🔍 Look for Koplik's spots - tiny white lesions on a red background (like grains of salt). They are pathognomonic for measles. ⚰️ Fatality rates vary: - ~1 per 1000 in otherwise healthy people in developed countries 🌍. - Up to 10% in underdeveloped nations with malnutrition/poor healthcare 🍚. - ~30% in immunocompromised patients (very high risk) ⚠️.

ℹ️ About

📈 Epidemics occur every 2–3 years.
⏳ Incubation: 8–14 days.
💉 Vaccination + herd immunity = key prevention.

🦠 Virology

RNA paramyxovirus → highly infectious.
Spread by aerosols 😷.
👶 Neonates (up to 6 months) protected by maternal IgG.

⚰️ Mortality Rates

Developing countries & immunocompromised: up to 25%.
Developed countries: ~0.1% (1 per 1000).

🌍 Epidemiology

📑 Notifiable disease in the UK.
One attack → lifelong immunity 🛡️.

🩸 Measles Rash

🔍 Koplik Spots in Oral Cavity

🩺 Clinical

Fever 🌡️ ≥3 days + “4 Ks”: Cough, Coryza 🤧, Conjunctivitis 👀, Koplik’s spots.
Maculopapular rash: starts on face → spreads downwards. Blotchy, red, blanching → brownish later.
General lymphadenopathy, seizures/convulsions possible.
Infectious until 5 days after rash appears ⚠️.

⚠️ Complications

💩 Diarrhoea, pneumonia (bacterial 5%, giant cell in immunocompromised).
🧠 Encephalitis: 1 in 1000; inclusion-body encephalitis (immunocompromised); SSPE (1 in 100,000, delayed 7 years).
👁️ Corneal ulceration/scarring → blindness.
👂 Otitis media, ❤️ Myocarditis, Pericarditis.
More severe in adults 🚶‍♂️.
In malnourished: cancrum oris, fatal diarrhoea/pneumonia.
Acute disseminated encephalomyelitis (ADEM).

🚨 More Severe Illness

Pregnancy 🤰: pneumonitis, hepatitis.
Vitamin A deficiency, malnutrition 🍚, elderly 👵.
Neonates once maternal Ig wanes 👶.

🔎 Investigations

📊 Fourfold rise in acute/paired sera for IgM/IgG.
💉 Serum/saliva measles IgM or IgG.

🛡️ Prevention

MMR (live attenuated): 13 months + preschool booster 💉.
Herd immunity essential (95%+ coverage).
Human immunoglobulin can be given post-exposure in high-risk patients.

💊 Management

ABCDE, IV fluids 💧.
Antibiotics if proven secondary bacterial infection 🦠.
Vitamin A supplementation in children (reduces mortality).
Severity increases with age ⏳.
Consider post-exposure prophylaxis (IgG or MMR) in high-risk groups after specialist advice.

📷 Useful Links

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Measles (notifiable)