Measles is an acute highly contagious viral disease caused by measles virus - PowerPoint Presentation

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Measles is an acute highly contagious viral disease caused by measles virus

Measles

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Etiology/agent factor

paramyxovirus.

morbillivirus

it is spherical in appearance ,measuring about 100~150nm in diameter

It has an outer envelope composed of M-protein, H-protein, F-protein, and internal core is RNA.

Only one antigenic type of measles virus

is known.

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.

.

Agent factor

Source of infection-cases of measles,

but not carriers

No animal reservoir

Communicability- Highly infectious during

prodromal

period and at the time of eruption

Secondary attack rate- > 80%

Infective period- 3 days before and 5 days after the appearance of rash

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Host factors

Age- 6 months to 3 years even up to 10 years

Incidence equal in both sexes

Immunity – life long immunity

Malnourished children are susceptible

vitamin A deficient -> low mucosal defense

lack of vaccination (need cold chain)

poor hygiene

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↓

PATHOGENESIS

measles virus

respiratory tract

epithelial cells(multiply

lymphoid tissue

blood ( 2ndry

viremia

)

)

general toxic symptoms

Primary

viremia

Reticuloendothelial

cells

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Clinical features

Prodromal

stage

Eruptive stage

Post-measles

stage

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Measles clinical type

Typical type

Incubation period is approximately 7~18days.

Last 3~4 days.

Fever;

Catarrhal inflammation of URT;

Koplik’s

spots;

conjunctivitis

Atypical

measles

Mild measles

Hemorrhagic

measles

Toxic and shock like measles

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Koplik

‘s spot

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COMPLICATIONS

Bronchopneumonia

Otitis media

diarrhea

Flare-up of T.B

Myocarditis

Laryngitis;

Encephalitis

SSPE

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Measles encephalitis

1/1000 cases

sequelae

deafness

seizures

mental disorders

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SSPE

sub-acute

sclerosing

panencephalitis

inflammatory disease

defective virus (often lacking M protein

early infection with measles is a risk factor

rare (7/1,000,000 cases of measles

)

decrease since vaccination program

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IMMUNOSUPPRESSION AND MEASLES

TEMPORARY DEPRESSION OF IMMUNE RESPONSE

Tuberculin +

ve

individuals may temporarily become -

ve

MAY GET REACTIVATION OF HERPES, TUBERCULOSIS

Don’t see with vaccine strain

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DIAGNOSIS

Serodiagnosis

Significant increase in

IgG

(need two samples)

Positive for IgM

Isolation

RT-PCR

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DIFFERENTIAL DIAGNOSIS

Rubella (German measles)

Roseola

infantum

(

exanthem

subitum

)

Drug rashes.

Infectious mononucleosis

meningococcemia

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Treatment

Supportive and symptomatic

Vit

-A 2

lacs

IU given orally for 2 days in children older than 1 yr

Treatment of complication

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Prognosis

Self limiting

ds

,unless complicated

Recovery prolonged with respiratory complication

Deaths

may

occur

Mortality

90% of deaths due to respiratory or neurological

Respiratory complication more common in young child

Neurological complication more common in older children

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Prevention

Control source of infection

Interruption of transmissions

.

Protection of the susceptible person

.

1. Active immunization

. Lived attenuated measles vaccine.

2 . Passive immunization

.

gamaglobulin

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Mumps

Mumps is an acute self limiting disease characterized by fever, parotid swelling and tenderness

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Etiology

Paramyxovirus

,

Single stranded R.N.A virus

Single strain known

Human is only reservoir

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Epidemiology

Age : 5-9yrs

Winter and spring

Spread by droplets

Infective period :

7 days before and 7 days after appearance of parotid swelling

Isolation:5dayss after appearance of parotid swelling

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Pathogenesi

s

Infection

Replication in

resp.epithelium

Lymph node

viremia

Salivary glands, CNS ,

pancreas,testis,thyroid,ovaries,heart,kidneys,liver

and

synovia

.

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Clinical features

Incubation period :16-18 days

Asymptomatic to mild non specific symptoms

Typical presentation start with

prodrome

,lasting 1-2 days and consisting of fever, headache, vomiting, body ache,

Parotitis , usually bilateral in 70%

Submandibular gland may also be involved

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Diagnosis

Mainly clinical

Leucopenia with relative

lymphocytosis

,

raised serum amylase

↑

IgG

between acute and convalescent sample

Virus isolation

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Differential diagnosis

Parotid swelling may caused by other infection and noninfectious condition.

Influenza and

para

influenza virus

CMV ,

EBV,enterovirus,HIV

,

Purulent

parotitis

–

S.aureus

.

Obstruction to

stensons duct,collagen

vascular ds

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complication

Abortion

Meningo

-encephalitis

Orchitis

and

oophoritis

pancreatitis

myocarditis

arthritis

thyroiditis

Conjunctivitis

Optic neuritis

nephritis

pneumonia

thrombocytopenia

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Treatment

No specific treatment

Prognosis

Excellent even when complicated by meningoencephalitis

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Prevention

Live attenuated vaccine

Given along with MMR

Efficacy-90%

2 doses ,at 16-18months and at 5 yrs

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Rubella

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Etiology

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Epidemiology

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pathogenesis

Most important risk factor for severe congenital defect is the gestational age at the time of infection

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Clinical manifestation

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Differential diagnosis

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Complication

CRS

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CONGENITAL RUBELLA SYNDROME

In 1941 an ophthalmologist described a syndrome of cataract and congenital heart

ds

associated with maternal infection with rubella.

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CRS contd

……

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Treatment

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Prognosis

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Prevention

Live attenuated RA 27/3 strain

Two doses along with measles and mumps

At 15-18 months and 5yrs

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