Measles Flashcards
What is the family?
Paramyxovirus
How is it transmitted?
Spread by aerosol and extremely contagious
Where does it replicate in?
Viraemia, virus replication in respiratory epithelium and skin
What are the clinical presentations?
- Fever
- Conjunctivitis
- Rhinorrhoea
- Cough
- Koplik’s spots around parotid duct orifices herald onset
- Few days later - typical maculopapular rash from face and spreads to entire body
How long is the incubation period?
10-14 days
Does it confer life-long immunity?
Yes
What is it an ubiquitous infection in?
Early childhood
What are the mucosal infections?
- Conjunctivitis
- Otitis media
What are the respiratory complications?
- Bronchopneumonia
- Giant cell pneumonia (rare progressive measles lung infection in immunocompromised/malnourished)
What is the gastrointestinal complication?
Diarrhoea due to measle virus or secondary bacterial infection
What kind of complications can it result in?
Mucosal infections, respiratory, gastrointestinal, Neurological
What are the neurological complications?
- Encephalitis (high mortality)
- Sub-acute sclerosing panencephalitis (develops long period following apparent recovery, persistent latent infection of neurons by defective measle virus? abnormal immune response to measles virus? impaired host immunity?)
- Myoclonic seizures, intellectual deterioration, characteristic suppression burst EEG pattern, rapidly fatal
- Cytoplasmic inclusions in neuronal cells
What are the neurological complications?
- Encephalitis (high mortality)
- Sub-acute sclerosing panencephalitis (develops long period following apparent recovery, persistent latent infection of neurons by defective measle virus? abnormal immune response to measles virus? impaired host immunity?)
- Myoclonic seizures, intellectual deterioration, characteristic suppression burst EEG pattern, rapidly fatal
- Cytoplasmic inclusions in neuronal cells
How to diagnose?
- Cell culture (virus ioslated from pharynx, conjunctiva, urine)
- RT-PCR
- Serology (IgM assay for recent infection, IgG for retrospective diagnosis)
Describe the immunisation
- Live attenuated vaccine adminstered at age 12 months and 15-18months
- New MMRV vaccine includes VZV antigens
- Confers effective and long-lasting immunity
- Mild pyrexia but serious complications are rare
- Contraindcated in severely malnourished and immunocompromised children, pergnant women (passive immunisation with immune gammaglobulin for contacts with immunodeficiency)
