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MEASLES

Measles Elimination our goal, Measles immunization day march 16

It is a highly contagious viral illness, a leading cause of death among children < 5 years of age

Causative agent- Measles virus( RNA virus of Paramyxoviridae family,Morbillivirus genus)
Infectious period-4-5 days before the appearance of the rash to 4-6 days after the onset of rash
Infectivity -90%of exposed susceptible individuals develop measles
Transmission- Direct & indirect contact and by droplet infection
Portal of entry -respiratory tract or conjunctivae
Incubation Period – 8-12 days

Clinical Features
Measles infection has 4 phases – Incubation period, prodromal ( catarrhal phase), eruptive phase & convalescent
phase
Prodromal ( catarrhal phase) – 3-5 days- high Fever, cough,rhinorrhea,,conjunctival congestion,photophobia,
Koplik spots
Erruptive phase – 3-5 days after the onset of disease, exanthem an erythematous, maculopapular, blanching
rash begins on the face& behind the ears and spreads to neck, trunk and extremities .It lasts for 4-7 days.
The rash starts fading from 3rd to 4thday,disappearing in the order of appearance,leaving behind a light brown
pigmentation.
Complications
Immediate - otitis media,Gaint cell Pneumonia, encephalitis, keratitis, hemorrhagic measles,superimposed
bacterial infection,activation of TB
Late neurological syndromes- subacute sclerosing panencephalitis
Diagnosis
Primarily clinical
Isolation of measles virus in culture or detection of measles virus RNA by RTPCR
serum measles IgM antibody, significant rise in serum measles IgG antibody
Differential diagnosis
Drug rash,
Kawasaki disease
IMN, Exanthem subitum, rubella
Treatment
No specific treatment
Isolation of patient,
Supportive treatment
Hydration& nutrition
Vitamin A administration
Treatment of complications
Prevention
Vaccination
MMR vaccine – 9,15- 18months, 4-6 years(IAP schedule)
MR vaccine – 9-12 months,16-24 months(NIS)
Passive protection- measles immunoglobulin

As we move towards last mile coverage for MR elimination, India is targeting a vaccination coverage of 95% with
two doses of MR vaccine .Outbreak -based surveillance to case-based acute fever and rash surveillance for MR
Elimination is being done across the country.

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