Mea sles
als o k no wn as
Rubeo la
Shellah Zafirah E. Abantas
Introduction
• Measles- a.k.a. Rubeola
• an infection of the respiratory system caused
by measles virus belonging to paramyxovirus
group.
• Is an endemic disease.
• Muhammad ibn Zakariya ar-Razi (860-932)
• a Persian physician, known to the west as
“Rhazes”
• the one who discover the first scientific
description of measles and its distinction from
smallpox and chickenpox in his book entitled
The Book of Smallpox and Measles (in Arabic:
Kitab fi al-jadari wa-al-hasbah).
Measles Virus
Etiologic Agent
• Measles is caused by paramyxovirus roup of the
genus Morbillivirus.
Paramyxovirus
• From Greek para-, beyond, -myxo-, mucus or
slime, plus virus, from Latin poison, slime.
• It is a spherical virus, 120-250 nm in diameter,
surrounded by a lipoprotein envelope having
haemagglutinin spikes only.
• Physical structure Virions are enveloped and can
be spherical, filamentous or pleomorphic. Fusion
proteins and attachment proteins appear as spikes
on the virion surface. Matrix proteins inside the
envelope stabilise virus structure. The
nucleocapsid core is composed of the genomic
RNA, nucleocapsid proteins, phosphoproteins and
polymerase proteins.
Incubation
• The infection has an average incubation
period of 14 days (range 6–19 days) and
infectivity lasts from 2–4 days prior to 2–5
days following the onset of the rash.
(maculopopular rash)
Mode of Transmission
• Measles is spread through respiration (contact
with fluids from an infected person’s nose and
mouth, either directly or through aerosol
transmission). The measles virus is a highly
contagious airborne pathogen which spreads
primarily via the respiratory system. The virus
is transmitted in respiratory secretions, and
can be passed from person to person via
aerosol droplets containing virus particles,
such as those produced by a coughing patient.
Once transmission occurs, the virus infects
and replicates in the lymphatic system, urinary
tract, conjunctivae, blood vessels and central
nervous system of its new host.
Disease
Process/Pathophysiology
• Measles is highly infectious childhood
disease transmitted by inhalation of virus
present in respiratory secretion of patient.
• After multiplication in respiratory tract,
invades bloodstream and spreads to
reticuloendothlial system where it
multiplies further and via blood transported
to skin, mouth, respiratory tract and
conjunctiva.
Clinical Manifestation
• Measles include four day fevers. (fever may reach
up to 40° Celsius (104° Fahrenheit)
• Koplik’s spots – small bluish white dots surrounded
by a reddish zone that appear on the mucous
membrane of the cheeks and lips before the
appearance of the skin eruption.
• The three Cs—Cough, Coryza (runny nose) and
Conjunctivitis (red eyes).
• The characteristic measles rash is classically
described as a generalized, maculopapular,
erythematous rash that begins several days after
the fever starts. It starts on the head before
spreading to cover most of the body, often causing
itching. The rash is said to "stain", changing color
from red to dark brown, before disappearing.
Early Sign
This child shows a day-4 rash
with measles.
Medical Management
• Avoid exposing children to any person with
fever or with acute catarrhal symptoms.
• Isolation of cases from diagnosis until 5-7 days
after onset of rash.
• Disinfection of all articles soiled with secretion
of nose and throat.
• Encouragement by health department and by
private physician of administration of measles
immune globulin to susceptible infants and
children under 3yrs. Of age in families or
institutions where measles occurs.
• Live attenuated and inactivated measles virus
vaccines have been tested and are available
foe use in children with no history of measles
at 9 months of age or soon thereafter.
Nursing Management
• Protect eyes patients from glare of strong
light as they are apt to be inflamed.
• Keep the patient in an adequately
ventilated room but free from drafts and
chilling to avoid complications of
pneumonia.
• Teach, guide and supervise correct
technique of giving sponge bath for
comfort of patient.
• Check for correction of medication and
treatment prescribed by physician.
