Rubeola (Measles)

Question 1

Rubeola is a highly contagious _____ disease where there is a _____% chance of secondary infection in susceptible individuals

Answer 1

viral, 90%

Question 2

What is the failure percentage of the vaccine for those who received a single dose of vaccine at 12 mo. or older?

Answer 2

5%. Need 2nd vaccine to induce immunity in these 5% of people who didn’t develop immunity with the first vaccine

Question 3

When are rubeola pts contagious?

Answer 3

few days before onset of sx (3-5 days before rash) to 4 days after the appearance of the rash

Question 4

Is the incubation of rubeola long or short?

Answer 4

Long, 8-12 days

Question 5

What are the clinical manifestations of rubeola?

Answer 5

• mild fever (101),
• cough, coryza, conjunctivitis (3c’s)
• rash spreading from the face going outward
• White spots inside cheeks prior to rash (Koplik spots)
• acute encephalitis (rare)

Question 6

What are the complications of Rubeola?

Answer 6

• 30% of people may get pneumonia, ear infections and diarrhea
• encephalitis in the first few days of rash

Question 7

Explain SSPE in relation to Rubeola

Answer 7

Subactue Sclerosing PanEnechpalitis is a degenerative CNS dz characterized by behavioral and intellectual deterioration and seizures. Results from persistent measles virus infection that develops years after original infection. This is rare and more common in measles pts under 1 year old

Question 8

What are the diagnostic tests we can do to test for rubeola?

Answer 8

IgM antibody or measles IgM antibody (detectable for at least 1 month after rash onset)
Alternative testing: IgG antibody level in paired acute (collected within 4 days of rash onset) and convalescent (collected 2 to 4 weeks later)

Question 9

How do we treat Rubeola?

Answer 9

fever reducing agents, antibiotics as indicated for any secondary bacterial infections, no specific treatment available but vit A deficient countries routinely administer vitamin A with vaccine to decrease death and blindness in children

Question 10

If you haven’t gotten your rubeola vaccine and you become exposed to it, should you go ahead and get the vaccination after the fact? Should they get any additional treatment?

Answer 10

Yes! post exposure vaccination is indicated within 72 hours of contact. You may still get infection but sx will be milder. Immune globulin should also be given to pt and household contacts-can be given up to 6 days after exposure

Question 11

When should the first dose of rubeola be given?

Answer 11

12-15 months old