MEASLES

(RUBEOLA / MORBILLI)

MEASLES
An

acute, contagious and exanthematous disease that usually affects children which are susceptible to URTI (Upper Respiratory Tract Infection). This maybe one of the most common and most serious of all childhood diseases.

 Measles

is best known for causing a rash in childhood, but measles can affect other parts of the body and sometimes occurs in adults. There are two types of measles, each caused by a different virus. Although both produce a rash and fever, they are really different diseases: The rubeola virus causes "red measles," also known as "hard measles" or just "measles. Although most people recover without problems, rubeola can lead to pneumonia or inflammation of the brain (encephalitis). The rubella virus causes "German measles" also known as "three-day measles. This is usually a milder disease than red measles. However, this virus can cause significant birth defects if an infected pregnant woman passes the virus to her unborn child.

INCUBATION PERIOD
10-12

days (longest: 20days ; shortest: 8days) Single attack conveys a lifelong immunity.

PERIOD OF COMMUNICABILITY
Lasts

about 9-10days, measured from the beginning of the prodromal symptoms to the fading of the rash. Communicable 4days before and 5days after the appearance of rashes. Not communicable during the height of rash.

MODE OF TRANSMISSION
Direct

contact with the droplets spread through coughing or sneezing. Indirect contact through articles or fomites freshly contaminated with respiratory secretions of infected patients.

PATHOGNOMONIC SIGN
KOPLIKS

SPOTS -inflammatory lesions of the buccal mucuos glands with superficial necrosis; -appear at inner cheek opposite to the 2nd molars or near the junction of the gum and inner cheek; -appear 1-2 days before the measle rash

CLINICAL MANIFESTATIONS
1st

PRE-ERUPTIVE STAGE 2 stage : ERUPTIVE STAGE 3 stage : CONVALESCENCE STAGE

stage :
nd

rd

PRE-ERUPTIVE STAGE
Fever Catarrhal

symptoms (rhinitis, conjunctivitis, photophobia, coryza) Respiratory symptoms : cough and colds Enanthema sign (Kopliks spot, Stimsons line)

ERUPTIVE STAGE
(seen late on the 4th day) Maculo-papular rash (appears first on either the cheeks, bridge of the nose, along the hairline, at the temple or the earlobe) End of 2nd day: Rash is fully developed and all S/Sx are at their maximum High grade fever that comes on and off Anorexia and irritability Abdominal tympanism, pruritus, lethargy Throat is red and extremely sore As fever subsides, coughing may diminish, but more often it hangs on for a week or two, became looser and less metallic
Rash

CONVALESCENCE STAGE
Rashes

fade away in the manner as the

erupted Fever subsides as eruption disappears When the rashes fade, desquamation begins Symptoms subside and appetite is restored

DIAGNOSTIC PROCEDURES
Nose

and throat swab Urinalysis Blood Exams (CBC, Leukopenia, Leukocytosis) Complement fixation or hemogglutinin test

MODE OF TREATMENT
Anti-viral

drugs (Isoprenosine) Antibotics (if with complication) Supportive therapy (O2 inhalation, IV fluids)

COMPLICATIONS
Bronchopneumonia

Otitis

media Pneumonia/ Bronchitis Nephritis Encephalitis ; Encephalo-myelitis Blindness (seldom)

NURSING MANAGEMENT
Isolation

of the patient is necessary. Control the patients high temperature with warm or tepid sponges Skin care is utmost. Oral and nasal hygiene. Care of the eyes. The patient is sensitive to light, therefore, position the patient where a direct glare of light is avoided. Keep ayes free of secretions.

Care

of the ears. Alert for any signs of early mastoid infection. Daily elimination is important. Accomplished by mild laxative or as prescribed by the physician. During the febrile stage, limit the diet to fruit juices, milk, and water. If the patient is vomiting, give iced juices in small amounts and more frequently. Change patients position every 3-4hours. Give prescribed medications (e.g. Penicillin) in cases where there is complication.

PREVENTIVE MEASURES
Immunization

with:
the age of 3months, as

Anti-measles at

single dose. Mumps, Measles, Rubella (MMR) vaccine to be given at 15months old, and the 2nd dose at 11-12years old. Measles vaccine should NOT be given to pregnant women, or to persons with active tuberculosis, leukemia. Lymphoma, or depressed immune system.

THANK YOU! REPORTED BY: SALONGA, FRANCES ROSE C. BSN 4I- GROUP3