TRANS 4: MEASLES Measles - family Paramyxoviridae: enveloped, helical, (-)ssRNA - genus Morbilivirus aka Rubeola disease of the respiratory

tract multiplies in the nasopharynx & lymph nodes important pathogen in infants and children

Transmission: - ingestion - damage to microvilli-> malabsorption - causes abnormal gastric motility & delayed gastric emptying ____________________________________________________ STRUCTURE: H glycoprotein F glycoprotein M protein lipid bilayer RNA nucelocapsid RNA polymerase caps : hemagglutinin spikes: fusion, hemolysin inner lining: matrix outer lining infectious core attached to nucleocapsid

____________________________________________________ General features - also occurs in animals - ONE SEROTYPE: can provide lifetime immunity once acquired - Tigdas hangin causes milder form of measles - sensitive to adverse features ____________________________________________________ PATHOGENESIS - transmission is by respiratory route: inhalation of infectious droplets or aer osols !! fomites do not play a role in transmission - replicates in nasopharynx and regional lymph nodes >Primary viremia : 2-3 days >Secondary viremia: 5-7 days - causes generalized immunosuppression IP: 10-12 days - Prodromal symptoms: before initial rash > high fever, coryza, lymphopenia, Koplik's spot - Maculopapular Rash (10-14 days)

- Self-limiting with desquamation of skin (brown) ____________________________________________________ COMPLICATIONS Pneumonia Otitis media Diarrhea Encephalitis Subacute Sclerosing Panencephalitis = higher risk with children < 2y/o = may occur 4-17 years later =loss of intellectual capacity-> motor activity-> coma-> DEATH !!!NO WAY TO STOP OR CURE SSPE ____________________________________________________ EPIDEMIOLOGY - HUMAN= ONLY NATURAL HOST - mortality increases at <1y/o & malnourished - communicability: 4 days before and after onset of rash ____________________________________________________ VACCINATION MMR: live attenuated vaccine; do not give to pregnant women Measles: monovalent MR MMRV *Immunization starts at 6-9 mos. at endemic areas & 12-15 mos. at low prevalence areas