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Measles (Rubeola)
BY: Mohammed H

2. ETIOLOGY SS RNA Species: Measles Virus, Family: Paramyxoviridae
Genus: Morbillivirus
Highly contagious
The portal of entry is through the respiratory tract or conjunctivae following contact with air droplets.

3. CLINICAL MANIFESTATION
Infectious: 3 days before and 4-6 days after onset of rash
Incubation period
8-12 days
Prodromal phase
Exanthematous phase
Recovery
LIFELONG IMMUNITY
Still cough
Red maculopapular eruption
Cepalocaudal progression
With the onset of the rash, symptoms begin to subside but cough persists.
The rash fades over 7 days cephalocaudally
Mild fever
3Cs: Conjuctivitis, Cough and Coryza
Koplik spots appear 1-4
days prior to the onset of the rash
Symptoms increase in intensity for 2-4 days until the 1st day of the rash.

4. DIAGNOSIS
Clinically
WBC ↓ed, Lymphopenia
CRP and ESR are normal
Serology: IgM Ab, 4 fold ↑ in IgG Ab
Viral culture
Viral PCR

5. DIFFERENTIAL DIAGNOSIS
Rubella
Adenovirus, enterovirus infection, and Epstein-Barr virus infection.
Mycoplasma pneumoniae and group A streptococcus may also produce rashes similar to that of measles.
Kawasaki syndrome.
Drug eruption.

6. COMPLICATIONS Acute otitis media Pneumonia
Croup, tracheitis, and bronchiolitis
Encephalitis and Subacute sclerosing panencephalitis (SSPE)

7. Vitamin A therapy is indicated for all patients with measles.
TREATMENT
Supportive
Antiviral
Antibiotic
Vitamin A
Vitamin A therapy is indicated for all patients with measles.
administered once daily for 2 days at doses of:
200,000 IU for children ≥12 mo
100,000 IU for infants 6-11 mo
50,000 IU for infants younger than 6 mo.

8. Vaccination 12-15 mo and 4-6 yr
PREVENTION
Isolation
Vaccination mo and 4-6 yr
Immunoglobulin is indicated for susceptible household contacts of measles patients, especially infants younger than 6 mo of age, pregnant women, and immunocompromised persons.
20,000,000/year
deaths (kids)
USA 63/yr

9. REFERENCES https://emedicine.medscape.com/article/96622 0-clinical
Nelson textbook of pediatrics, 20th edition, Page Chapter 246