Rubeola/measles相关

Dr.Faust

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enveloped -ssRNA virus
Robeola (ola, 好麻啊)/cough--ola

Koplik spots with 3Cs (cough, coryza/鼻塞, conjunctivitis)
subacute sclerosing panencephalitis (after years), poor prognosis

A highly contagious airborne infectious disease

Can spread to vaccinated children
Vaccine 95% effective

Signs and symptoms
Onset: 10--14 days after exposure

Classic symptoms:
four-day fever
         temperature tends to be high (≥ 39°, a range of 40 to 41° can be common), especially compared with other common pediatric diseases
3Cs prodrome
maculopapular itiching rashes
         appear after 2--4 days after first onset/fever of symptoms, may last up to 8 days
         Starts at head → spreads to feet (Cephalocaudal rash)
Rashes reslove after about 3 weeks with color change (from red to brown)

rubeola--long lasting rash after the onset of high fever?
roseola--short lasting rash after the abatement of fever?

Koplik spots--small white spots which are commonly seen inside of oral cavity.
(inner aspect of cheeks, opposit the molars)
Koplik spots are temporary leisions that might be diagnositic but not commonly seen.

Complications
Diarrhea, pneumonia (primary or secondary), bronchitis, otitis media, acute encepahlitis, corneal ulceration and scarring

Rare complications
Measles encephalitis
Subacute sclerosing panencephalitis (SSPE) - YEARS after
         Personality changes, odd behavior, dementia
Giant cell pneumonia
         Immunocompromised
         Multinucleated giant cells in lung tissue

30% mortality in patients with AIDS

早夭SSPE, 不打疫苗人麻了

Pathophysiology
Respiratory epithelium
CD46 (all nucleated cells)
CD150/SLAM (B,T cells, APCs)
nection-4
Lung
H-protein (hemagulutinin)
F-protein
一一一
local lymph nodes (whole body)
DC, Mfs

Diagnosis
History
Fever over 3 d, with at least one of 3Cs

Lab tests:
+measles IgM antibodies
Measles RNA virus from respiratory specimens
Salivary measles-specific IgA

Treatment
no specific anti-viral therapy
supportive care mainly
management to complications

Possible therapies:
Vitamin A
Ribavirin



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