Measles, Mumps &Rubella
Transcript of Measles, Mumps &Rubella
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MMRMeasles, Mumps &Rubella
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Measles(English Measles)
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Agent
• Agent- RNA virus ( Paramyxo virus family, genus Morbillivirus )
• Source of infection-cases of measles, but not carriers.
• No animal reservoir• Infective material- Nasal secretion ,Respiratory
tract &Throat• Communicability- Highly infectious during
prodromal period and at the time of eruption.• Secondary attack rate- > 80%
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Host factors
• Age- 6 months to 3 years even up to 10 years
• Incidence equal in both sexes
• Immunity – life long immunity
• Malnourished children are susceptible
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Environmental factor
• Winter season, over crowding
• Transmission – Droplet infection
• 4 days before and 4 days after rash
• Incubation period- 7 days
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Courtesy : Adapted from Mims et al. Medical Microbiology, 1993, Mosby
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Clinical features
• Prodromal stage
• Eruptive stage
• Post-measles stage
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Clinical features• 3 Cs (Cough, Coryza & Conjunctivitis)• Koplik spots• Four days fever (400c)• Generalized, maculopapular,erythematous
rash.
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Courtesy : This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #3168
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KOPLIK SPOTSource: http://phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg
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Complication
• Diarrhea,
• Pneumonia
• Otitis media
• Convulsions,
• SSPE (sub acute sclerosing panencephalitis)
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WHO strategy for control and prevention of Measles
1) Catch up
2) Keep up
3) Follow up
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Mumps
The name comes from the British word "to mump", that is grimace or grin. The appearance of the patient as a result of parotid gland swelling seems to be in grin
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Courtesey: This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #130 Content Providers: CDC/NIP/Barbara Rice
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Agent
• Myxovirus parotidis –RNA virus
• Source of infection – Respiratory, milk
• Period of communicability – 4-6 days of onset of symptoms
• Secondary attack rate – 86%
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• Age & sex 5-15 yrs and girls common
• Immunity - life long
• Environmental factor – winter and spring season favors
• Mode of transmission – droplet
• I.P - 2 to 3 weeks
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Clinical features
• Parotid swelling
•Ovaritis
• Pancreatitis
• Ear ache
•Orchitis
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Courtesy : Adapted from Mims et al. Medical Microbiology, 1993, Mosby
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Complications
• Orchitis
• Epididymitis
• Oophoiritis
• Spontaneous abortion
• Sensori neural hearing loss, (uni- or bilateral).
• Mild form of meningitis
• Encephalitis
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Rubella (German measles)
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• The name rubella is derived from a Latin term meaning "little red."
• Rubella is sometime called German Measles or 3-day Measles.
• The synonym "3-day measles" derives from the typical course of rubella exanthema that starts initially on the face and neck and spreads centrifugally to the trunk and extremities within 24 hours.
• It then begins to fade on the face on the second day and disappears throughout the body by the end of the third day.
• It is a generally mild disease caused by the rubella virus.
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• Agent – RNA virus (Togo virus family), Genus Rubivirus.
• Source of infection – Respiratory secretion
• Host -3-10 yrs
• Immunity –life long
• Environmental factors –winter and spring season
• Transmission – droplet, vertical transmission
• I.P – 2-3 weeks average 18 days
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• Eye pain on lateral and upward eye movement (a particularly troublesome complaint)
• Conjunctivitis• Sore throat• Headache• General body aches• Low-grade fever• Chills• Anorexia• Nausea• Tender lymphadenopathy (particularly posterior auricular and
suboccipital lymph nodes)• Forchheimer sign (an enanthem observed in 20% of patients
with rubella during the prodromal period; can be present in some patients during the initial phase of the exanthem; consists of pinpoint or larger petechiae that usually occur on the soft palate)
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Temperature
• Fever is usually not higher than 38.5°C (101.5°F).
Lymph nodes
• Enlarged posterior auricular and suboccipitallymph nodes are usually found on physical examination.
Mouth
• The Forchheimer sign may still be present on the soft palate.
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Image in a 4-year-old girl with a 4-day history of low-grade fever, symptoms of an upper respiratory tract infection, and rash. Courtesy of Pamela L. Dyne, MD.
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• 0–28 days before conception - 43% chance
• 0–12 weeks after conception - 51% chance
• 13–26 weeks after conception - 23% chance
• Infants are not generally affected if rubella is contracted during the third trimester
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Photo source: U.S. Centers for Disease Control and Prevention
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Salt and pepper retinopathy
Content Providers(s): CDC Creation Date: 1976
Courtesy http://phil.cdc.gov/phil_images/20030724/28/PHIL_4284_lores.jpg
http://www.kellogg.umich.edu/theeyeshaveit/congenital/retinopathy.html
Courtesy: Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center
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• Sensorineural hearing loss – 58%
• Ocular abnormalities including cataract, infantile glaucoma, Micro ophthalmia and pigmentary retinopathy occur in approximately 43%
• Congenital heart disease including patent ductus arteriosus (PDA) and pulmonary artery stenosis - 50%
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Measles vaccine
• Live attenuated measles virus (Edmonston-zagrebstrain) Propagated on human diploid cell (MRC-5)
• 0.5 ml of vaccine
• Not less than 1000 CCID50 of measles virus
• 2.5% of gelatin
• 5% of sorbitol as stabilizers
• 0.5 ml of sterile water
• Dose – 0.5 ml
• Route of administration: Sub-cutaneously
• 3 to 5 weeks antibody level – 200mLU/ml
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Age Vaccines Note
9 months MeaslesDeep subcutaneous injection into the upper arm.
12-15 months MMR -1
Deep subcutaneous injection into the upper arm.
5 years MMR -2Deep subcutaneous injection into the upper arm.