Measles

Reported by:
Castrillo, Mariam P. BSN IV B Group 4

Virginia A. Jupiter, RN, MAN 06/25/10

- The Rubeola virus causes "red measles," also known as "hard measles" or just "measles." Although most people recover without problems, rubeola can lead to pneumonia or inflammation of the brain (encephalitis).

- The Rubella virus causes "German measles," also known as "three-day measles." This is usually a milder disease than red measles. However, this virus can cause significant birth defects if an infected pregnant woman passes the virus to her unborn child.

Measles (Rubeola)
‡ Agent: Paramyxovirus ‡ Incubation period: 10-20 days ‡ Communicable period: 4 days before and 5 days after the rash. ‡ Source: respiratory tract secretions, blood or urine of infected person.

Measles (Rubeola)

Measles (Rubeola)
‡ Prodromal symptoms are Cough, Coryza, Conjunctivitis + fever and anorexia. ‡ RASH - appears red , erythematous. Maculo papular eruption starts on the face to the feet, blanches to pressure and turns to brownish color ( last for 6-7 days), may have desquamation.

Measles (Rubeola)
‡ KOPLIK`s spots - small red spots with a bluish white center and a red base buccal mucosa 3 days. ‡ Measles, with koplik s spot on the buccal mucosa. This is an unsually severe case, enough to cause considerable discomfort when feeding.

Measles (Rubeola)

Measles (Rubeola)

‡ The rash often begins behind the ears.

Measles (Rubeola)
The common complications of measles are secondary bacterial infections of the respiratory tract (particularly pneumonia and otitis media).

Measles (Rubeola)
‡ During the healing phase, a transient brown staining of the skin maybe apparent in white children.

Rubella (German Measles)
‡ Agent: Rubella virus ‡ Incubation period: 14-21 days ‡ Communicability: 7 days before to about 5 days after the rash. ‡ Source: Nasopharyngeal secretions, also through blood, stool and urine.

Rubella (German Measles)

Rubella (German Measles)
‡ Transmission: a. Airborne and direct contact with droplets. b. Indirectly via freshly contaminated nasopharyngeal secretions, feces and urine. c. Transplacental

Rubella (German Measles)
‡ German measles causes milder symptoms than red measles. ‡ Symptoms are more common in adults: ‡ Fatigue ‡ Low-grade fever ‡ Headache ‡ Red eyes several days before the rash appears

Rubella (German Measles)
‡ Swollen, tender lymph nodes may occur in the back of the neck. ‡ The rash does not usually itch, but as it clears up, the skin may shed. ‡ Adult women who get rubella may get painful joints for days to weeks after the infection. This affects the hands, wrists, and knees.

Rubella (German Measles) ‡ Clinical Manifestation:
‡ - Prodromal period ‡ - Eruptive period

Rubella (German Measles)
‡ The most feared complication of rubella is "congenital rubella," which occurs when an infected pregnant woman passes the virus to her unborn child. Among other problems and birth defects, affected infants may have cataracts, heart defects, hearing impairment, and learning disabilities. The risk of transmission is highest early in pregnancy. The virus may also cause miscarriage or stillbirth.

Rubella (Pathogenesis)
MATERNAL VIREMIA PLACENTAL INFECTION FETAL VIREMIA DISSEMINATED INFECTION INVOLVING MANY FETAL ORGANS

Rubella (German Measles)
‡ There is no specific therapy for rubella. ‡ Live vaccines are used in an attempt to prevent congenital rubella. ‡ Other countries vaccinate girls as they approach puberty.

Measles Treatment

Nursing Management
‡ ‡ ‡ ‡ ‡ Isolation Rest until fever subsides Use dim light if patient have photophobia Must take mild liquid diet but nourishing diet, Use warm normal saline to prevent irritation to patient s eyes. ‡ Good ventilation

Nursing Management
‡ Spread of infection must be prevented. ‡ Occurrence of complication must be prevented.

Measles Treatment
‡ Self-Care at Home ‡ Although there is no cure for measles, there are steps that can make the disease more tolerable. These include the following: ‡ - Get plenty of rest. ‡ - Sponge baths with lukewarm water may reduce discomfort due to fever. ‡ - Drink plenty of fluids to help avoid dehydration.

Measles Treatment
‡ - A humidifier or vaporizer may ease the cough. ‡ - Pain relievers and fever reducers such as acetaminophen (Tylenol, Liquiprin Drops, and other brands) and ibuprofen (Advil, Motrin and other brands) can help with symptoms when used according to directions. Remember never to give aspirin to children or teenagers because it may cause a disease known as Reye syndrome.

Prevention
‡ MMRV Given 2 doses. 1st dose given at 12 months, minimum of 3 months interval between the doses for children less than 13 years old. ‡ MMR and Chickenpox vaccine st dose at 12 months, Given 2 doses. 1 2nd dose is recommended at 4-6 years of age.

Prevention
‡ Immunization ‡ Measles-Mumps-Rubella (MMR) - This vaccine protects against both red measles and German measles. ‡ As with all other contagious illnesses, covering the mouth when coughing or sneezing and good hand-washing practices will help prevent the spread of the diseases.

Other Complications:
‡ Approximately 30% of cases of measles have an associated complication. These complications include diarrhea (8%), ear infections (7%), pneumonia (6%), blindness (1%), acute brain inflammation (encephalitis).

Medical Treatment

There is no specific treatment or cure for measles. Prevention is the most effective treatment.

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