MEASLE MEASLE Measles (rubeola) is a viral disease that causes fever and a rash. It’s highly contagious and spreads through the air when a person with measles talks, coughs or sneezes. There isn’t a medical treatment for measles — you have to let the virus run its course. The best protection against measles is to receive the measles vaccine. Measles is a highly contagious viral infection that is most common among children. It is characterized by fever, cough, coryza, conjunctivitis, an enanthem (Koplik spots) on the oral mucosa, and a maculopapular rash that spreads cephalocaudally. Complications, mainly pneumonia or encephalitis, may be fatal, particularly in medically underserved areas. Diagnosis is usually clinical. Treatment is supportive. Vaccination is effective for prevention. Pathophysiology Measles is caused by a paramyxovirus and is a human disease with no known animal reservoir or asymptomatic carrier state. It is extremely communicable; the secondary attack rate is > 90% among susceptible people who are exposed. Measles is spread mainly by secretions from the nose, throat, and mouth during the prodromal or early eruptive stage. Communicability begins several days before and continues until several days after the rash appears. Measles is not communicable once the rash begins to desquamate. Pathophysiology Transmission is typically by large respiratory droplets that are discharged by cough and briefly remain airborne for a short distance. Transmission may also occur by small aerosolized droplets that can remain airborne (and thus can be inhaled) for up to 2 hours in closed areas (eg, in an office examination room). Transmission by fomites seems less likely than airborne transmission because the measles virus is thought to survive only for a short time on dry surfaces. An infant whose mother has immunity to measles (eg, because of previous illness or vaccination) receives antibodies transplacentally; these antibodies are protective for most of the first 6 to 12 months of life. Lifelong immunity is conferred by infection. Clinical manifestation • A high fever. • Tiredness. • A barky cough. • Red or bloodshot eyes. • A runny nose. • blotchy rash that spreads from your face to the rest of your body • A sore throat. • White spots in your mouth. • Muscle pain. • Sensitivity to light Diagnostic investigation • History and physical examination • Serologic testing • Secretions from your nose and throat. • Urine (pee). • Reverse-transcription polymerase chain reaction (PCR). Reversetranscription polymerase chain reaction (PCR) evaluation is highly sensitive to visualizing measles virus RNA in blood, throat, nasopharyngeal, or urine specimens and, where available, can be used to rapidly confirm the diagnosis of measles. Nursing management • Taking acetaminophen or NSAIDs for aches, pains or fever. • Getting plenty of rest. • Drinking lots of fluids. • Gargling with salt water. • Avoiding harsh light if your eyes hurt. Medical management • Management of symptoms such as fever with antipyretic, and antihistamin to relief itching • Isolation • Vitamin A supplementation • Monitoring complication such as encephalitis and pneumonia • Hydration • Rest Complication • Diarrhea. • Ear infections. • Pneumonia. • Encephalitis. • Pregnancy complications like low birth weight or preterm birth (in people who have measles during pregnancy).
