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MEASLES (CAMPAK)

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Introduction

Measles = morbili = rubeola

Acute and highly contagious viral disease

Near universal infection of childhood in

prevaccination eraSerious complications involving the gastrointestinal

respiratory tracts and CNS occur in 5-15% patients inhighly developed countries

he !idespread use of live attenuated measles virusvaccine follo!ed by a sharp decline in the incidenceof the disease

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P A R A M Y X O V I R U S ( R N A )

R A P I D L Y I N A C T I V A T E D B Y H E A T A N DC O L D A N D U L T R A V I O L E T L I H T

Measles virus

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"vervie! # $irologi

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athology

&yperplasia of the lymphoid tissue in the tonsils'adenoids' lymph nodes' spleen and appendi(

)arge *1++ ,m multinucleated giant cells in the

pharyngeal and bronchial mucosaSuringa et al *1./+ 0opli2s spots and the sin

lesions of measles # syncytial epithelial giant cells 3ntercellular and intracellular edemaaraeratosis and dyseratosis

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C!inic"! M"ni#$%t"tion

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Measles virus is transmittedvia droplets and infects epithelialcells of the nose and con4unctivae $irus multiplies in theseepithelial cells and then e(tends to the regional lymph nodesrimary viraemia occurs 6 to 7 days after infection' andmeasles virus continues to replicate in epithelial and

reticuloendothelial system tissue over the ne(t fe! days

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Secondary viraemia occurs on days 5 to /' andinfection becomes established in the sin and othertissues including the respiratory tract on days / to11

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he prodromal phase' !hich lasts 6 to 8 days' occurs at thistime !ith fever' malaise' cough' cory9a' and con4unctivitis0opli:s spots may develop on the buccal mucosa about 1 to 6days before the rash and may be apparent for 1 to 6 days afterrash onset

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he rash then develops at about 18 days afterinfection; at this time virus can be found in blood'sin' respiratory tract' and other organs

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M$"%!$% Ko&!i' S&ot

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Measles 0opli Spot

INLESSVER INCREASE

PAINULLEVER DECREASE

&>AN?3NA or &

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>ash

6-8 days after prodrome' 18 days after e(posure

Maculopapular' becomes confluent

egins as erythematous macules behind the ears and

on the nec and hairlinehe rash progresses to involve the face' trun and

arms !ith involvement of the legs and feet by theend of the second day

ersists 5-B days

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Mori!i#or* R"%+

E"r!, R"%+ L"t$%t R"%+

CONVALESENTRASH

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Di"-no%tic $."!u"tion

0opli2s spots # appear early and pathognomonic

C@C # ?enerali9ed maculopapular rash of at least 7 days2 duration

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Mortalitas# measles pneumonia

A .-year-old boy presented !ith fever'rash' cory9a' and photophobia hroatcultures !ere negative "ver the ne(t 8days the rash !orsened significantlyand the boy developed a dry baringcough and difficulty breathing &e died11 days after the rash initially appeared

hroat cultures' blood cultures' and sputum cultures all failedto gro! pathogenic bacteria @ !as negative and there !asneither caseaous necrosis nor granulomas in his lungs

http#DDpathmicromedsceduDpathology%6+imagesD)>3-aring-coughhtm

http://pathmicro.med.sc.edu/pathology%20images/LRI-Barking-cough.htmhttp://pathmicro.med.sc.edu/pathology%20images/LRI-Barking-cough.htmhttp://pathmicro.med.sc.edu/pathology%20images/LRI-Barking-cough.htmhttp://pathmicro.med.sc.edu/pathology%20images/LRI-Barking-cough.htm

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Tr$"t*$nt

&umidification of the patient2s room may benecessary for laryngitis or an e(cessively irritatingcough

3t is best to eep the room comfortably !armrather than cool

Avoid e(posure to strong light during the period ofphoto-phobia

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http#DD!!!!hointDmediacentreDfactsheetsDfs6BDenD

http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/

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An adeFuate fluid intae should be maintained toprevent dehydration

Administer antipyretics to reduce high fever

*Salicylate must be avoided as this !ill increase theris of developing >eye2s syndrome

http#DD!!!!hointDmediacentreDfactsheetsDfs6BDenDT"t"n-0ustiman Samsi' M@ E"? MA>-A>1...

http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/http://www.who.int/mediacentre/factsheets/fs286/en/

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$itamin A arclay et al *1./ and &ussey G 0lein *1..+ # striing

beneficial effects of giving vitamin A to children !ith severemeasles

8++'+++ 3H !ithin 5 days of onset of rash I&" recommended vitamin A supplementation for all

children in regions # $itamin A deficiency e(ists

Measles mortality rate is 1% or higher

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encegahan

3munisasi 3munisasi campa MM>

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emahaman tentang $asinasi Campa' Ead!al

erapa ali seorang ana harus mendapat

imunisasi Campa JJ

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T$ri*" K"%i+