Measles
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Mea sles als o k no wn as Rubeo la
Shellah Zafirah E. Abantas
Introduction • Measles- a.k.a. Rubeola • an infection of the respiratory system caused by measles virus belonging to paramyxovirus group. • Is an endemic disease. • Muhammad ibn Zakariya ar-Razi (860-932) • a Persian physician, known to the west as “Rhazes” • the one who discover the first scientific description of measles and its distinction from smallpox and chickenpox in his book entitled The Book of Smallpox and Measles (in Arabic: Kitab fi al-jadari wa-al-hasbah).
Measles Virus
Etiologic Agent • • • •
Measles is caused by paramyxovirus roup of the genus Morbillivirus. Paramyxovirus From Greek para-, beyond, -myxo-, mucus or slime, plus virus, from Latin poison, slime. It is a spherical virus, 120-250 nm in diameter, surrounded by a lipoprotein envelope having haemagglutinin spikes only. Physical structure Virions are enveloped and can be spherical, filamentous or pleomorphic. Fusion proteins and attachment proteins appear as spikes on the virion surface. Matrix proteins inside the envelope stabilise virus structure. The nucleocapsid core is composed of the genomic RNA, nucleocapsid proteins, phosphoproteins and polymerase proteins.
Incubation • The infection has an average incubation period of 14 days (range 6–19 days) and infectivity lasts from 2–4 days prior to 2–5 days following the onset of the rash. (maculopopular rash)
Mode of Transmission • Measles is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission). The measles virus is a highly contagious airborne pathogen which spreads primarily via the respiratory system. The virus is transmitted in respiratory secretions, and can be passed from person to person via aerosol droplets containing virus particles, such as those produced by a coughing patient. Once transmission occurs, the virus infects and replicates in the lymphatic system, urinary tract, conjunctivae, blood vessels and central nervous system of its new host.
Disease Process/Pathophysiology • Measles is highly infectious childhood disease transmitted by inhalation of virus present in respiratory secretion of patient. • After multiplication in respiratory tract, invades bloodstream and spreads to reticuloendothlial system where it multiplies further and via blood transported to skin, mouth, respiratory tract and conjunctiva.
Clinical Manifestation • •
• •
Measles include four day fevers. (fever may reach up to 40° Celsius (104° Fahrenheit) Koplik’s spots – small bluish white dots surrounded by a reddish zone that appear on the mucous membrane of the cheeks and lips before the appearance of the skin eruption. The three Cs—Cough, Coryza (runny nose) and Conjunctivitis (red eyes). The characteristic measles rash is classically described as a generalized, maculopapular, erythematous rash that begins several days after the fever starts. It starts on the head before spreading to cover most of the body, often causing itching. The rash is said to "stain", changing color from red to dark brown, before disappearing.
Early Sign
This child shows a day-4 rash with measles.
Medical Management • Avoid exposing children to any person with fever or with acute catarrhal symptoms. • Isolation of cases from diagnosis until 5-7 days after onset of rash. • Disinfection of all articles soiled with secretion of nose and throat. • Encouragement by health department and by private physician of administration of measles immune globulin to susceptible infants and children under 3yrs. Of age in families or institutions where measles occurs. • Live attenuated and inactivated measles virus vaccines have been tested and are available foe use in children with no history of measles at 9 months of age or soon thereafter.
Nursing Management • Protect eyes patients from glare of strong light as they are apt to be inflamed. • Keep the patient in an adequately ventilated room but free from drafts and chilling to avoid complications of pneumonia. • Teach, guide and supervise correct technique of giving sponge bath for comfort of patient. • Check for correction of medication and treatment prescribed by physician.
Shellah Zafirah E. Abantas
Introduction • Measles- a.k.a. Rubeola • an infection of the respiratory system caused by measles virus belonging to paramyxovirus group. • Is an endemic disease. • Muhammad ibn Zakariya ar-Razi (860-932) • a Persian physician, known to the west as “Rhazes” • the one who discover the first scientific description of measles and its distinction from smallpox and chickenpox in his book entitled The Book of Smallpox and Measles (in Arabic: Kitab fi al-jadari wa-al-hasbah).
Measles Virus
Etiologic Agent • • • •
Measles is caused by paramyxovirus roup of the genus Morbillivirus. Paramyxovirus From Greek para-, beyond, -myxo-, mucus or slime, plus virus, from Latin poison, slime. It is a spherical virus, 120-250 nm in diameter, surrounded by a lipoprotein envelope having haemagglutinin spikes only. Physical structure Virions are enveloped and can be spherical, filamentous or pleomorphic. Fusion proteins and attachment proteins appear as spikes on the virion surface. Matrix proteins inside the envelope stabilise virus structure. The nucleocapsid core is composed of the genomic RNA, nucleocapsid proteins, phosphoproteins and polymerase proteins.
Incubation • The infection has an average incubation period of 14 days (range 6–19 days) and infectivity lasts from 2–4 days prior to 2–5 days following the onset of the rash. (maculopopular rash)
Mode of Transmission • Measles is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission). The measles virus is a highly contagious airborne pathogen which spreads primarily via the respiratory system. The virus is transmitted in respiratory secretions, and can be passed from person to person via aerosol droplets containing virus particles, such as those produced by a coughing patient. Once transmission occurs, the virus infects and replicates in the lymphatic system, urinary tract, conjunctivae, blood vessels and central nervous system of its new host.
Disease Process/Pathophysiology • Measles is highly infectious childhood disease transmitted by inhalation of virus present in respiratory secretion of patient. • After multiplication in respiratory tract, invades bloodstream and spreads to reticuloendothlial system where it multiplies further and via blood transported to skin, mouth, respiratory tract and conjunctiva.
Clinical Manifestation • •
• •
Measles include four day fevers. (fever may reach up to 40° Celsius (104° Fahrenheit) Koplik’s spots – small bluish white dots surrounded by a reddish zone that appear on the mucous membrane of the cheeks and lips before the appearance of the skin eruption. The three Cs—Cough, Coryza (runny nose) and Conjunctivitis (red eyes). The characteristic measles rash is classically described as a generalized, maculopapular, erythematous rash that begins several days after the fever starts. It starts on the head before spreading to cover most of the body, often causing itching. The rash is said to "stain", changing color from red to dark brown, before disappearing.
Early Sign
This child shows a day-4 rash with measles.
Medical Management • Avoid exposing children to any person with fever or with acute catarrhal symptoms. • Isolation of cases from diagnosis until 5-7 days after onset of rash. • Disinfection of all articles soiled with secretion of nose and throat. • Encouragement by health department and by private physician of administration of measles immune globulin to susceptible infants and children under 3yrs. Of age in families or institutions where measles occurs. • Live attenuated and inactivated measles virus vaccines have been tested and are available foe use in children with no history of measles at 9 months of age or soon thereafter.
Nursing Management • Protect eyes patients from glare of strong light as they are apt to be inflamed. • Keep the patient in an adequately ventilated room but free from drafts and chilling to avoid complications of pneumonia. • Teach, guide and supervise correct technique of giving sponge bath for comfort of patient. • Check for correction of medication and treatment prescribed by physician.
