2. Description
O Measles, also known as Rubeola, is a highly-contagious
viral disease caused by a single-stranded
RNA paramyxovirus that spreads through
respiratory droplets of infected people when they
cough or sneeze.
O The disease begins with a fever, runny nose,
cough, red eyes, and sore throat, and is
accompanied by a rash that spreads all over the
body.
O Roughly 3 out of 10 people who get measles will
develop one or more complications including
pneumonia, ear infections, or diarrhea.
O Complications are more common in adults and
young children.
3. Description
O Measles is classified as an acute,
communicable disease.
O Communicable means that the disease is
infectious.
O Acute means that the duration of the
disease is less than 3 months and the
peak of the symptoms occurs and
subsides during this time period.
4. Symptoms
O High fever
O Runny nose
O Troublesome cough
O Enlarged lymph
nodes
O Conjunctivitis
O Aversion to light
O Malaise
O Rash
O Koplik’s spots
O Usually begin within
6-19 days after
infection.
O Person is contagious
four days before the
onset of the rash and
up to 5 days after
onset.
O Rash fades and
peels, but cough may
remain up to two to
three weeks later.
5. A Look at Measles
O This patient had an early symptom
of measles known as Koplik’s spots.
O This patient has a moderate case and
exhibits a runny nose and watery eyes
O These patients have had the virus
for over three days and have a cough
to accompany the skin rash
6. Diagnosis
O Conditions that mimic the symptoms include:
O Erythema Infectiosum (Slapped Cheek
Disease)
O Scarlet Fever or other streptococcal infections
O Early meningococcal infection
O Syphilis
O Other drug reactions
O Samples of oral fluid for serological and viral
RNA testing may be performed to confirm the
diagnosis.
7. Management and Prevention
O Drink plenty of fluids.
O Take Ibuprofen to
relieve symptoms.
O Avoid schools and
contact with others for
4 days after the rash
appears.
O May be prescribed
antibiotics for the
chest infection and
conjunctivitis
O Receive all rounds
of the Measles,
Mumps, and
Rubella (MMR)
vaccine.
8. Vaccine and Concerns
O In the late 1990’s the MMR vaccine was
allegedly linked to gastrointestinal
abnormalities and autism spectrum
disorders.
O Crohn’s disease and autism cases were
being reported at a time when measles
vaccinations were prevalent.
O These allegations have been discredited,
and the MMR vaccine is completely safe
for people to receive.
9.
10. Prevalence
O In the United States, measles elimination
was documented in 2000.
O However, measles is making a comeback.
From January 1,2014 to October 31,
2014, the Center for Disease Control has
confirmed 603 cases of measles.
O Causes for the high cases in the U.S. is
believed to be from travel to and from the
Philippines.
13. Who Does it Affect?
O Measles affects adolescents and adults who were never
fully vaccinated or, in rare instances, affects those who
received the recommended vaccine but never
developed immunity or developed immunity that waned
over time.
O Measles remains a common disease in many parts of
the world, including areas in Europe, Asia, the Pacific,
and Africa.
O In the United States, most of the measles cases result
from international travel. The disease is brought into the
United States by unvaccinated people who get infected
in other countries. They spread measles to others, which
can cause outbreaks.
O Anyone who is not protected against measles is at risk
of getting infected when they travel internationally.
14. Who Does it Affect?
O People who neglect to become vaccinated
are 22 times more likely to become
infected than those who are vaccinated.
O Among unvaccinated school-aged (ages
3-10) children, the risk of measles is 62
times greater than among vaccinated
children.
O Infants and immunocompromised
individuals are especially susceptible as
well.
15. Pregnant with Measles
Case Study Information
O A case of a Japanese
woman who delivered in her
24th week of pregnancy was
recorded to have an infant
with a low birth weight and
was in respiratory distress.
O The infant received
surfactant therapy, and also
had her ductus arteriosus
(which closes on its own as
the heart develops further)
surgically closed.
O Pregnant women with
measles can occasionally
lead to death,
miscarriage, premature
birth, and low birth
weight.
O Human normal
immunoglobin (HNIG) is
believed to reduce
complications of the
disease
16. Global Eradication of Measles
O Three biological criteria are deemed
important for disease eradication:
1. Humans are the sole pathogen
reservoir
2. Accurate diagnostic tests exists
3. An effective, practical intervention is
available at reasonable cost
17. Global Eradication of Measles
O Recently, the threat of bioterrorism has
presented itself as an obstacle in the
possibility of the eradication of measles.
O The U.S. currently spends at least $45
million a year for the measles component
to the MMR vaccine.
O A recent estimate of 7 industrialized
countries’ cumulative annual savings
could be between $69 and $623 million.
18. Global Eradication of Measles
Compared to Other
Eradication Programs
O Five disease eradication
programs that pose
political, social, economic,
and other constraining
factors include yaws,
malaria, smallpox, guinea
worm, and polio.
O A potential measles
eradication program would
do better than the former
programs because of:
O Strong social and political
support
O Cost-effective
O Rigorous upfront
processes
O However, increasing
population density,
urbanization, and
wars and civil
conflicts will present
serious challenges.
O Measles eradication
will not be as difficult
as polio eradication if
the program has the
proper political,
social, economical,
and technical support.
19. References
O Castillo-Solorzano, C., Matus, C. R., Flannery, B., Marsigli,
C., Tambini, G., & Andrus, J. K. (2011). The Americas:
Paving the Road Toward Global Measles Eradication.
Journal Of Infectious Diseases, 204S270-S278.
doi:10.1093/infdis/jir166
O Go, H., Hashimoto, K., Imamura, T., Sato, M., Kawasaki, Y.,
Momoi, N., & Hosoya, M. (2010). An extremely low body
weight infant born to a mother with measles. Journal Of
Perinatology, 30(2), 146-148. doi:10.1038/jp.2009.111
O Keegan, R., Dabbagh, A., Strebel, P. M., & Cochi, S. L.
(2011). Comparing measles with previous eradication
programs: enabling and constraining factors. The Journal
Of Infectious Diseases, 204 Suppl 1S54-S61.
doi:10.1093/infdis/jir119
O McKenzie, J., & Pinger, R. (n.d.). Epidemiology: Prevention
and Control of Diseases and Health Conditions. In <i>An
introduction to community and public health</i> (Eight ed.,
pp. 108-109).
20. References
O Measles. (n.d.). Retrieved November 21, 2014, from
http://www.who.int/immunization/monitoring_surveillance/burden/vp
d/surveillance_type/active/measles/en/
O Measles Cases and Outbreaks. (2014, November 4). Retrieved
November 21, 2014, from http://www.cdc.gov/measles/cases-outbreaks.
html
O Measles (Rubeola). (2014, November 3). Retrieved November 21,
2014, from http://www.cdc.gov/measles/index.html
O Meissner, H., Strebel, P., & Orenstein, W. (2004). Measles vaccines
and the potential for worldwide eradication of measles. Pediatrics,
114(4 Part 1), 1065-1069.
O Moss, W. J., & Strebel, P. (2011). Biological feasibility of measles
eradication. The Journal Of Infectious Diseases, 204 Suppl 1S47-
S53. doi:10.1093/infdis/jir065
O Schub, E., & Caple, C. (2014). Measles in Adolescents and Adults.
O Watkins, J. (2011). Diagnosis, management and prevention of
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