Today is our topic of discussion Definition of Measles
Definition of Measles
Definition:
Measles is an acute infectious viral disease of childhood characterized by fever and catarrhal symptoms of upper respiratory tract, followed by a typical rash, The disease may be associated with high morbidity and mortality.
Bangladesh situation:
Measles is the fifth leading cause of death among under-5 children in Bangladesh. An estimated 20,000 children die annually from measles in Bangladesh. First phase of the Measles Catch Up Campaign started in 2005, when 1.5 million children were vaccinated through support from GoB, Government of Japan, CDC-USA, WHO and UNICEF. Phase two begins on 2006. For both phases UNICEF Bangladesh has ensured an adequate supply of vaccines.
Epidemiology:
Agent factors:
1. Agent: Measles virus
2. Source of infection: Cases
3. Infective material: Secretions from nose, throat and respiratory tract..
4. Communicability: Highly infectious during the prodromal period and at the time of eruption.
5. Secondary attack rate: Infections confer life-long immunity.
Host factors:
1. Age: Mostly in infancy and childhood where environmental conditions are poor.
2. Sex: Incidence is equal.
3. Immunity: No age is immune.
4. Nutrition: Measles tends to be severe in malnourushed child with high mortality.
Environmental factors:
Common during winter and early spring. Mode of transmission: Droplet infection, from 4 days before onset of rash until 5 days thereafter. Incubation period: 10 to 14 days.
Clinical features:
Prodromal or pre-eruptive stage:
Begins 10 days after exposure, characterized by fever, flu-like illness and sometimes vomiting with diarrhoea. Koplik’s spot on buccal mucosa may be visible.
Eruptive stage:
Dusky-red and maculo-papular rash begins behind the ear, spreads rapidly over the face and neck to extend down to whole body within 2-3 days.
Post-measles stage:
The child may have loss of weight and remain weak due to secondary infection.
Diagnosis:
Diagnosis done mainly on clinical ground. CFT is the confirmatory test.
Treatment:
1. Bed rest & isolation for 7 days after appearance of rash
2. Analgesic and antipyretic (if necessary)
3. Care of the eye
4. Oral hygiene is maintained
5. Maintenance of hydration and adequate nutrition
6. Vitamin A supplementation: First day, second day and seventh day
7. Antibiotics (if necessary) to prevent secondary bacterial infection
Complication of measles:
1. Measles-associated diarrhoea
2. Pneumonia and ARI
3. Otitis media
4. Malnutrition
5. Growth retardation
6. Reactivation of pulmonary tuberculosis
7. Encephalitis
Prevention of measles:
1. Achieving an immunization rate above 95%
2. Immunization against measles with both active (EPI & MMR) and passive immunization.
3. Young children should not be exposed to during epidemics of measles in the vicinity.
Control measures:
1. All cases should be notified to health authorities
2. Immunization of contacts within 2 days of exposure.
3. Cases should be isolated for 5 to 7 days after the appearance of rash.
4. Prompt immunization at the beginning of an epidemic.
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