Measles Virus

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Introduction

The measles virus is one of the most infectious viruses.

A brief case (1-2 sentences) with 2-3 questions (no answers) to prompt thinking by students.

worldwide occurrence
vaccination has made North American epidemics rare, though a slight increase in the 1980's was due to the need for a 2nd dose
incidence greater during winter months

Morbillivirus

Measles is spread by direct droplet contact and likely airborne routes.

Incubation is 10-14 days. Patients are infectious for 4 days pre-rash.

Prodromal symptoms include the three C's - conjunctivitis, cough, coryza.

Signs and symptoms of infection include:

maculopapular rash evolves from face and hairline before spreading to trunk and extremities.
Koplik spots (little sugary spots on mucosa next to molars) are present for 1-2 days before and after the rash
fever

Complications are common in very young and in older kids and young adults, including:

encephalitis
ataxia
seizures
coma
subacute sclerosing panencephalitis is rare (1:100,000) but can manifest years later as a slow, progressive cerebral deterioration, with death occurring within 6-12 months

Mortality is increased with malnutrition, especially vitamin A.

Secondary bacterial infection, including: