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Measles: Case Study

Measles: Case Study. Hiro Landazuri Karla Gonzalez Jonathan Chen. Case.

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Measles: Case Study

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  1. Measles: Case Study Hiro Landazuri Karla Gonzalez Jonathan Chen

  2. Case • An 18 yr old freshman complained of a cough, runny nose, and conjunctivitis. The physician in the campus health center noticed small white lesions inside the patient’s mouth. The next day, a confluent red rash covered his face and neck.

  3. Overview • Rubeola • Paramyxovirus - Morbillivirus • Negative-sense ssRNA • F (fusion) protein/H (hemoagglutanin) protein http://www.cdc.gov/vaccines/vpd-vac/measles/photos.htm

  4. Overview • Systemic infection • Respiratory transmission • Primary site of infection = nasopharynx • Primary viremia (2-3 days post exposure) • Secondary viremia (5-7 days post exposure) http://www.homehealth-uk.com/image_01/image/throatdiagram.gif

  5. Physical Diagnosis • The 3 C’s • Cough, coryza, conjunctivitis • Koplik’s spots • MV rash • Maculopapular • Macule – red lesion flushing • Papule – raised red lesion dermatlas.med.jhmi.edu

  6. Conjunctivitis Koplik’s Spots http://en.wikipedia.org/wiki/Conjunctivitis MV rash http://www.cdc.gov/vaccines/vpd-vac/measles/photos.htm

  7. Laboratory Diagnosis • Isolation of MV from clinical specimen • Serodiagnosis • IgM ab (ELISA) • IgG ab • ELISA, HI, Indirect flourescent ab test, microneutralization, plaque reduction neutralization, complement fixation

  8. Complement Fixation Assay Positive Negative http://web.indstate.edu/thcme/PSP/labtests/complementfix.htm

  9. Treatment • No treatment • Supportive Care Only • Tylenol, Non-steroidal anti-inflammatory drugs like Advil, Aspirin, Motrin etc. • Isolation • Vitamin K • Hydration • Post-exposure Prophylaxis • Antibiotics for serious complications (rare) Melissa Burnett, MD, Measles, Rubeola, EMedicine from WebMD, http://www.emedicine.com/derm/topic259.htm (Oct. 29, 2007).

  10. When was this patient contagious? • Course of the infection • Incubation 7-14 days • Initial symptoms immediately following incubation: cough, coryza, conjunctivitis, fever • Koplik’s spots 2-3 days after initial symptoms • Rash appears 4-5 days after the initial symptoms • Infection communicable four days before his rash appeared to four days after MayoClinic.com Tools for Healthier Lives, Measles, http://www.mayoclinic.com/print/measles/DS00331/DSECTION=all&METHOD=print (Oct. 29, 2007). Melissa Burnett, MD, Measles, Rubeola, EMedicine from WebMD, http://www.emedicine.com/derm/topic259.htm (Oct. 29, 2007).

  11. Why is this disease not common in the United States? • the United States is a developed country • most children are immunized with MMR (Measles Mumps Rubella) vaccination • required proof of MMR immunization • the Measles Initiative is working on standard global immunization for measles

  12. Several possible reasons for patient’s susceptibility to measles at 18 years of age. • if the patient did not receive MMR vaccinations • allergic reaction to component of MMR • recent studies have shown no direct correlation • poor healthcare • undeveloped countries without required MMR • linking of MMR and autism • studies lacked substantial scientific evidence • if patient did receive MMR vaccinations • may not have developed immunity • either way, patient was susceptible to measles and was exposed via • traveling • dorms/college campus

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