Infectious Disease Book

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MeaslesAka: Rubeola, Morbilli, Fourth Viral Exanthem of childhood, Red Measles

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  1. Etiology
    1. Morbillivirus: Briareus morbillorum
  2. Pathophysiology
    1. Incubation: 10-11 days
    2. Transmission
      1. Droplets of nasopharyngeal secretions
      2. Highly contagious
        1. Affects 90% of susceptible household contacts
  3. Epidemiology
    1. Outbreaks in teenagers and young adults
    2. Incidence
      1. U.S. Cases in 1941: 894,000 cases
      2. U.S. Cases in 2000: 86 cases
  4. Symptoms
    1. Prodrome
      1. Classic "3 C's"
        1. Severe Cough (dry, hacking)
        2. Coryza
        3. Conjunctivitis
      2. Fever
      3. Malaise
      4. Irritability
      5. Photophobia
    2. Koplik's Spots in Mouth (3-4 days after prodrome)
    3. Rash spreads from forehead to trunk (1-2 days later)
  5. Signs
    1. Koplik Spots (pathognomonic)
      1. Grayish-white sand-like dots
      2. Slight, reddish areolae that may be hemorrhagic
      3. Often opposite upper first and second molars
      4. My spread to involve any of Buccal mucosa
    2. Fever (Onset with rash)
    3. Blotchy erythematous morbilliform rash
      1. Discrete red-brown Macules blanch with pressure
      2. Begins on forehead
      3. Spreads to face and neck, behind ears
      4. Spreads to trunk and entire body
    4. Cervical Lymphadenopathy
  6. Course
    1. Severity related to extent and confluence of the rash
    2. When rash reaches feet, clinical improvement has begun
  7. Complications
    1. Early
      1. Severe disease with dehydration
      2. Pneumonitis
      3. Pneumonia (3% of young adults)
        1. Includes Interstitial Giant Cell
      4. Otitis Media
      5. Hepatitis
      6. Glomerulonephritis
      7. Myocarditis
      8. Encephalitis (1 per 1000 Measles cases)
        1. Onset 4-7 days after rash
        2. Mortality: 10%
    2. Late
      1. Subacute sclerosing panencephalitis (SSPE)
        1. Incidence: 8.5 cases per 1 million Measles cases
    3. Overall Mortality: 1-2 deaths per 1000 Measles cases
  8. Labs
    1. Complete Blood Count
      1. Leukopenia during prodrome
        1. Lymphocytes <2000 associated with poor prognosis
    2. Respiratory secretions with multinucleated giant cells
    3. Immunofluorescent staining of respiratory cells
    4. Serology
  9. Prevention
    1. Active Immunization at 12-15 months
      1. Contraindications: Immunocompromised
    2. Passive Immunization post exposure
      1. Dose
        1. Gamma globulin: 0.25 ml/kg (MAX 15 ml)
      2. Indications
        1. Children under age 3 years
        2. Pregnant women
        3. Tuberculosis
        4. Immunocompromised patients

Measles (C0025007)

Definition (MSH)A highly contagious infectious disease caused by MORBILLIVIRUS, common among children but also seen in the nonimmune of any age, in which the virus enters the respiratory tract via droplet nuclei and multiplies in the epithelial cells, spreading throughout the MONONUCLEAR PHAGOCYTE SYSTEM.
Definition (CSP)childhood viral disease manifested as acute febrile illness associated with cough, coryza, conjunctivitis, spots on the buccal mucosa, and rash starting on the head and neck and spreading to the rest of the body.
ConceptsDisease or Syndrome (T047)
ICD9055
BasqueELGORRIA
DanishMaeslinger
DutchMazelen
EnglishMeasles, Morbilli, Rubeola, RUBEOLLA
FinnishTUHKAROKKO
FrenchRougeole
GermanMasern
Hungariankanyaro
ItalianMorbillo
NorwegianMESLINGER b05
PortugueseSarampo
Spanishsarampión, Sarampion
SwedishMASSLING/MORBILLI
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Measles Vaccine (C0025010)

Definition (MSH)A live attenuated virus vaccine of chick embryo origin, used for routine immunization of children and for immunization of adolescents and adults who have not had measles or been immunized with live measles vaccine and have no serum antibodies against measles. Children are usually immunized with measles-mumps-rubella combination vaccine. (From Dorland, 28th ed)
Definition (CSP)vaccine used to induce immunity against measles virus.
Definition (HL7V3.0)measles virus vaccine
ConceptsPharmacologic Substance (T121) , Immunologic Factor (T129)
Englishmeasles, Measles live virus vaccine, Measles Vaccine, Measles Virus Vaccine Live, Rubeola virus vaccine
Spanishvacuna antirrubeólica de virus vivo y atenuado, vacuna antirrubeolica de virus vivo y atenuado, vacuna antisarampionosa, vacuna antisarampionosa a virus vivo, vacuna antisarampionosa de virus vivo y atenuado, vacuna de virus vivo contra el sarampión, vacuna de virus vivo contra el sarampion, vacuna de virus vivo contra la rubéola, vacuna de virus vivo contra la rubeola
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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