Measles

Definition

Measles is an acute, highly contagious viral disease, primarily affecting children. It is also known as rubella (meaning red spots), and is characterized by fever, cough, sneezing, and a typical rash. Measles has high morbidity and mortality, especially in developing countries, and is associated with a febrile illness and maculopapular eruption.

• Acute viral disease caused by a paramyxovirus (RNA virus).

• Highly infectious, especially among children.

• Symptoms include fever, cough, sneezing, runny nose, and rash.

Epidemiological Factors

Understanding the epidemiology of measles is essential for its prevention and control.

• Causative organism: Paramyxovirus (RNA virus).

• Source of infection: Infected individuals (cases of measles).

• Infective period: Infectious 4 days before and 5 days after rash appearance.

• Incubation period: 10–14 days.

• Mode of transmission:

  • Nasopharyngeal secretions

  • Direct contact

  • Droplet infection (sneezing, talking)

• Age: Primarily affects children before school age.

• Gender: Both males and females are affected.

• Immunity: Infection confers lifelong immunity.

• Environmental factors: Virus can spread in any season; most cases occur during the dry season.

• Epidemics: Common during winter and early spring (January–April).

Risk Factors

Certain populations are at increased risk for measles infection and complications.

• Vitamin A deficiency

• Unvaccinated individuals

• Immunodeficiency

• Pregnant women

• Close contact with infected persons

Signs and Symptoms

Measles presents in distinct clinical stages, each with characteristic features.

1st Stage: Prodromal Stage

• Fever

• Nasal discharge

• Cough

• Conjunctivitis

• Koplik's spots: Small, red, irregular spots with blue-white centers on the oral mucosa and conjunctiva, appearing 1–2 days before the rash.

2nd Stage: Eruptive Stage

• Maculopapular rash first appears on the forehead and spreads downward over the face, beyond the ears, neck, and trunk.

3rd Stage: Postdromal Stage

• Weight loss

• Weakness

• Growth retardation

• Nutritional and metabolic effects

Diagnostic Evaluation

Diagnosis is based on clinical features and laboratory tests.

• Clinical signs and symptoms

• Koplik's spots

• Swab culture of nasopharynx

• Serology: High IgM antibodies confirm acute infection; IgG antibodies indicate immunity.

• Viral culture

General Measures and Treatment

Management of measles is primarily supportive, focusing on symptom relief and prevention of complications.

• Isolation: Isolate patient for at least 5 days after rash onset.

• Bed rest during fever and weakness.

• Hydration and nutrition: Encourage fluids and easily digestible, nutritious diet.

• Good ventilation: Provide fresh air, avoid chilling.

• Antipyretics for fever.

• Vitamin A supplementation:

  • 6–11 months: 100,000 IU orally, once daily for 2 days

  • 12 months and older: 200,000 IU orally, once daily for 2 days

  Reduces risk of eye damage and mortality.

Immunization and Prevention

• MMR vaccine (Measles, Mumps, Rubella): First dose at 9 months, booster at 16–24 months (as per national schedule).

• Post-exposure prophylaxis: Measles vaccine within 72 hours of exposure or immunoglobulin within 6 days for high-risk children.

Nursing Interventions

• Symptomatic care and respiratory isolation

• Provide dark room for photophobia

• Encourage adequate fluid intake

• Bed rest in humid and warmed room

• Strict isolation

• Oral and personal hygiene

Complications

• Diarrhea

• Otitis media

• Bronchitis

• Pneumonia

• Rarely: Seizures, blindness, encephalitis (inflammation of the brain)

Mumps

Definition and Introduction

Mumps is an acute, infectious viral disease caused by the mumps virus (an RNA paramyxovirus). It primarily affects the salivary glands, especially the parotid glands, and is transmitted via respiratory droplets.

• Causative agent: Mumps virus (RNA paramyxovirus)

• Target site: Parotid salivary glands

• Transmission: Droplet infection, saliva, nasal secretions, close contact

Epidemiological Factors

• Agent factor: Myxovirus parotids (RNA virus)

• Age and sex: Can occur at any age and sex, depending on immunity; most common in children aged 5–15 years

• Reservoir: Humans are the only natural host

• Incubation period: 14–21 days (2–3 weeks)

• Route of transmission: Respiratory route via droplets

• Environment: Higher incidence during winter

Pathophysiology

The mumps virus is transmitted via respiratory droplets, replicates in the nasopharynx and regional lymph nodes, and then spreads via viremia to multiple tissues, especially the salivary glands.

Risk Factors

• Unvaccinated individuals

• Immunodeficiency

• Close contact with infected persons

Signs and Symptoms

• Fever

• Cough

• Headache

• Sore throat

• Pain in ear, jaw, chin

• Loss of appetite

• Weight loss

• Swelling of parotid glands (characteristic sign)

Diagnosis

• Clinical signs and symptoms

• History collection

• Physical examination

• Buccal/oral swab

• Blood and urine tests

Management and Treatment

• Supportive management: Analgesics for pain, antipyretics for fever, fluid therapy for dehydration

• Isolation: Until symptoms subside

• Surveillance of contacts

• Encourage plenty of fluids

Nursing Interventions

• Droplet precautions

• Proper bed rest

• Assess for complications

• Maintain oral hygiene

• Apply warm or cool compresses to affected area

• Provide liquid diet

• Avoid citrus, spicy foods, candies

Prevention

• Do not share food or drinks

• Use masks to cover face

• Stay home when sick

• Maintain aseptic technique

• Clean and disinfect areas

• Immunization: Mumps vaccine (live attenuated, 0.5 ml IM), part of MMR vaccine

Complications

• Orchitis (inflammation of the testes, especially in post-pubertal males)

• Other complications: Meningitis, encephalitis, oophoritis, pancreatitis, hearing loss

Summary Table: Comparison of Measles and Mumps

Additional info: The notes have been expanded to include full academic context, definitions, and a comparison table for clarity. All key points from the original materials have been covered and organized for exam preparation.