麻疹(英文)

Typical clinical manifestations
2.Prodromal stage: 3-4days
The magnitude and pattern of fever are variable in patients, from a low-grade to moderate fever or a sudden high fever may occur. They are not specific symptoms for measles, which are identical to a common cold but catarrhal symptoms maybe more severe.
4.Epidemic features： features：
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Epidemiology
Routes of transmission
Droplet spray
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
The prodrome develops on the day symptom begins (fever) and lasts until rash appear.
Fever Cough Coryza Conjunctivitis Koplik’s spots
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Pathophysiology
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Pathophysiology
Measles virus
Respiratory epithelium regional lymph nodes First viremia Monocytes/Macrophage Second viremia Respiratory tract, conjunctiva, skin, etc Virus elimination
Typical manifestations
Atypical manifestations
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations Incubation stage: 10-14days Prodromal stage: 3-4days
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations Exanthem stage: 3-5days
Maculopapular rash: rash: Fever: temperature rises abruptly Catarrh: Other manifestations: enlarged lymph
Pathology – Cytopathic change
Multinucleated giant cell (Warthin(Warthin-finkeldey giant cells)
Φ= 100µm, several
nucleus inside the cell, formed by confluence of several virus infected reticuloendothelial cells In smears of the nasal mucosa in the prodromal stage
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations
Maculopapular rash
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
麻
疹
பைடு நூலகம்
MEASLES
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Key points
MEASLES
Acute respiratory infectious disease caused by measles virus clinical feature: Fever, Cough, Runny nose, Conjunctivitis, Exanthem Specific sign: Koplik’s Spots (a kind of enanthem )
nodes, slight splenomegaly, gastrointestinal symptoms such as diarrhea and vomiting
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations
Typical clinical manifestations
typical facial appearance of measles in prodromal stage
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations
Epidemiology
Epidemic Features
Prior to the use of vaccine Morbidity (1/100000) Peak season
Major epidemics: 500-1000 Mild epidemics: 400 In winter and spring
1200 1000 800
595
600 400
493 383 293 250 192 195 152 139 110 155 120 112 22 13 7 21 297
200 0
1960
00 10 64 68 72 76 80 84 88 92 96 2000 03 DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
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Major epidemics appear by Epidemic cycle 2-4 yr intervals
Age Clinical manifestations
6m-5y (98%<10y) Typical cases severe manifestations more complications high mortality
2. Prodromal period 3-4 days 3.Apparent manifestation period 3-5 days 4. Convalescent period 3-5 days
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1. Incubation period 10-14 days
Pathology
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Pathology – skin
Red maculopapule
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Clinical manifestations
DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
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Epidemiology Measles cases of in-patients in CHCUMS in2000
麻疹病例数
1728
1800 1600 1400
1125
Measles Vaccine Inoculation in whole China (1968)
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Pathogen
measles virus
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Epidemiology
1.Infectious 1.Infectious sources ： Measles
DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Typical clinical manifestations
appearing sequence of the rash
It become increasingly maculopapular as the rash spreads rapidly over the entire face, neck, upper arms, and upper part of the chest 27 within approximately the 24hr.
acute stage patients in
2.Routes transmission： 2.Routes of transmission： Droplet spray 3.Population susceptibility： 3.Population susceptibility：
It is susceptible to all the people without infection or inoculation. The age of peak incidence was 6 months to 5 years old. The incidence of baby under 6m is lower.
Fever
Cough Coryza
Conjunctivitis
Koplik’s spots.
May suggest measles before
Koplik’s Spots: Pathognomonic sign
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
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DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY
Pathogen
Classification: Classification A RNA virus Genus: morbillivirus Family: paramyxoviridae Serotype: Only one Location: Nasopharyngeal secretions, Blood, Urine of patients
PATHOGNOMONIC FOR MEASLES
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Pathology – Cytopathic change
Multinucleated giant cell
PATHOGNOMONIC PRESENTATION FOR MEASLES
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Pathology
• Respiratory tract • Skin • Koplik’s spots
Typical clinical manifestations
appearing sequence of the rash
The rash usually starts on the upper lateral parts of the neck, behind the ears, along the hairline, and on the posterior parts of the cheek. 26
After the use of vaccine
9.5 in 1990 In any time of a year Epidemic cycle disappeared, Sporadic cases increased Below 6m and above 5y Atypical cases mild manifestations less complications rarely death