An acute, highly communicable viral infection characterized by a generalised skin rash, fever, and inflammation of mucous membranes. Measles is a notifiable disease. Measles virus is caused by a virus. The measles virus a single-stranded, lipid-enveloped RNA virus in the family Paramyxoviridae and genus Morbillivirus
- Measles virus spreads by droplet infection and direct contact: through the respiratory tract or conjuctivae following contact with aerosals Virus remains viable after 1 hour in airdroplet.
Stages of measles
- Incubation phase.
- Prodromal phase.
- Exanthematous phase
- Catarrhal stage: high fever, Koplik’s spots (diagnostic) runny nose, barking cough, conjunctivitis
- Misery, anorexia, vomiting, diarrhoea
- Later: generalised maculopapular skin rash followed by desquamation after few days
- Secondary bacterial respiratory tract infection, e.g. bronchopneumonia, otitis media
- Severe acute malnutrition especially following diarrhoea
- Cancrum oris (from mouth sepsis)
- Corneal ulceration and panophthalmitis – can lead to blindness
- Demyelinating encephalitis
- Thrombocytopaenic purpura
- German measles (Rubella)
- Other viral diseases causing skin rash
- Clinical diagnosis is sufficient though virus isolation is possible
- Isolate patients (at home or health centre)
- Paracetamol prn for fever
- Apply tetracycline eye ointment 1% every 12 hours for 5 days
- Increase fluid and nutritional intake (high risk of malnutrition and dehydration)
- Give 3 doses of vitamin A: first dose at diagnosis, 2nd dose the next day and 3rd dose on day 14
- Child <6 months: 50,000 IU
- Child 6-12 months: 100,000 IU
- Child >12 months: 200,000 IU
- Monitor for and treat secondary bacterial infections with appropriate antibiotics immediately
- Refer to hospital in case of complications
In HIV positive patients, Ribavirin is recommended.
- Measles vaccination (see chapter 18)
- Avoid contact between infected and uninfected persons
- Educate the public against the common local myths e.g. stopping to feed meat and fish to measles patients.
1: Uganda Clinical Guidelines 2016.
2: Nelson textbook of Paediatrics 19th Edition.