Measles virus infection

Dr. Ruwanka De Livera

15/11/11
Kelaniya
 Pathogenesis
• 1. Infects only- humans & non-human primates
• 2.Transmission- by aerosals
• 3.Enters via - respiratory route, oro-pharynx,
conjunctiva
• 4. Incubation period – 10-14 days
• 5. Infectivity – few days before / after onset of rash
• 6. Highly infectious

15/11/11
Kelaniya
 Clinical Features
• 1. Prodromal phase 1st 3 days–
fever, conjunctivitis , respiratory symptoms
*Koplik spots – pathognomonic, opposite 2nd molar

• 2. Rash – 3rd day onwards

maculo-papular,
face to extremities erythematous

15/11/11
Kelaniya
Common complications

15/11/11
Kelaniya
Differential diagnosis
• some
1. Rubella
bacterial and rickettsial diseases
• Kawasaki’s
2. Dengue disease
• toxic
Echo shock syndrome
• drug
Coxsackie
reaction
• Parvo B19
• Herpes 6

15/11/11
Kelaniya
 Diagnosis of measles
• 1. Serological assays
– IgM detection
– IgG – sero conversion 4 x fold rising titer (acute &
convalescent blood samples taken 10 – 14 days apart)
– IgG - Positive single sample indicates vaccination or prior
infection
• 2. Virus Isolation
• 3. Detection of viral genome

15/11/11
Kelaniya
 Laboratory specimens for Virus isolation
• Urine sediments
• Naso-pharyngeal aspirates (NPA)
• Throat Swabs
• Blood / Lymphocytes

Collect the specimen at first contact with the

suspected case , best within 0-5 days after rash
onset, transport in viral transport media in ice

0 - 5 days- virus isolated from 40% 0f IgM +ve cases

> 6 days - no virus isolated from IgM + ve cases

15/11/11
Kelaniya
Management
• 1. No specific management
• 2. Paracetamol and fluids
• 3. Antibiotics for IIry bacterial infection
• 4. Complications
• 5. Vit A (modulate immune system)
• 6. Ribavarine (immunocompramised)

15/11/11
Kelaniya
Prevention
• Highly effective and safe vaccine
• 1. Isolation
• 2. Immunization
• 3. Vit A
• 4. Notification

15/11/11
Kelaniya