Epidemiology & Control Measures of Measles.pptx

It is an acute highly infectious disease of childhood caused by a specific virus of the group myxovirus.
One of the top five causes of vaccine-preventable deaths in the world
Easy to prevent – the vaccine costs less than US$1 and gives life-long immunity
Found in every part of the world – measles outbreaks have taken place on every continent and in all climates
One of the most contagious diseases – 90% of those exposed to the measles virus will catch it if they do not have immunity

1. EPIDEMIOLOGY & CONTROL MEASURES OF MEASLES Professor Dr. AB Rajar, MBBS, Dip-Diab, MPH, Ph.D. CPHE Director of Research and Innovative Center [IBN-E-SINA UNIVERSITY]

2. After one hour lecture the students will be able to understand the: Define measles and mention key facts Describe the importance of the agent, host, and environmental factors of measles. Describe the preventive and control measures for measles. LEARNING OBJECTIVES

3. Even though a safe and cost-effective vaccine is available, in 2018, there were more than 140 000 measles deaths globally, mostly among children under the age of five. Measles vaccination resulted in a 73% drop in measles deaths between 2000 and 2018 worldwide In 2018, about 86% of the world's children received one dose of the measles vaccine by their first birthday through routine health services – up from 72% in 2000 . During 2000- 2018 , measles vaccination prevented an estimated 23.2 million deaths making the measles vaccine one of the best buys in public health. KEY FACTS

4. INTRODUCTION

5. One of the top five causes of vaccine-preventable deaths in the world Easy to prevent – the vaccine costs less than US$1 and gives life-long immunity Found in every part of the world – measles outbreaks have taken place on every continent and in all climates One of the most contagious diseases – 90% of those exposed to the measles virus will catch it if they do not have immunity INTRODUCTION

6. Definition : It is an acute highly infectious disease of childhood caused by a specific virus of the group myxovirus. MEASLES

7. AGENT FACTORS : Agent : RNA Paramyxovirus. Source of Infection : A case of measles. Infective Material : Secretions of the nose, throat & respiratory of a case of measles during the prodromal period & the early stages of the rash. Period of Communicability : 4 days before & 5 days after the appearance of the rash EPIDEMIOLOGY

8. MEASLES VIRUS

9. EPIDEMIOLOGY

10. HOST FACTORS: Age: 1=B/W 6 months & 3 years of age in developing countries. 2= Over 5yrs in developed countries. Sex : incidence is equal. Immunity : No age is immune, however, one attack confers lifelong immunity. Nutrition : Measles tend to be very severe in the malnourished child. Time: The measles virus can spread during any season but is most prevalent from January to April. EPIDEMIOLOGY

11. MODE OF TRANSMISSION : Direct: From person to person by droplet infection & droplet nuclei. Indirect: Through articles freshly soiled with nasal & throat secretions. Portal of Entry : Respiratory tract. Incubation Period: It varies from 10-14 days, in most cases, it is 10-11 days. EPIDEMIOLOGY

12. CLINICAL FEATURES

13. C/F of Measles

14. PRODROMAL STAGE : Characterized by Fever, Redness of the eye, Lacrimation, Photophobia, Vomiting, and Diarrhea. KOPLICK’S SPOTS :( Pathognomonic sign of measles ) It occurs a day or 2 before the appearance of the rash. It appears on the buccal mucosa opposite the first & second upper molars. They are small, bluish-white spots on a red base smaller than the head of the pin. CLINICAL FEATURES

15. MEASLES - Koplik’s spots

16. ERUPTIVE STAGE : This phase is characterized by a typical, dusky-red, macular or maculopapular rash, which begins behind the ears, spreads rapidly in a few hours over the face & neck, extends down the body taking 2 to 3 days to progress to the lower extremities. In absence of complications disappear in another 3 to 4 days in the same order of appearance leaving a brownish discoloration that may persist for 2 months or more. CLINICAL FEATURES

17. ERUPTIVE STAGE

18. PATHOGENESIS

19. POST-MEASLES STATE: Growth retardation Susceptibility to other infections Pneumonia (20-80%) Diarrhea Pyogenic infections candidiasis, and reactivation of pulmonary tuberculosis. CLINICAL FEATURES

20. TREATMENT

21. Isolation for 7 days after the onset of rash No specific antiviral treatment. Suppurative care : good nutrition, adequate fluid intake, and treatment of dehydration. Antibiotics : to treat eye and ear infections, and pneumonia TREATMENT

22. All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. Vitamin A can help prevent eye damage and blindness. Vitamin A supplements reduce the deaths from measles by 50% . TREATMENT

23. COMPLICATIONS

24. Pneumonia, Otitismedia, Encephalitis, Keratitis, Conjunctivitis, Myocarditis, Reactivation of primary complex. COMPLICATIONS

25. CONTROL OF PATIENTS & CONTACTS: Notification to the health authorities. Isolation for 7 days after the appearance of the rash & for 14 days from school for contacts. Disinfection of the articles soiled by discharges. Immunization of contacts. Investigations of contacts under 3 years of age. Investigations of the source of infection. CONTROL & PREVENTION

26. PREVENTION OF MEASLES: ACTIVE IMMUNIZATION :(Vaccination) A live attenuated virus freeze-dried vaccine s/c at left deltoid in 0.5cc, according to the EPI schedule. Immunity: It develops 11-12 days after vaccination & appears to be of long duration probably for life. Contacts: Susceptible individuals over the age of 9-12 months may be protected against measles provided that the vaccine is given within 3 days of exposure . CONTROL & PREVENTION

27. MEASLES VACCINE

28. LIVE VIRUS VACCINE Freeze-dried (lyophilized) and used with diluent Store vaccine at 2 ° -8 ° C (but can be frozen) Protect from light at all times Efficacy: 85% at 9months (EPI schedule) 95% at 12-15months Duration of immunity: lifelong MEASLES VACCINE

29. PASSIVE IMMUNIZATION: It can be done by the administration of Immunoglobulin (human) early in the incubation period at 0.25ml/kg body wt. It should be given within 3-4 days of exposure. Live measles vaccine should be given 8-12 wks., later of passive immunization. MEASLES VACCINE

30. Q-1 Measles virus is transmitted through airborne droplets and is one of the leading causes of respiratory infections mostly seen in children of developing countries. Which of the following statements is not correct about the epidemiologic features of measles? More than one serotype of the virus has been identified Humans are the only reservoir Infection confers lifelong immunity Infection can be transmitted from the mother to the fetus

31.   Q-2 The symptoms of the measles virus infection develop within 2 to 5 days, the most common is skin rashes.  Which of the following are not the other symptoms related to measles ? a) Red and watery eyes b) Runny nose c) High-grade fever d) Enlarged salivary glands

32. Q-3 Each of the following statements about the measles vaccine is correct,  EXCEPT ? The vaccine was first introduced in 1963 It is available only in a monovalent form The vaccine can be introduced to the child as early as 12 months of age The vaccine contains live, attenuated virus

33. Thank You Any Question?