Measles:a preventable disease.

Measles is a common and serious exanthamatous illness,which still causes 350,000 childhood deaths annually in develop ing countries.
The disease is common in preschool children and occur in all season,mostly in spring and winter.

It has a worldwide distribution Both sexes are equally susceptible.The disease is rare in the 1st 6 months of life due to passive protection received from the mother.
Measles is caused by an RNA virus belonging to the Paramyxovirus family.
Spread of the disease is by direct contact or by droplet spread from the secretion of the nose or throat.The maximum infectivity is in between 4days before and 5 days after the appearance of rash.
Clinical features:-
The incubation period varies between 8-12 days.
The onset of illness is rapid with fever,malaise and irritability. There is coryza ,dry cough,watery eyes.

The child may improve after 3 days but again begin to deteriorate after appearance of rashes.Rashes appear in 4-7 days of illness.It is accompanied by sharp temperature rise ,increased respiratory rate and crepitation in chest.Rash first appear in forehead ,behind the ears and along the hair margins.Whithin 12-48 hours it spreads rapidly over the face ,neck ,trunk and limbs.The rash is maculopapular .Itching is rare.
Koplik's spot is a pathognomonic sign of measles.It is small table salt crystal like blueish white lesions in the buccal mucosa opposite the molar teeth.It appears usually two days before the apprearence of rashes.

The rash disappears in the sequence of its appearance.It leaves behind a brownish staining and desquamation.

Complications:-
Measles leaves behind many complications like otitis media ,pneumonia ,encephalitis ,laryngitis ,measles diarrhea .It may also lead to fatal condition like subacute sclerosing panencephelaitis (SSPE) rarely.

Treatment:-
Measles is a self limiting disease.It only require supportive treatment comprising of antipyretics,proper hygiene ,adequate fluid and caloric intake and humidification.
Vitamin A solution should be given in single oral dose of 100,000 IU(below 1year) and 200,000(over 1year).
Complications should be managed appropriately .

Image source- www.cdc.gov
Prevention:-
It is most important strategy of measles treatment .
It is and should be widely practised.
Two doses of vaccine is given in India
One dose given at 9 completed months and 2nd dose is given on 12-15 months
Dose,Route,Site - 0.5ml,subcutaneous,Right upper arm.
Post exposure prophylaxis done by passive immunization of susceptible individuals with immunoglobulin.