EPIDEMIOLOGY OF MEASELS

1. EPIDEMIOLOGY OF
MEASELS (RUBEOLA)
DR. MAHESWARI JAIKUMAR.
maheswarijaikumar2103@gmail.com

2. MEASLES
• An acute highly infectious
disease of childhood caused
by a specific virus of the group
MYXOVIRUS.

4. • It is clinically characterized by
fever and catarrhal symptoms of
the upper respiratory tract
(CORYZA, COUGH) followed by a
typical rash.

5. • Measles occurs only in humans.
There is no animal reservoir.

7. AGENT
• Measles is caused by an RNA
paramyxovirus.
• The virus cannot survive outside
the human body for any length
of time.

9. SOURCE OF INFECTION
• The only source of infection is a
case of measles.

10. INFECTIVE MATERIAL
• Secretions of the nose, throat
and respiratory tract of a case of
measles during the prodromal
period and the early stages of
the rash.

11. COMMUNICABILITY
• Measles is highly infectious during
the prodromal period and at the
time of eruption.
• Communicability declines rapidly
following the appearance of the
rash.

12. • The period of communicability is
approximately 4 days after the
appearance of the rash.

13. SECONDARY ATTACK RATE
Infection confers life long
immunity. Hence there are no
secondary attack rates.

15. AGE
• Affects everyone in infancy or
childhood between 6 months & 3
years.
• The case may also be present
among children above 5 years in
certain developing countries.

16. GENDER
• Incidence of measles among
both the gender are equal.

17. IMMUNITY
• No age is immune if there was
no previous immunity.
• One attack of measles confers
life long immunity.

18. NUTRITION
• Measles tends to be very severe in
the malnourished child.
• Even in a healthy child, an attack of
measles may be followed by Wight
loss, precipitating into
malnutrition.

20. • Given a chance the virus can
spread in any season.
• Most of the cases occur during a
dry season.

21. • In temperate climates, measles is
a winter disease, probably due
to staying close (overcrowding).
• Population density and
movement do affect epidemicity.

22. TRANSMISSION
• Transmission occurs directly
from person to person mainly by
droplet infection and droplet
nuclei, from 4 days before onset
of rash until 4 days thereafter.

23. • The portal of entry is the
respiratory tract .
• Infection through conjunctiva is
also possible (if the virus is
instilled into the conjunctiva).

24. INCUBATION PERIOD
• Incubation period is 10 days
from exposure to the onset of
fever and 14 days to the
appearance of rash.

25. CLINICAL FEATURES

27. PRODROMAL STAGE
• It begins 10 days after infection
and lasts upto 14 days.
• It is characterized by fever,
coryza with sneezing and nasal
discharge, cough, redness of the
eyes, lacrimation and often
photophobia.

30. • There may be vomiting or
diarrhoea.
• Koplik’s spots (like table salt
crystals) appear on the buccal
mucosa opposite the first and
second lower molars. (This is
before the development of rash.

31. • They are small, bluish-white
spots on a red base, smaller than
the head of a pin.
• Their presence is pathognomonic
of measles.

33. • During the prodromal phase (2-4
days)and the first (2-5 days)of the
rash,virus is present in tears, nasal
and throat secretions, urine and
blood.
• As the maculo papular rash appears,
the circulating antibodies become
detectable. (viraemia disappears
and fever falls)

34. ERUPTIVE PHASE
• This phase is characterized by a
typical, dusky-red, macular or
maculo-papular rash which
begins behind the ears and
spreads rapidly in a few hours
over the face and neck.

35. • Further it extends down the
body taking 2 to 3 days to
progress to the lower
extremities.
• The rash may remain discrete,
but often it becomes confluent
and blotchy.

36. • In the absence of complications, the
lesions and fever disappear in
another 3 or 4 days signaling the
end of the disease.
• The rash fades in the same order of
appearance leaving a brownish
discolouration which may persist for
two months or more.

37. RASHES

38. DIAGNOSIS
• Diagnosis is based on the typical
rash and koplik’s spots seen in
oral mucosa.
• Specific IgM antibodies are also
being used for diagnosis.

39. POST MEASLES STAGE
• The child has loss of weight and
remains week for a number of
days.
• There may be growth retardation
and diarrhoea, (and other
conditions such as reactivation
of TB, candidosis)

40. COMPLICATIONS
• The most common
complications are measles
associated diarrhoea,
pneumonia and other
respiratory complications, and
otitis media.

41. • Serious complications include
febrile convulsions, encephalitis,
SSPE (Subacute Sclerosing Pan
Encephalitis).
• Measles during pregnancy
causes congenital abnormalities.

43. GUIDELINES FOR
COMBATING MEASLES
• 1. Achieving an immunization
rate over 95%.
• 2. Ongoing immunization against
measles through successive
generations of children.

44. MEASLES VACCINE
• Live attenuated vaccines are
available.
• MMR vaccine is given (in India)
to infants on completing 9
months of age

48. CHILD GETTING A SHOT OF
MEASLES VACCINE

49. POSSIBLE ADVERSE REACTION
FOLLLOWING MMR

51. PREVENTION OF MEASLES

52. THANK YOU