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Measles

Background knowledge ๐Ÿง 

Definition

  • Highly contagious viral infection caused by the measles virus.
  • Characterised by fever, cough, and maculopapular rash.
  • Measles is a notifiable disease.ย 

Epidemiology

  • Common in unvaccinated populations.
  • Worldwide distribution, with higher incidence in developing countries.
  • Outbreaks still occur in the UK, especially in areas with low vaccination rates.

Aetiology and Pathophysiology

  • Caused by the measles virus (genus Morbillivirus).
  • Transmitted via respiratory droplets.
  • Incubation period: 10-14 days.
  • Virus infects the respiratory tract then disseminates systemically.

Types

  • No specific subtypes; disease presentation varies by severity.
  • Complicated vs. uncomplicated measles.

Clinical Features ๐ŸŒก๏ธ

Symptoms

  • Prodromal phase: fever, cough, coryza, conjunctivitis.
  • Koplik spots (small white spots inside the mouth).
  • Maculopapular rash starting on the face, then spreading.
  • Malaise and irritability.

Signs

  • High fever (up to 40ยฐC).
  • Conjunctivitis.
  • Generalized lymphadenopathy.
  • Characteristic rash (cephalocaudal spread).
  • Photophobia.

Investigations ๐Ÿงช

Tests

  • Clinical diagnosis based on symptoms and signs.
  • Serology: measles-specific IgM antibodies.
  • PCR for measles RNA from throat swab/saliva.
  • Full blood count (lymphopenia).

Management ๐Ÿฅผ

Management

  • Supportive care (hydration, antipyretics).
  • Vitamin A supplementation is used in children in developing countries.
  • Isolation to prevent spread.
  • Consider antibiotics for secondary bacterial infections.

Complications

  • Otitis media.
  • Pneumonia.
  • Encephalitis.
  • Subacute sclerosing panencephalitis (SSPE).
  • Death in severe cases.

Prognosis

  • Generally good with supportive care.
  • Higher morbidity and mortality in developing countries.
  • Risk of complications in immunocompromised individuals.

Key Points

  • Highly contagious; vaccination is key.
  • Recognise early symptoms for prompt isolation.
  • Monitor for complications, especially in vulnerable groups.

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