‘Measles’

ETIOLOGY AND PATHOPHYSIOLOGY:

• Measles is caused by morbillivirus, which is mostly seen in the winter and spring. It's spread from one child
to another through direct contact with discharge from the nose and throat. Sometimes, it is spread through
airborne droplets (from a cough or sneeze) from an infected child
•In addition, Measles is a very contagious respiratory infection, it is also called rubeola, "10-day measles," or
"red measles," is a very contagious viral illness that causes a distinct rash, fever, and cough.
•It causes a total-body skin rash and flu-like symptoms.
•Despite being considered primarily a childhood illness, measles can affect people of all ages.
•Infection is transmitted via respiratory droplets, which can remain active and contagious, either airborne or
on surfaces, for up to 2 hours.

SOURCE OF INFECTION PERIOD OF COMMUNICABILITY

• THE VIRUS IS FOUND IN THE PATIENT’S BLOOD, AS WELL IN SECRETIONS FROM THE EYES, NOSE AND
THROAT.
• Measles usually lasts about 9 to 10 days, counted from the beginning of the prodromal symptoms to the
fading of the rash.

Common Communicable and Infectious Diseases: A System- Based Approach

• The disease is communicable four days before and five days after the appearance of rashes.
• About 90% of susceptible people who are exposed to someone with the virus will be infected
• Measles is most communicable during the height of the rash.

The most serious complications from measles can include:

•Pneumonia
•encephalitis (inflammation of the brain)
•ear infections
•death
•Pregnant women who develop measles are at higher risk of miscarriage and premature birth.

CAUSES:
•Measles is a highly contagious illness. It is caused by a virus found in the nose and throat of an infected child
or adult. •When someone with measles , coughs, sneezes or talks, infectious droplets spray into the air, when
other people can breath them in. The infectious droplets can hang in the air for about and hour.
•The infectious droplets may also land on a surface, where they can live and spread for several hours. You can
get the measles virus by putting your fingers in your mouth and nose or rubbing your eyes after touching the
infected surface.
-about 90% of people who haven’t had measles or been vaccinated against measles will become infected
when
SIGNS AND SYMPTOMS:
Measles signs and symptoms appear around 10- 14 days after exposure to the virus.
Signs and symptoms of measles typically include:
•Fever
•Dry Cough
•Sore Throat
•Inflamed eyes (conjunctivitis)
•Tiny white spots with bluish- white center on a red background found inside the mouth on the inner lining of
the cheek. ( Koplik’s spot) •A skin rash made up of large, flat blotches that often flow into oneanother

RISK FACTORS:
1. Being unvaccinated- unvaccinated children are more at risk for acquiring measles.
2. Travelling Internationally- clients, specially children travelling to developing countries (where measles is
more common ) are at higher risk of catching the disease.
3. Vitamin A Deficiency- a child with a vitamin A- deficient diet is more likely to have severe symptoms and
complications.

Diagnostics Procedures:
•Nose and Throat Swab
•Routine Analysis
•Blood Exams ( CBC results either with leukopenia or leukocytosis)
•Complement fixation or hemogglutinin test.

Complications:
•Bronchopneumonia, pneumonia, and bronchitis are common
•Otitis media
•Nephritis
•Encephalitis; encephalomyelitis
•Blindness (seldom)
•If a woman is pregnant, there is a need to take special care to avoid measles because the disease can cause
preterms labor , low birth weight, and maternal death.

Prevention:
If someone in the household has measles, take note of these precautions to protect vulnerable family
members and other people.
1. Isolation- measles is highly contagious from about four days before to five days after the rash breaks out.
Patients should minimize or avoid interaction with other people during this period.
It may also be necessary to keep non-immunized people, like siblings, away from the infected person.

2. Immunization
•anti- measles vaccine is given at the age of nine months as single dose, unless there is an outbreak of
measles. •Mumps, measles, rubella (MMR) to be given at the age 12- 15 months old, and the second dose is
given at six to eight years old.

NURSING MANAGEMENT
▪Isolation (quite, well- ventilated, subdued light in the patient’s room)
▪Control high temperature with warm or tepid sponge baths.
▪The patient should have a daily cleansing bath. The water should be comfortably warm.
▪Oral and nasal hygiene are very important aspect of nursing care in patients with measles.
▪The patient is sensitive to light; adjust the position of the patient to avoid direct glares. Keep the eyes free
from secretion.
▪Careful attention should be given to the ears. It is the responsibility of the nurse to be on the alert for any
signs of early mastoid infection .
▪Daily elimination is important. This can be accomplish by using a mild laxative or as prescribed by the
physician.
▪During the febrile stage, limit the diet to fruit juices, milk, and water. If the patient is vomiting, give iced juice
in small amounts frequently.
▪The patients position should be changed every three to four hours.
▪Penicillin or other prescribed medications are usually given in cases with complications.