PRESBYTR TRIAN UNIVERSIT SITY OUTSPAN MEDICAL L COLLEGE B BY - PDF document

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. PRESBYTR TRIAN UNIVERSIT SITY OUTSPAN MEDICAL L COLLEGE B BY P.K.K K.KUBAI CLINICIAN/ANA NAESTHETIST/MPH EXP XPERT

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. MCP 211 C CT. COMMO COMMO ON VIRAL ON VIRAL CONDI DITIONS

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Definition n An acute systemic vir viral infection transmitted by inhalation of infect by inhalation of infect ective droplets of measles ective droplets of measles virus

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Epidemiology n Highly infectious dise isease n Humans are the only Humans are the only ly reservoir ly reservoir n Average incubation p period 10-12 days, varying from 7- - 18 days from exposure to onset of fever.

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. § Direct contact with nasa asal or throat secretions of infected persons. § Spreads slightly before re the onset of symptoms to 4 days after the appear arance of rash. § All people who have no not had the disease or not immunized are suscept immunized are suscept ptible. ptible.

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Reported cases Vs un unvaccinated children 2500 2100 2000 1877 1677 1500 1500 1344 1344 134 134 1344 1344 1243 1200 1000 500 0 2002 2003 2004 20005 2006 2007 2008 2009 Reported measles cases Confirm irmed measles cases Unvaccinated children

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Incidence n Its highest incidence ce is in young children and once infected with me once infected with me measles one acquires measles one acquires permanent immunity ity (natural immunity)

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. . n Its more virulence (co (communicability) is greater during eruptio tion/rapturing stage or as long as the rash rema mains

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Common Charac racteristic n Kopliks spots- unique ue spots on mucous membrane esp. on bu buccal cavity n Conjunctivitis – inflam lamed conjunctiva n Cough n Cough n Coryza/flu n Rash- maculo papura ura in character ****KC3R

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Mode of Transmiss ission the infection (moi) n Route nasal – pharyn rynx by the infective droplets from an infe fected person during crying, sneezing and nd oughing

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Key Information to Key Information to to Collect on to Collect on Suspected Measles Suspected Measles les Cases les Cases Person � Age � Measles vaccination ion status Time � Date of rash onset Place � Residence at onset et � Potential exposures es (places, persons)

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Measles Disea ease n . Cough OR Maculopapular Fever Runny nose (Coryza) + + Rash + + OR OR Red eyes (Conjunctivitis) OR OR Clinician Susp uspects Measles

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Clinical manifest festations v Divided into various stag ages q Prodromal Phase v High fever v Cough, v runny nose (coryza) an and/or v red eyes (conjunctivitis itis)

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Clinical Course of M Clinical Course of M f Measles f Measles . Prodrome Rash Incubation Period (about 4 days) (about 4-8 days) (7-18 days before Rash) +1 + +1 + -18 -17 -16 -15 -14 -13 -12 -11 -10 -9 -18 -17 -16 -15 -14 -13 -12 -11 -10 -9 -8 -8 -7 -7 -6 -6 -5 -5 5 5 -4 -4 -3 -3 -2 -2 -1 -1 0 0 +3 +3 +4 +5 +6 +7 +8 +4 +5 +6 +7 +8 2 Communicable Period Rash minus 18 Rash minus 4 Rash plus 4 days is earliest days is probable days is probable Onset of rash possible start of end of exposure date infectiousness infectiousness

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Catarrhal stage o e of measles Its characterized by: n q Catarrhal Rash v Onset 2-4 days after onset et of prodrome v Incubation period: 14 days s (range, 7-18 days) v Red, blotchy (maculopapula ular) v Moves from face to trunk of of body, then to arms/legs v Lasts 5-6 days v Fades in order of appearan ance Common S/S in this stage q Coryza – occurs between day 2 y 2 -4 /7 after infection (range ) 1. Conjunctivitis which may have e secondary bacterial infection 2. Running nose 3. Apathy/malaise 4. Fever 5.

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. . n Most of the time this s is stage passes unnoticed because the s/s are li e like for other disease except for Kopliks spo except for Kopliks spo spots – Nb. they are spots – Nb. they are greyish, white dots us usually like grains of sand/table salt, reddis dish and sometimes haemorrhagic on the the palate/buccal cavity

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. NB: n Kopliks spots may als also appear on the 1. Cheeks 2. Conjunctiva folds 3. Vagina mucous mem 3. Vagina mucous mem embranes embranes 4. The tongue will be c e coated with reddish grains on the margin gins 5. Lymphadenopathy is is common 6. Followed by fever (4 r (40 – 41 Oc ) and rash -

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Measles Rash n Begins as faint macu cules n Starts from lateral sid side of the neck/head along the hairline n Post auricular / cheek n Post auricular / cheek eks eks n Individual lesions late ater changes to macular – papular rash n Then it later spreads ds to the whole face, neck then upper limbs, che hest abdomen , back and lower limbs

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. NB n Rash which appears rs first on face and necks fades off by 2-3/7 n Itching may occur as as it fades off n The rash affects all b n The rash affects all b l body systems i.e. l body systems i.e. externally and interna rnally

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Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. S/E/REVIEW or or Regional Exam n P/A – splenomegally lly may be an evidence in some patients GIT – Symptoms - d diarrhea and vomiting are n common common n R/S: Are common w with assoc. complications like Otitis media and d pneumonia n Lab. CBC – Low WBC BCS with lymphocytosis

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. DXX n Purely by hx and exa xamination n Throat swab for lab b but it rarely yields the virus because of late te diagnosis or lack of it

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Differential Diag iagnosis (DDX) DDX of measles are d e diseases which present with with ith RASH ith RASH

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Dengue Measle les Other Viral Exanthems Rubella Kawasaki Rash Rash h h Illness Scarlet Fever Meningococcemia Toxoplasmosis Mononucleosis Roseola Infantu tum

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. GERMANY MEAS ASLES (RUBELLA RASH) n Common in pregnant nt women and usually very severe and fatal tal n Mild and transient in n in non pregnant women n The rash has same a n The rash has same a appearance and pattern appearance and pattern but no constitutional s al signs and symptoms like in measles morbili i.e i.e. fever , diarrhoe, conjunctivi tivitis and vommiting

Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. Complications of s of Measles Morbili n Common in malnouris urished children because of their weak immune ne system/HIV or ISS n In normal children the there may be non because they have antibodies they have antibodies es from their parents es from their parents 1. Head Structures – a) Conjunctivitis – ulce lcerations/neuritis/blindness Otitis Media – Bact acterial infxn may occur b)