Measles: Difference between revisions
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*10d incubation period | *10d incubation period | ||
*3d prodromal period | *3d prodromal period | ||
===Current Outbreaks=== | |||
*2/14 | |||
**14 known measles cases in California | |||
**5 of the patients recently traveled to the Philippines or had contact with international travelers | |||
**the majority of patients were unvaccinated | |||
**a recent outbreak in the Philippines has resulted in over 20 deaths and thousands of cases | |||
==Diagnosis== | ==Diagnosis== | ||
*URI symptoms: high fever, cough, conjunctivitis | *Begins with URI symptoms: high fever, cough, coryza, and conjunctivitis | ||
* | *Koplik's spots may appear in 2-3 days after onset of symptoms | ||
**Pathognomonic enanthem | |||
** | **Tiny red spots (base) with bluish-white centers on the mucosa of the cheek or palate | ||
** | *Then rash (begins day 4 - lasts to day 7) | ||
** | **red, blotchy, and maculopapular; rapidly progresses to confluence | ||
** | **Usually starts on the face (hairline and behind the ears) | ||
*** | **Rapidly spreads to the chest, back, and finally the legs and feet | ||
*** | *Obtain a history of measles immunization, travel outside of the Americas, or contact with international travelers in recent weeks. Simple community transmission is also possible. | ||
==Work Up== | |||
*Usually you need (check with your lab): | |||
**1-2 ml blood in a red-top tube | |||
**throat or nasopharyngeal swab using a viral culturette with viral transport media | |||
**10-40 ml of urine in a sterile container. | |||
==Management== | |||
*ALERT YOUR LOCAL HEALTH DEPARTMENT ASAP | |||
**The risk of measles transmission to others and large contact investigations can be reduced if control measures are implemented immediately. | |||
===Post-Exposure Prophylaxis=== | |||
*Can be administered to contacts | |||
*Checking with your local health authorities | |||
**Within 72 hours of exposure use MMR vaccine | |||
**Up to 6 days after exposure use IM immune globulin | |||
===Infectious Precautions=== | |||
*For suspected patients | |||
**MASK the patient and ISOLATE immediately in an airborne infection isolation room | |||
**All personnel entering the room should use respiratory protection at least as effective as an N95 respirator | |||
**If possible, allow only personnel with documentation of 2 doses of live measles vaccine or laboratory evidence of immunity (measles IgG positive) to enter the room | |||
**Do not use the room for at least 2 hours after the patient leaves. | |||
==See Also== | ==See Also== | ||
[[Rashes (Peds)]] | [[Rashes (Peds)]] | ||
==Source== | |||
*VEP HEALTH ADVISORY 2/25/14 | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Derm]] | [[Category:Derm]] | ||
[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 01:58, 26 February 2014
Background
- 10d incubation period
- 3d prodromal period
Current Outbreaks
- 2/14
- 14 known measles cases in California
- 5 of the patients recently traveled to the Philippines or had contact with international travelers
- the majority of patients were unvaccinated
- a recent outbreak in the Philippines has resulted in over 20 deaths and thousands of cases
Diagnosis
- Begins with URI symptoms: high fever, cough, coryza, and conjunctivitis
- Koplik's spots may appear in 2-3 days after onset of symptoms
- Pathognomonic enanthem
- Tiny red spots (base) with bluish-white centers on the mucosa of the cheek or palate
- Then rash (begins day 4 - lasts to day 7)
- red, blotchy, and maculopapular; rapidly progresses to confluence
- Usually starts on the face (hairline and behind the ears)
- Rapidly spreads to the chest, back, and finally the legs and feet
- Obtain a history of measles immunization, travel outside of the Americas, or contact with international travelers in recent weeks. Simple community transmission is also possible.
Work Up
- Usually you need (check with your lab):
- 1-2 ml blood in a red-top tube
- throat or nasopharyngeal swab using a viral culturette with viral transport media
- 10-40 ml of urine in a sterile container.
Management
- ALERT YOUR LOCAL HEALTH DEPARTMENT ASAP
- The risk of measles transmission to others and large contact investigations can be reduced if control measures are implemented immediately.
Post-Exposure Prophylaxis
- Can be administered to contacts
- Checking with your local health authorities
- Within 72 hours of exposure use MMR vaccine
- Up to 6 days after exposure use IM immune globulin
Infectious Precautions
- For suspected patients
- MASK the patient and ISOLATE immediately in an airborne infection isolation room
- All personnel entering the room should use respiratory protection at least as effective as an N95 respirator
- If possible, allow only personnel with documentation of 2 doses of live measles vaccine or laboratory evidence of immunity (measles IgG positive) to enter the room
- Do not use the room for at least 2 hours after the patient leaves.
See Also
Source
- VEP HEALTH ADVISORY 2/25/14