L 64 Viral Skin Disease 1 Rubeola/Rubella

Question 1

Difference between rubeola and rubella

Answer 1

Rubeola= measles
Rubella= german measles

Question 2

Measles reservoir

Answer 2

No known natural reservoir, thought to be a disease of civilization. Humans only.

Question 3

Measles incubation period

Answer 3

10-14 days

Question 4

How is measles spread?

Answer 4

Sets up shop in the respiratory epithelium, virus spread through respiratory droplets that remain in environment for considerable amount of time

Question 5

Measles Prodromal stage

Answer 5

1-12 days post infection
Fever, Coryza, cough, conjunctivitis
Koplick’s spots on buccal mucosa pathognomonic for measles

Question 6

When does measles rash appear? What accompanies it?

Answer 6

3-4 days after exposure
Starts below ears, spreads to face and then down
High fever accompanies it

Question 7

When is it best to get measles?

Answer 7

Better to get while young, like polio, because much of the unpleasant symptoms come from the reaction of the immune system so an immature immune system will not react so severely

Question 8

Atypical measles

Answer 8

First vaccine produced antibodies that actually didn’t completely inactivate the virus and instead sensitized the person to the virus so when they encountered the actual virus they got a sickness worse than if they had not received the vaccine.
Second vaccine fixed this problem.

Question 9

Complications of measles

Answer 9

Measles would often lead to secondary complications
Pneumonia–most common and life threatening
Diarrhea–in children
Used to cause death in many cases and rarely encephalitis
SSPE: subacute sclerosing panencephalitis, fatal complication, child would get better, but virus would remain in the brain and grow slowly and eventually cause death, now extinct
Immune depression: can cause TB exacerbation

Question 10

Why did lots of other diseases drop off after introduction of measles vaccine?

Answer 10

Stopping measles stopped a significant drop in immunity in kids and prevented them from getting lots of other diseases

Question 11

Measles type of virus

Answer 11

Paramyxovirus
Enveloped
ssRNA

Question 12

Measles trasmission

Answer 12

Respiratory droplets
HIGHLY contagious, surprisingly able to find those who are not vaccinated
Likes drier climates

Question 13

What vitamin can reduce severity of measles infection?

Answer 13

Vitamin A helps

Question 14

When is patient most contagious?

Answer 14

During prodrome until 4-5 days after rash erupts

Question 15

Does vaccination to measles last a lifetime?

Answer 15

It is questionable, not entirely perfect

Question 16

Measles diagnosis

Answer 16

Rash and Koplick’s spots
IgM antibody capture ELISA
Swabs of mouth show multinucleated giant cells

Question 17

Measles treatment

Answer 17

Treat the symptoms

No antiviral therapy

Question 18

Measles control

Answer 18

MMR-II vaccine
Live attenuated
Given in 2 doses at least 1 month apart
Contraindications: egg sensitivity, pregnancy, immunocompromised
Not all MMR’s used around the world are the same

Question 19

How do most people in US get measles?

Answer 19

Usually from travel

Not from immigrants

Question 20

What can be done to protect someone who can’t receive the vaccine?

Answer 20

BayGam immunoglobulin can be given to help protect them

Question 21

How is rubella different from measles?

Answer 21

Like measles, but very mild in comparison

Question 22

Rubella clinical manifestations

Answer 22

14-21 day incubation
Minimal prodromal
Rash face then down body
Mild fever, conjunctivitis, coryza
Spread through respiratory

Question 23

How is rubella spread?

Answer 23

Respiratory
Prolonged and close contact probably needed
Measles would find everyone in their youth, but rubella was less aggressive

Question 24

Rubella type of virus

Answer 24

Togavirus

Question 25

Rubella epidemiology

Answer 25

Usually infects older children, adolescents, young adults

Young children often escape infection

Question 26

Rubella complications

Answer 26

Usually a benign infection except for CRS

CRS: Congenital Rubella Syndrome= mother infected while pregnant, spreads through placenta to fetus during first trimester and causes major malformations–cardiac, eye, hearing, CNS

Question 27

How was CRS found?

Answer 27

Cataracts found in newborns

Question 28

Rubella diagnosis

Answer 28

Serology detection of antibody

Question 29

Rubella treatment and prevention

Answer 29

Symptomatic relief
Isolate patients for 7 days after rash
Kids with CRS infectious for at least 1 year

MMR vaccine is live attenuated, some kids get a rash, contraindicated in pregnancy

Question 30

Why do we get a rubella vaccine if it is concidered a “nothing” disease?

Answer 30

It is to protect the next generation by preventing infection of mothers and thereby newborns to prevent CRS