Lecture By MINA MONTEFRIO FEVER WARD HEAD NURSE

1. MEASLES
MINA MONTEFRIO
FEVER WARD HEAD NURSE

3. Measles Virus
1. Paramyxovirus (RNA)
2. One antigenic type
3. Rapidly inactivated by
heat, sunlight, acidic pH,
ether and trypsin

4. Measles Pathogenesis
1. Respiratory transmission of virus
2. Replication in nasopharynx and regional lymph nodes
3. Primary viremia 2-3 days after exposure
4. Secondary viremia 5-7 days after exposure

5. Measles Clinical Features
1. Incubation period 10-12 days
2. Prodrome 2-4 days stepwise
increase in fever to 103°F–
105°F
 cough, coryza,
conjunctivitis
 Koplik spots (rash on
mucous membranes)
3. Rash 2-4 days after prodrome,
14 days after exposure
 persists 5-6 days
 begins on face and upper
neck
 maculopapular, becomes
confluent
4. Recovery: fades in order of
appearance

6. Measles Complications
1. Diarrhea 8%
2. Otitis media 7%
3. Pneumonia 6%
4. Encephalitis 0.1%
5. Seizures 0.6-0.7%
6. Death 0.2%

8. Measles Laboratory Diagnosis
1. Isolation of measles virus from urine, nasopharynx, blood, throat
2. Significant rise in measles IgG by any standard serologic assay
(e.g., EIA, HI)
3. Positive serologic test for measles IgM antibody

9. Measles Epidemiology
1. Reservoir human
2. Transmission respiratory Airborne
3. Temporal pattern peak in late winter–spring
4. Communicability 4 days before to 4 days after rash onset

10. MMR Vaccine
1. First dose of MMR at 12-15 months
2. 12 months is the minimum age
3. Second dose of MMR at 4-6 years
4. Second dose may be given any time at least 4 weeks
after the first dose Intended to produce measles
immunity in persons who failed to respond to the
first dose.
5. May boost antibody titers in some persons
PREVENTION

11. MMR Vaccine Indication
1. All children 12 months of age and older
2. Susceptible adolescents and adults without documented
evidence of immunity
3. All persons who work within medical facilities should
have evidence of immunity to measles
NOTE:
*** YOU CAN CONSIDERED TO BE IMMUNE TO MEASLES ONLY IF
YOU RECEIVED 2 DOSES OF MEASLES VACCINE.

12. Vaccine Contraindications and Precautions
1. History of anaphylactic reactions to neomycin
2. History of severe allergic reaction to any component of the vaccine
3. Pregnancy
4. Immunosuppression
5. Moderate or severe acute illness
6. Recent blood product
7. Personal or family (i.e. sibling or parent) with history of seizures of
any etiology.

13.  A person with measles can spread the virus to others for about eight days,
starting four days before the rash appears and ending when the rash has
been present for four days.
Communicable period.

14. TREATMENT AND NURSING INTERVENTION
SUPPORTIVE CARE:
1. INTRAVENOUS FLUIDS (IV)
2. Medications to control fever & pain
3. Antibiotic to treat secondary infection from bacteria
4. Vit. A
5. GOOD nursing care: (INCLUDES)
a. Isolation until 5th of rash
b. kept on bed until fever & cough subsides
c. provide dim light, clean eye lid, irrigate affected eye with saline
d. encourage more fluid intake during fever.
e. Increase humidity (for children) of the room to relieve cough
f. Relieve itching of skin (for children) by tepid bath & soothing lotion
g. Immune serum or gamma-globuline may be given to modify illness & reduce
complication
h. Antibacterial therapy given for treatment of complication (e.i. respiratory
infection & gastroenteritis).