MEASLES 

Measles is a highly contagious viral infection caused by the measles virus, characterized by fever, cough, coryza, conjunctivitis and a generalized maculopapular rash.

Transmission

• Mainly through respiratory droplets and aerosols
• Extremely contagious
• Incubation: usually 10–14 days

Classic Clinical Features

Prodrome:

• High fever
• Cough
• Coryza — runny nose
• Conjunctivitis

Remember: The 3 Cs = Cough + Coryza + Conjunctivitis

4. Koplik Spots

• Small white/blue-white spots on an erythematous background
• Usually found on the buccal mucosa
• Highly characteristic of measles
• Usually appear before or around the onset of the rash

Measles Rash

• Maculopapular and erythematous
• Starts around the face/hairline
• Spreads downward → neck → trunk → limbs
• May become confluent

Complications

• Pneumonia — important cause of severe disease
• Otitis media
• Diarrhoea
• Laryngotracheobronchitis
• Encephalitis
• Keratitis/corneal damage
• SSPE — rare late neurological complication
• Severe disease is more likely with malnutrition or vitamin A deficiency

 Management

There is no routine specific treatment for uncomplicated measles.

Give:

• Fluids and nutritional support
• Antipyretics
• Vitamin A
• Treat complications appropriately
• Antibiotics only when there is a suspected bacterial infection

Prevention

Measles-containing vaccination is the main preventive measure.

Also:

• Isolate suspected cases
• Respiratory infection-control measures
• Vaccinate susceptible contacts according to public-health guidance

⭐ EXAM PEARLS

Measles = 3 Cs + Koplik spots + descending rash

3 Cs:

Cough

 Coryza

Conjunctivitis

Rash: Face → trunk → limbs

Classic oral finding: Koplik spots

Major complication: Pneumonia

Important treatment: Vitamin A + supportive care

Prevention: Vaccination