bKGD
-3-3
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(3E
Measles Agent- RNA virus ( Paramyxo virus family, genusMorbillivirus)
Environmental factor
Clinical features
3 Cs (Cough, Coryza Conjunctivitis) Koplik spots Four days fever (400c) Generalized maculopapular,erythematous rash. The rash begins on face then becomes generalized, lasts for 4-7 days.
Courtesy This media comes from theCenters for Disease Control and PreventionsPublic Health Image Library(PHIL), with identification number3168
KOPLIK SPOT
Source http//phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg
Complication
Diarrhea, Pneumonia Laryngotracheobronchitis Otitis media Convulsions, Encephalitis, SSPE (sub acute sclerosing panencephalitis) (rarely)
Diagnosis of Measles
Mumps
(Infectious parotitis)
Mumps
Courtesey This media comes from theCenters for Disease Control and PreventionsPublic Health Image Library(PHIL), with identification number130 Content Providers CDC/NIP/Barbara Rice
Clinical features
Fever Swelling tenderness of one or more salivary glads, usually parotid. Orchitis most commonly unilateral (postpubertal males)
Courtesy Adapted from Mims et al. Medical Microbiology, 1993, Mosby
Complications
Orchitis Oophoiritis Spontaneous abortion. Sensory neuralhearing loss, (uni- or bilateral). Mild form of meningitis. Encephalitis. Pancreatitis usually mild , 4 of cases Symptomatic aseptic meningitis up to 10 of cases
Acute mumps infection can be confirmed by A positive serological test for specific-mumps IgM. A significant ( at least 4 folds ) rise in serum mumps IgG. Isolation of mumps virus.
Rubella (German measles)
Clinical feature Low-grade fever Conjunctivitis Mild coryza. Tender lymphadenopathy (particularly posterior auricular and ooccipital , posterior cervical lymph nodes). Leukopenia is common . Body rashes, Maculo-papular rashes
Complications
Image in a 4-year-old girl with a 4-day history of low-grade fever, symptoms of an upper respiratory tract infection, and rash. Courtesy of Pamela L. Dyne, MD.
Photo source U.S. Centers for Disease Control and Prevention
Salt and pepper retinopathy
Content Providers(s) CDC Creation Date 1976
Courtesy http//phil.cdc.gov/phil_images/20030724/28/PHIL_4284_lores.jpg
http//www.kellogg.umich.edu/theeyeshaveit/congenital/retinopathy.html
Courtesy Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center
Prevention
U.S. Dept. of Health Human Services, Wikimedia Commons
Vitamin A supplements reduce the risk of death and complications in children in less developed countries People who lack vitamin A are more likely to get infections, including measles.
Prevention
Control of patients and contacts
Isolation Precautions
Age
Vaccines
Note
9 months
Measles
Deep subcutaneous injection into the upper arm.
12-15 months
MMR -1
Deep subcutaneous injection into the upper arm.
5 years
MMR -2
Deep subcutaneous injection into the upper arm.
Contraindication for live virus vaccine
Patient with primary immune deficiency e.g. lymphoma, leukemia.. Patient with sever acute illness e.g. upper respiratory disease. Patient with anaphylactic hypersensitivity. Vaccine should be given at least 14 days before IG or blood transfusion.
Chicken pox
Chicken pox is acute , generalized disease caused by a virus called varicella zoster.
Varicella Zoster Virus
Herpes virus (DNA) Primary infection results in varicella (chickenpox) Recurrent infection results in herpes zoster (shingles) Short survival in environment
Varicella Pathogenesis
Respiratory transmission of virus Replication in nasopharynx and regional lymph nodes Repeated episodes of viremia Multiple tissues, including sensory ganglia, infected during viremia
Varicella Clinical Features
Incubation period 14-16 days (range 2-3 weeks) Mild prodrome for 1-2 days Generally appear first on head most concentrated on trunk Successive crops (2-4 days) of pruritic vesicles
Varicella Epidemiology
Reservoir Human Transmission Air droplet , Direct contact with lesion. Communicability 1-2 days before, to 4-5 days after onset of rash..
Varicella Vaccine
Composition Live virus (Oka-Merck strain) Efficacy 95 (Range, 65-100) Duration of 7 years Immunity Schedule 1 Dose (13 years of age) May be administered simultaneously with measles-mumps-rubella (MMR) vaccine
Whooping cough (Bordetella pertussis)
http//www.hhmi.princeton.edu/sw/2002/psidelsk/Microlinks.htm
Whooping Cough (Pertussis)
http//microvet.arizona.edu/Courses/MIC420/lecture_notes/bordetella_pertussis/ gram_pertussis.html
Clinical Features
http//www.cdc.gov/nip/publications/pertussis/chapter1.pdf
Transmission
Very Contagious Transmission occurs via respiratory droplets Reservoir Human Period of communicability Highly during catarrhal stage at beginning of paroxysmal stage(1-2 weeks)
http//www.ratbags.com/rsoles/history/2000/12december.htm
http//www.universityscience.ie/imgs/scientists/whoopingcough.gif
Diagnosis
Isolation by culture PCR Serological testing
http//medinfo.ufl.edu/year2/mmid/bms5300/images/d7053.jpg
Pertussis Vaccine
http//www.nfid.org/publications/clinicalupdates/pediatric/pertussis.html
http//www.tdh.state.tx.us/immunize/providers.htm
Control of patients and contacts
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