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Measles (Rubeola)Lanie Lissard
HHP 637
Description
O Measles, also known as Rubeola, is a highly-contagious viral disease caused by a single-stranded RNA paramyxovirus that spreads through respiratory droplets of infected people when they cough or sneeze.
O The disease begins with a fever, runny nose, cough, red eyes, and sore throat, and is accompanied by a rash that spreads all over the body.
O Roughly 3 out of 10 people who get measles will develop one or more complications including pneumonia, ear infections, or diarrhea.
O Complications are more common in adults and young children.
Description
O Measles is classified as an acute,
communicable disease.
O Communicable means that the disease is
infectious.
O Acute means that the duration of the
disease is less than 3 months and the
peak of the symptoms occurs and
subsides during this time period.
Symptoms
O High fever
O Runny nose
O Troublesome cough
O Enlarged lymph nodes
O Conjunctivitis
O Aversion to light
O Malaise
O Rash
O Koplik’s spots
O Usually begin within 6-19 days after infection.
O Person is contagious four days before the onset of the rash and up to 5 days after onset.
O Rash fades and peels, but cough may remain up to two to three weeks later.
A Look at Measles
O This patient had an early symptom
of measles known as Koplik’s spots.
O This patient has a moderate case and
exhibits a runny nose and watery eyes
O These patients have had the virus
for over three days and have a cough
to accompany the skin rash
Diagnosis
O Conditions that mimic the symptoms include:
O Erythema Infectiosum (Slapped Cheek
Disease)
O Scarlet Fever or other streptococcal infections
O Early meningococcal infection
O Syphilis
O Other drug reactions
O Samples of oral fluid for serological and viral
RNA testing may be performed to confirm the
diagnosis.
Management and Prevention
O Drink plenty of fluids.
O Take Ibuprofen to relieve symptoms.
O Avoid schools and contact with others for 4 days after the rash appears.
O May be prescribed antibiotics for the chest infection and conjunctivitis
O Receive all rounds
of the Measles,
Mumps, and
Rubella (MMR)
vaccine.
Vaccine and Concerns
O In the late 1990’s the MMR vaccine was allegedly linked to gastrointestinal abnormalities and autism spectrum disorders.
O Crohn’s disease and autism cases were being reported at a time when measles vaccinations were prevalent.
O These allegations have been discredited, and the MMR vaccine is completely safe for people to receive.
Prevalence
O In the United States, measles elimination
was documented in 2000.
O However, measles is making a comeback.
From January 1,2014 to October 31,
2014, the Center for Disease Control has
confirmed 603 cases of measles.
O Causes for the high cases in the U.S. is
believed to be from travel to and from the
Philippines.
Measles in the United States
Measles Globally
Who Does it Affect?O Measles affects adolescents and adults who were never
fully vaccinated or, in rare instances, affects those who received the recommended vaccine but never developed immunity or developed immunity that waned over time.
O Measles remains a common disease in many parts of the world, including areas in Europe, Asia, the Pacific, and Africa.
O In the United States, most of the measles cases result from international travel. The disease is brought into the United States by unvaccinated people who get infected in other countries. They spread measles to others, which can cause outbreaks.
O Anyone who is not protected against measles is at risk of getting infected when they travel internationally.
Who Does it Affect?
O People who neglect to become vaccinated
are 22 times more likely to become
infected than those who are vaccinated.
O Among unvaccinated school-aged (ages
3-10) children, the risk of measles is 62
times greater than among vaccinated
children.
O Infants and immunocompromised
individuals are especially susceptible as
well.
Pregnant with Measles
Case Study Information
O A case of a Japanese woman who delivered in her 24th week of pregnancy was recorded to have an infant with a low birth weight and was in respiratory distress.
O The infant received surfactant therapy, and also had her ductus arteriosus(which closes on its own as the heart develops further) surgically closed.
O Pregnant women with measles can occasionally lead to death, miscarriage, premature birth, and low birth weight.
O Human normal immunoglobin (HNIG) is believed to reduce complications of the disease
Global Eradication of Measles
O Three biological criteria are deemed
important for disease eradication:
1. Humans are the sole pathogen
reservoir
2. Accurate diagnostic tests exists
3. An effective, practical intervention is
available at reasonable cost
Global Eradication of Measles
O Recently, the threat of bioterrorism has
presented itself as an obstacle in the
possibility of the eradication of measles.
O The U.S. currently spends at least $45
million a year for the measles component
to the MMR vaccine.
O A recent estimate of 7 industrialized
countries’ cumulative annual savings
could be between $69 and $623 million.
Global Eradication of Measles Compared to Other
Eradication Programs O Five disease eradication
programs that pose political, social, economic, and other constraining factors include yaws, malaria, smallpox, guinea worm, and polio.
O A potential measles eradication program would do better than the former programs because of:O Strong social and political
support
O Cost-effective
O Rigorous upfront processes
O However, increasing population density, urbanization, and wars and civil conflicts will present serious challenges.
O Measles eradication will not be as difficult as polio eradication if the program has the proper political, social, economical, and technical support.
References
O Castillo-Solorzano, C., Matus, C. R., Flannery, B., Marsigli, C., Tambini, G., & Andrus, J. K. (2011). The Americas: Paving the Road Toward Global Measles Eradication. Journal Of Infectious Diseases, 204S270-S278. doi:10.1093/infdis/jir166
O Go, H., Hashimoto, K., Imamura, T., Sato, M., Kawasaki, Y., Momoi, N., & Hosoya, M. (2010). An extremely low body weight infant born to a mother with measles. Journal Of Perinatology, 30(2), 146-148. doi:10.1038/jp.2009.111
O Keegan, R., Dabbagh, A., Strebel, P. M., & Cochi, S. L. (2011). Comparing measles with previous eradication programs: enabling and constraining factors. The Journal Of Infectious Diseases, 204 Suppl 1S54-S61. doi:10.1093/infdis/jir119
O McKenzie, J., & Pinger, R. (n.d.). Epidemiology: Prevention and Control of Diseases and Health Conditions. In <i>An introduction to community and public health</i> (Eight ed., pp. 108-109).
References
O Measles. (n.d.). Retrieved November 21, 2014, from http://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles/en/
O Measles Cases and Outbreaks. (2014, November 4). Retrieved November 21, 2014, from http://www.cdc.gov/measles/cases-outbreaks.html
O Measles (Rubeola). (2014, November 3). Retrieved November 21, 2014, from http://www.cdc.gov/measles/index.html
O Meissner, H., Strebel, P., & Orenstein, W. (2004). Measles vaccines and the potential for worldwide eradication of measles. Pediatrics, 114(4 Part 1), 1065-1069.
O Moss, W. J., & Strebel, P. (2011). Biological feasibility of measles eradication. The Journal Of Infectious Diseases, 204 Suppl 1S47-S53. doi:10.1093/infdis/jir065
O Schub, E., & Caple, C. (2014). Measles in Adolescents and Adults.
O Watkins, J. (2011). Diagnosis, management and prevention of measles. British Journal Of School Nursing, 6(8), 375-378.
