days
*Extremely contagious

Question 4

Where is measles common?

Answer 4

-temperate areas (mild climates)
-peak incidence in late winter/spring

Question 5

How is measles spread?

Answer 5

-Respiratory transmission (spread by droplets, fomites)
-Initial infection starts in tracheal/bronchial epithelial cells
-In 2 to 4 days can infect lymphatic tissues and cause spread to organs (viremia)
-Cell associated viremia will disseminate (spread) virus to various organs prior to rash
-may suppress immune system and make people vulnerable to secondary infections

Question 6

Are infants under 1 year at risk for contracting Measles?

Answer 6

Not usually, protected by maternal antibodies
-after 1 year should be vaccinated

Question 7

How does a measles infection present?

Answer 7

-Upper respiratory prodrome phase: high fever (step wise fever), malaise, anorexia

-THREE C’s: conjunctivitis, cough, coryza (runny nose)
-Koplik spots in buccal mucosa form 2-3 days before rash (WHITISH-GRAY/BLUE)

-MACULOPAPULAR BRICK RED rash beginning on face and spreads to extremities (fades top to bottom and lasts 7 days)

-Complications in high risk patients: persistent cough, pneumonia (giant cell), diarrhea, otitis media (ear infection), acute enchephalitis,
*subacute sclerosing panencephalitis (SSPE): brain disorder caused by measles in kids and young adults

Question 8

What could happen if a pregnant mother contracted Measles?

Answer 8

-Pneumonitis (lung inflammation)
-Hepatitis
-SSPE (subacute sclerosing panencephalitis)
-Premature labor
-delivery/spontaneous abortion

Question 9

How is measles diagnosed?

Answer 9

Clinical: classic triad of symptoms

Confirm with:
-Serology for IgG and IgM
-PCR, viral culture
-CBC: leukopenia (low WBC)
-LFT’s
-Chest X-ray if pneumonia
-CSF tap if encephalitis suspected

Question 10

What is the treatment for Measles?

Answer 10

-Supportive care, IV hydration
-Vitamin A will reduce severity and duration
-Prophylactic (preventative treatment) in unvaccinated contacts
-Antibiotic treatment for complications
-Immunocompromised: Ribavirin

-Vaccination within 3 days of exposure
-Human immunoglobulin within 6 days of exposure for infants, pregnant women, immunocompromised