This is a very common disease among small children. It is a “pediatric priority” in the developing countries, and is an erupting fever caused by a specific virus, clinically characterized by fever and catarrhal symptoms followed by typical rash.

Measles is an important disease throughout the world, and may occur in epidemic and endemic forms. It begins with cold, cough and fever.

Spread

Spread is by direct contact through droplet infection from sneezing or coughing. It is very contagious, especially in the catarrhal stage before the rash appears.

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Incidence

The maximum incidence of the disease is between 8 months and 5 years.

Symptoms & Signs

1. The onset is usually abrupt with the following catarrhal symptoms predominant: –

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(a) Coryza. (b) Conjunctivitis.

(c) Phorophobia. (d) Bronchitis.

With these symptoms the child gives a picture of running eyes and nose, coughing and sneezing. In some cases laryngitis with hoarseness is present.

2. Before l he rash appears, many cases will show the typical Koplik’s Spots. These are small white spots on the mucous membrane of the mouth beside the molar teeth, and often disappear when the rash comes out.

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3. Temperature rises on the first day to 100° to 103° F, and falls slightly on the third day, to rise again on the fourth day with the onset of rash.

4. The rash appears first on the forehead and behind the ears and soon spreads all over the face and body. The rash is a dusky red macular eruption, which gives a blooded, swollen appearance to the face.

5. The rash gradually fades and is gone in a week whilst the temperature falls slowly.

Complications

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(a) Broncho-pneumonia. (b) Acute gastroenteritis.

(c) Conjunctivitis. (d) Otitis media and mastoiditis.

(e) Stomatitis.

(f) Inflammation of the brain.

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As such utmost care must be taken during the infection so that it does not develop these complications, which are serious.

Treatment

The patient is nursed in strict isolation in a well ventilated, warm room.

Regular eye bath in warm water if the eyes are discharging. Guard against direct sunlight.

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If pneumonia is suspected give sulphonamides, penicillin or other antibiotics. If there is pain is the ear, discharge from the ear or swelling behind the ear, any antibiotic drug will clear the inflammation.

Patient should be kept in bed well after the full recovery. All clothes, linen, utensils etc, should be disinfected at the end of the illness.

Immunization

No active immunity can be confirmed on measles by artificial means. A passive immunity to measles can be given by the injection of gamma globulin, which contains most of the antibodies against the measles virus. In practice, full protection is usually given to infants under 2 years of age.