References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | VIRUS - RNA. Paramyxoviridae, Paramyxovirinae, Morbillivirus: Measles virus |
| Reservoir | Human |
| Vector | None |
| Vehicle | Droplet |
| Incubation Period | 8 to 14 days |
| Diagnostic Tests | Viral culture (difficult and rarely indicated) Serology Nucleic acid amplification |
| Typical Adult Therapy | Respiratory isolation; supportive. Ribavirin 20 to 35 mg/kg/day X 7 days has been used for severe adult infection |
| Typical Pediatric Therapy | As for adult |
| Vaccines | Measles Measles-Mumps-Rubella Measles-Rubella |
| Clinical Hints | Coryza, fever, headache, conjunctivitis, photophobia and a maculopapular rash after 3 to 5 days; Koplik’s spots (bluish-grey lesions on buccal mucosa, opposite second molars) often precede rash; encephalitis or viral pneumonia occasionally encountered. |
| Synonyms | Masern, Massling, Mazelen, Meslinger, Morbilli, Morbillo, Rubeola, Rugeole, Sarampion, Sarampo |
WHO Case Definition for Surveillance
Any person with:
- Fever, and
- Maculopapular (i.e. non-vesicular) rash, and
- Cough, coryza (i.e. runny nose) or conjunctivitis (i.e. red eyes).
- or any person in whom a clinician suspects measles infection.
Laboratory criteria for diagnosis
- At least a fourfold increase in antibody titer or
- Isolation of measles virus or
- Presence of measles-specific IgM antibodies
Case classification
- Clinically confirmed: A case that meets the clinical case definition.
- Probable: Not applicable.
- Laboratory-confirmed: only for outbreak confirmation and during elimination phase A case that meets the clinical case definition and that is laboratory-confirmed or linked epidemiologically to a laboratory-confirmed case.
Acute Illness
Symptoms begin to appear about 10 to 12 days after exposure to the virus, with fever followed by cough, rhinorrhea, and/or conjunctivitis.
- The rash appears approximately 14 days after exposure and lasts 5 to 6 days.
- The rash begins at the hairline, spreading to the face and neck.
- Over the next three days, the rash gradually extends, eventually reaching the hands and feet.
Complications
Complications of measles include diarrhea, otitis media (10%), pneumonia (5%), encephalitis (0.1%), arthropathy (28%), seizures, and death.
- Twenty percent of patients experience one or more complications, most often children below five years of age and adults over 20.
- Measles in pregnancy may be associated with maternal pneumonia, abortion, low birth weight or congenital infection of the newborn.
- In developing countries, measles has been known to kill as many as one out of four people.
- Measles is the leading cause of blindness among African children, as a result of concomitant vitamin A deficiency.
- Measles pneumonia accounts for approximately 17% of bronchiolitis obliterans in children (Beijing, 2001 to 2007)
- Rare instances of thyroiditis, pancreatitis and sialadenitis have been reported.