MeaslesMumpsandRubellaCh.pptVIP

Measles, Mumps and RubellaCh 10, 11 12 Measles Pathogenesis and Clinical Features Respiratory transmission of virus Replication in nasopharynx and regional lymph nodes Primary viremia 2-3 days after exposure Secondary viremia 5-7 days after exposure with spread to tissues Incubation period 10-12 days Stepwise increase in fever to 103°F or higher Cough, coryza, conjunctivitis Koplik spots 2-4 days after prodrome, 14 days after exposure Maculopapular, becomes confluent Begins on face and head Persists 5-6 days Fades in order of appearance Measles Complications Measles Epidemiology Reservoir Human Transmission Respiratory Airborne Temporal pattern Peak in late winter–spring Communicability 4 days before to 4 days after rash onset Measles Vaccine Composition Live virus Efficacy 95% (range, 90%-98%) Duration ofImmunity Lifelong Schedule 2 doses Should be administered with mumps and rubella as MMR, or with mumps, rubella and varicella as MMRV 1941 - 894,134 U.S. cases 1995 - 288 U.S. cases Measles VaccineIndications for Revaccination Vaccinated before the first birthday Vaccinated with killed measles vaccine Vaccinated prior to 1968 with an unknown type of vaccine Vaccinated with IG in addition to a further attenuated strain or vaccine of unknown type Mumps Acute viral illness Parotitis and orchitis described by Hippocrates in 5th century BC Viral etiology described by Johnson and Goodpasture in 1934 Frequent cause of outbreaks among military personnel in prevaccine era Mumps Virus Paramyxovirus RNA virus One antigenic type Rapidly inactivated by chemical agents, heat, and ultraviolet light Mumps Pathogenesis Respiratory transmission of virus Replication in nasopharynx and regional lymph nodes Viremia 12-25 days after exposure with spread to tissues Multiple tissues infected during viremia Mumps Clinical Features Incubation period 14-18 days Nonspecific prodrome of myalgia, malaise, headache, low-grade fever Parotitis in 30%-40% Up to 20% o