Measles is a viral infection characterised by Koplik spots during the prodome and rash during the active infection. It is diagnosed clinically and confirmed by serology or RT-PCR. It is treated supportively.

Pathophysiology

• Paramyxovirus infection
• Spread by respiratory secretions until rash desquamates

Contextual Factors

• Unvaccinated
• 134000 deaths annually, oftne due to complications such as pneumonia

Clinical Manifestation

Prodrome

• Fever
• Coryza
• Hacking cough
• Tarsal conjunctivitis
• Koplik spots - looks like grains of white sand surrounded by red areolae

Active Infection

• Macular rash originating at the ears and side of neck
  • Develops papules
• Rash spreads to trunk and extremities including palms and soles
  • Fades from face
• Severe: petechiae or ecchymoses

Complications

• Pneumonia
• Acute thrombocytopenic purpura
• Encephalitis
• Transient hepatitis
• Subacute sclerosing panencephalitis (SSPE)

Diagnosis

• Clinical (findings of Koplik spots or rash with correlative history)
• Lab testing required for public health tracking
  • Serology
  • Viral culture or RT-PCR

Treatment

• Supportive care
• Isolation for 4 days after rash development
• Vitamin A