Measles

    Child has measles rashes

 Measles

An acute, highly communicable viral infection characterized by a generalised skin rash

Cause

• Measles virus spread by droplet infection and direct contact

Clinical features

Catarrhal stage

• Fever, runny nose, barking cough

• Misery, anorexia, vomiting and conjunctivitis

• Koplik’s spots (diagnostic)

• (Later) generalised maculopapular skin rash

   Desquamation stage (later still)

• Diarrhoea (common)

• Skin lesions peel off

• Rash fades

• Temperature falls

Complications

• Secondary bacterial RTI, eg. bronchopneumonia

• Laryngotracheobronchitis

• Protein Energy Malnutrition (PEM)

   especially following diarrhoea

• TB

• Cancrum oris (from mouth sepsis)

• Otitis media

• Corneal ulceration & panophthalmitis

   leads to blindness

• Demyelinating encephalitis

• Thrombocytopaenic purpura

• Bronchiectasis

  because of long term blockage of small bronchi

Differential diagnosis

• German measles (Rubella)

• Other viral diseases causing skin rash

Investigations

Clinical diagnosis is sufficient though virus isolation is possible

Investigate complications

Management (symptomatic)

Apply tetracycline eye ointment 1% every 12 hours for 5 days

Increase fluid intake

Give vitamin A 200,000 IU

1st dose: at diagnosis

2nd dose: the next day

3rd dose: 2−4 weeks later

Prevention

• Measles vaccination