MEASLES

• Measles


  Acute contagious and exanthematous disease that usually affects children who are susceptible to Upper Respiratory Tract Infection (URTI)
• Other Terms


  Rubeola / Morbili / 7-day Measles
• Etiologic Agent


  • Filterable virus of Measles (Paramyxoviridae)
• Source of infection


  Secretions of nose and throat of infected persons
• Mode of Transmission


  1. Droplet Spread / Direct Contact with Infected person

  2. Indirect Contact (articles with secretions)

  3. Airborne
• Incubation Period


  1. 2 weeks
• Period of Communicability


  Starts just before the prodrome and lasts until 4 days after the rash appears
• Clinical Manifestations


  1. Koplik spots-pathognomonic sign

  2. Pre-eruptive Stage: Fever, Catarrhal Symptoms (cough, conjunctivitis, coryza), Photophobia, Stimson's line (red line on the lower conjunctiva)

  3. Eruptive Stage: Maculo-papular rash, High grade fever, Anorexia and irritability, Throat is red and extremely sore

  4. Convalescence Stage: Rashes fade away, Fever subsides, Desquamation begins, Symptoms subside and appetite is restored
• Diagnostic Procedures


  • Nose and Throat Swab
  • Urinalysis
  • Blood exams (Single raised IgM or rise on IgG)
• Treatment Modalities


  • Anti-viral drug (Isoprenosine)
  • Antibiotics
  • Oxygen Inhalation
  • IV fluids
• Complications


  • Bronchopneumonia
  • Otitis Media
  • Pneumonia
  • Nephritis
  • Encephalitis
• Nursing Management


  1. Isolation: Maintain standard and airborne precautions, Place the patient on a negative pressure room

  2. Tepid Sponge Bath (TSB)

  3. Skin care

  4. Oral and nasal hygiene

  5. Eye care (photosensitivity)

  6. Ear care

  7. Daily elimination (Mild laxative)

  8. During febrile stage, limit the diet to fruit juices, milk, and water

  9. Give medication as ordered by the physician (Penicillin)
• Preventive Measures


  • Immunization with: Anti-measles at the age of 9 months as a single dose, MMR vaccine (15 mos.); 2nd dose (11 to 12 years old)
  • Measles vaccine should not be given to pregnant women, or to persons with active tuberculosis, leukemia, lymphoma or depressed immune system