What Are Measles?
Related Info Measles And Rubella
What Are Measles?
Measles is also known as the First Disease, caused by the highly contagious Measles virus (an RNA paramyxovirus).
The clinical presentation can be considered in three stages:
- Prodromal stage: The prodrome (before appearance of the rash) lasts for 4-5 days with fever, malaise, loss of appetite, diarrhoea and upper respiratory tract symptoms of runny nose, cough and red eyes. The pathognomonic sign is the Koplik spots in the oral mucosa which appear during the prodrome.
- Exanthema stage: The rash is a typically blotchy, bright red maculopapular eruption, appearing first on the face and neck, and then gradually spreading to the body and extremities. This will lasts for 4-5 days. The rash is often confluent in the upper part of the body, but discrete in the legs. The rash blanches under pressure and the fever is even higher when the rash appears. The fever usually subsides within 5 days of the onset of the rash.
- Convalescent stage: The rash fades, leaving a temporary brownish “staining”. The patient’s cough may persist for days.
Complications
| Respiratory:During the course of measles, all patients show evidence of viral respiratory tract involvement. Middle ear infection is the most frequent bacterial complication in children. Bacterial laryngitis, tracheo-bronchitis and pneumonia are also well-recognized complications. Giant cell pneumonia is an uncommon, progressive fatal complication observed in children with immune deficiency. |
Central nervous system:
Febrile convulsions is a common complication. In about 1 in 1000 cases, post-infective encephalitis appears on the fourth to seventh day after the appearance of the rash. The symptoms vary according to the degree and site of neural tissue involved. There is invariably disturbance of consciousness, ranging from agitation, drowsiness and stupor to coma, in association with one or more of the following:
- speech and visual disturbance
- convulsions
- pyramidal signs
- cerebellar signs
- involuntary movements
- cranial nerve palsies
Death occurs in about 10% of cases and neurological and psychological sequelae are present about 30-40% of the survivors.
Late complications:
Two rare complications are bronchiectasis and subacute sclerosing panencephalitis. The latter can occur months or years after the measles infection, especially it occurred before the age of 2 years. The onset is insidious with gradual deterioration of intellect, accompanied by motor disturbance, myoclonic jerks and visual loss.
Treatment
There is no specific treatment except for symptomatic relieve. The patient should rest quietly, avoid bright lights and stay in bed until the fever subsides.
School exclusion
Children should be kept away from school until they have recovered or for at least 5 days from the onset of the rash.
Prevention
All children should be immunized against measles. Children having cytotoxic agents for malignant disease, or with immunodeficiency should not be given vaccine.
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