Measles

https://youtu.be/-JBW1benId8

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Measles

• Measles is a highly contagious disease caused by a virus. It spreads easily when an infected person breathes, coughs, or sneezes, potentially leading to severe complications and even death. While anyone can be affected, children are the most common victims of this disease.

Symptoms

• The measles virus infects the respiratory tract and swiftly spreads throughout the body. Its symptoms include a high fever, cough, runny nose, Koplik spots in the mouth, and a maculopapular rash covering the entire body.
• Koplik's spots seen inside the mouth are diagnostic for measles, but are temporary and therefore rarely seen. Koplik spots are small white spots that are commonly seen on the inside of the cheeks opposite the molars. They appear as "grains of salt on a reddish background."
• The measles rash is a generalized red maculopapular rash that begins several days after the fever starts. It starts on the back of the ears and spreads to the head and neck before spreading to cover most of the body, often causing itching. The measles rash appears two to four days after the initial symptoms and lasts for up to eight days. The rash is said to "stain", changing color from red to dark brown, before disappearing. Overall, measles usually resolves after about three weeks.

Vulnerability

• Complications tend to be most common in children under 5 and adults over 30. Those who are malnourished or have weakened immune systems, especially due to conditions like HIV, are at higher risk. Measles itself weakens the immune system, leaving children exceptionally vulnerable.

Transmission

• Measles is one of the most contagious diseases that spreads through air and contact with infected secretions. The virus remains active on surfaces for up to two hours, making it highly infectious. Vaccination remains the most effective way to prevent its spread.

Treatment

• Currently, there's no targeted treatment for measles. Treatments are supportive and focus on managing symptoms and preventing complications. Adequate hydration, a balanced diet, and antibiotics for complications such as pneumonia or ear infections are vital. Vitamin A supplements are essential to prevent complications and deaths.

Vaccination

• Community-wide vaccination is pivotal in preventing measles. The vaccine is safe, effective, and affordable. Children require two doses for full immunity, and routine vaccination, coupled with mass campaigns, plays a crucial role in decreasing global measles deaths.

The "Identify-Isolate-Inform" tool

• This tool is designed to help clinicians detect and manage measles patients presenting to the emergency department

1. Identify. 

• Recognize the signs and symptoms of measles. Clinicians should also inquire about immunization status, sick contacts, and travel to a region with measles. 

2. Isolate.

• Take appropriate infection control measures to prevent the spread of measles to other patients and healthcare workers. This may include placing the patient in a private room and using personal protective equipment. Isolated patients should have samples obtained urgently and sent to the local public health department laboratory for disease confirmation.

3. Inform.

• Notify the local health department and the hospital's infection control. This allows for proper public health measures to be implemented, such as contact tracing and vaccination campaigns.

Summary

• In summary, this lecture encourages clinicians to stay informed about measles and emphasizes the importance of quick diagnosis to prevent the spread of the disease in your community. One should stay up-to-date on clinical features and diagnosis of measles or other communicable diseases by attending orientation sessions and reviewing resources from trusted sources like CDC.