Measles overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Measles is a disease caused by the Morbillivirus. It is transmitted into the respiratory by contact with infected fluids. Incubation lasts for 4-12 days, during which patients are asymptomatic. Symptomatic onset includes the appearance of a distinct rash. Infected people remain contagious until appearance of the first symptoms until 3-5 days after the rash appearance.

Historical Perspective

Reports of measles go as far back to at least 600 B.C. however, the first scientific description of the disease and its distinction from smallpox is attributed to the Persian physician Ibn Razi (Rhazes) 860-932 who published a book entitled "Smallpox and Measles" (in Arabic: Kitab fi al-jadari wa-al-hasbah). In 1954, the virus causing the disease was isolated from an 11-year old boy from the US, David Edmonston, and adapted and propagated on chick embryo tissue culture.[1] To date, 21 strains of the measles virus have been identified.[2] Licensed vaccines to prevent the disease became available in 1963.

Pathophysiology

Measles is a disease caused by a virus , specifically a paramyxovirus of the genus Morbillivirus.

Epidemiology and Demographics

According to the World Health Organization (WHO), measles is a leading cause of vaccine preventable childhood mortality. Worldwide, the fatality rate has been significantly reduced by partners in the Measles Initiative: the American Red Cross, the United States Centers for Disease Control and Prevention (CDC), the United Nations Foundation, UNICEF and the World Health Organization (WHO). Globally, measles deaths are down 60 percent, from an estimated 873,000 deaths in 1999 to 345,000 in 2005. Africa has seen the most success, with annual measles deaths falling by 75 percent in just 5 years, from an estimated 506,000 to 126,000.

Diagnosis

History and Symptoms

The classical symptoms of measles include a fever for at least three days, and the three Cs—cough, coryza (runny nose) and conjunctivitis (red eyes). The fever may reach up to 104° Fahrenheit/ 40° Celsius. Koplik's spots seen inside the mouth are pathognomonic (diagnostic) for measles but are not often seen, even in real cases of measles, because they are transient and may disappear within a day of arising.

Treatment

Medical Therapy

There is no specific treatment or antiviral therapy for uncomplicated measles. Most patients with uncomplicated measles will recover with rest and supportive treatment.

Primary Prevention

he joint press release by members of the Measles Initiative brings to light another benefit of the fight against measles: "Measles vaccination campaigns are contributing to the reduction of child deaths from other causes. They have become a channel for the delivery of other life-saving interventions, such as bed nets to protect against malaria, de-worming medicine and vitamin A supplements. Combining measles immunization with other health interventions is a contribution to the achievement of Millennium Development Goal Number 4: a two-thirds reduction in child deaths between 1990 and 2015."[3]

References

  1. Live attenuated measles vaccine. EPI Newsl. 1980 Feb;2(1):6.
  2. Rima BK, Earle JA, Yeo RP, Herlihy L, Baczko K, ter Muelen V, Carabana J, Caballero M, Celma ML, Fernandez-Munoz R 1995 Temporal and geographical distribution of measles virus genotypes. J Gen Virol 76:11731180.
  3. UNICEF Joint Press Release

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