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Introduction
  • Classification
    • Virus
      • RNA
        • Negative-stranded
          • Paramyxovirus
            • Rubeola (measles)
  • Pathogenesis
    • transmission
      • respiratory
    • reservoir
      • respiratory tract
    • molecular biology
      • rash caused by cytotoxic T cell damage of infected endothelial cells
      • can cause cell-cell fusion
        • all paramyxoviruses contain F (fusion protein)
        • seen as Warthin-Finkeldey multinucleated giant cells during complication of giant cell pnuemonia
        • palivizumab prevents pneumonia in infants
  • Do not confuse with roseola
    • caused by HHV-6
Diseases
  • Measles
    • 3 C's (the measles prodrome)
      • cough
      • coryza
      • conjunctivitis with photophobia
      • fever
    • Koplik spots (shown) 
      • red spots with blue-white centers on buccal mucosa
      • diagnostic
    • maculopapular rash
      • after Koplik spots disappear
      • red, flat to slightly bumpy
      • begins on head and moves to trunk and extremities
      • mechanism
        • virus-infected cells destroyed by T-cells in capillaries
  • Complications of measles
    • subacute sclerosing panencephalitis (SSPE)
      • rare complication
      • encephalitis that arises many years after a measles infection
      • chronic CNS degeneration
      • believe to be caused by strains that do not contain M protein antigen
        • antibodies to M protein are absent in hosts suffering from SSPE
    • encephalitis
    • giant cell pneumonia
      • Warthin-Finkeldey multinucleated giant cells
  • During pregnancy
    • NOT teratogenic
    • does cause spontaneous abortion in 20% of cases
Laboratory
  • Characteristics
    • single serotype
    • hemagglutinin but no neuraminidase
  • Diagnose with serology
Treatment
  • Vaccine
    • MMR
      • live attenuated
  • Vitamin A
  • Treatment is supportive
 

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