Measles
Measles is an acute infectious disease with the development of high fever, inflammation of the VDP, conjunctivitis and papular spotted rash, intoxication syndrome.
ETIOLOGY
The causative agent of measles is the RNA virus of the pancovirus family genus Morbilivirus, is poorly resistant in the external environment, is inactivated during drying, ultraviolet irradiation, heat treatment of more than 50 degrees, however, at room temperature it is able to survive for a long time, at low temperatures -20 retains viability for up to several weeks. Weakened strains are necessary for the manufacture of a live measles vaccine.
Measles is one of the most contagious diseases, contagiousness tends to 100%. After the disease, a persistent lifelong immunity develops. Also, immunity is observed in children under 6 months old, born to mothers who have been ill or vaccinated against measles. The incubation period lasts 8-14 days. Transmission mechanism: aerogenic, airborne pathway. Due to its unstable stability in the external environment, the contact-household path is excluded. Infection occurs from a coughing, sneezing patient. Intrauterine transplacental infection of the fetus by the mother is possible.
A patient is considered contagious from day 11 to 16 after infection, that is, from the appearance of catarrhal symptoms. Children get sick much easier than adults. In patients with immunodeficiency, it is fatal in most cases. There are no cases of viral transmission without clinical manifestations of measles.
symptoms
Measles begins acutely, with a rapid rise in temperature of 38-40 degrees and the development of catarrhal symptoms. There is photophobia, a persistent dry cough, aphonia, intoxication. After 3-4 days, small white rashes (Koplik spots) appear on the mucous membrane of the cheeks. Then a rash appears all over the body in a descending type (ears, face, neck, body, limbs). The rash is small at first, then merges. After 4-5th from the beginning of the rash, the development occurs back – the rash is darker, hyperpigmented, dries up and forms crusts that gradually disappear. This condition lasts about two weeks.
COMPLICATIONS
Otitis media (inflammation of the middle ear)
Mastoiditis (inflammation of the mastoid process)
Pneumonia
Cervical lymphadenitis
Meningitis
Encephalitis
Croup (false, non-diphtheria)
Laryngitis (laryngospasm)
diagnostics
Measles is diagnosed on the basis of an epidemiological history, examination by an infectious disease specialist or pediatrician, serological examination.
treatment
There is no etiotropic therapy. Symptomatic treatment includes taking antipyretics, antiseptic (mouthwash). The patient is isolated from the first symptoms, bed rest and a gentle diet are prescribed. Antibiotics are indicated for adults as prevention of secondary bronchopneumonia against the background of measles. Frequent copious drinking is recommended, the temperature is 38-40 degrees, vitamin therapy, mucolytics, in the presence of itching – antihistamines (Claritin, Zodac). In some cases, the use of Ribavirin is effective (according to the doctor’s recommendations).
PREVENTION
Specific – immunoprophylaxis. Vaccination with live measles vaccine, according to the vaccination calendar. The use of an inactivated vaccine is not recommended, since immunity is short-lived. All contacts undergo passive immunization – immunoglobulin is injected. This does not guarantee protection from infection, but it greatly facilitates its course.
Nonspecific – anti-epidemic measures in the focus, quarantine, isolation of all patients, mask mode. In children’s institutions, large groups are divided into smaller ones for 21 days with the introduction of immunoglobulin and for 17 without immunoglobulin.
