A study on epidemiological and clinical characteristics of measles patients admitted to Sir Ronald Ross institute of tropical and communicable diseases, Hyderabad, India (original) (raw)
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Pakistan Journal of Public Health
BACKGROUND: Measles is highly endemic disease in Pakistan that can be prevented by vaccinating the child.Patients with rash and fever are the major syptoms of this infection. The aim of this study was to find the associationof clinical and serological outcome of measles and rubella with demographic profiles in patients hospitalised withclinical suspicion of these conditions. METHODS: A descriptive cross sectional study was conducted in children hospital of PIMS Islamabad where allchildren presenting with maculopapular rash in outdoor patient, indoor patient and accident and emergencydepartment were enrolled. The study duration was one year or the completion of required sample size. A total of 73children who fulfilled the inclusion criteria were enrolled in this study. A purposive sampling technique was used toselect cases. Data was collected through a structured proforma especially designed for this study. Permission wastaken from the Hospital Ethical Committee before the commenceme...
Sporadic cases of adult measles: a research article
BMC Research Notes, 2017
Background: Measles caused by a paramyxovirus, characterized by fever, malaise, cough, coryza conjunctivitis, a maculopapular rash is known to result in pneumonia, encephalitis and death. Fatal cases of measles in Sri Lanka are rare after implementation of the National Immunization Programme in 1984. Thereafter 0.1% case fatality rate was observed during October 1999-June 2000 which is a very low figure compared to other regional countries. Immunization guidelines were further revised in 2001, 2011 and in 2012 when additional immunization was recommended to age group 4-21 years; who are likely to have inadequate immunization, in order to achieve elimination of Measles by 2020. However, in 2013-2014, 4690 cases were reported and the majority were children less than 1 year of age. The occurrence in adults is hard to retrieve in published epidemiological reports, however had been 38% (out of 1008 patients) in the 3rd quarter of 2013. During this outbreak 73/101 (72%) reported from the North Central Province of Sri Lanka had been more than 12 years of age with 50% being more than 29 years. 14 Sri lankan adult patients [median age 32 years (range 25-48)] who presented sporadically from June 2014 to March 2016, with confirmed measles infection were enrolled retrospectively after informed consent. Details with regards to their clinical presentation, immunization and other relevant areas were collected using an interviewer administered questionnaire or using patient management records. Results: The patients presented with high fever, headache, severe body aches, sore throat, dry cough, intense tearing, red eyes and posterior cervical lymphadenopathy over 3-5 days duration. Later they developed discrete maculopapular rash helping the diagnosis. They had a variable degree of leucopenia, lymphocytosis, thrombocytopenia and derangements in the liver functions mimicking any other acute febrile illnesses such as dengue, chikungunya, leptospirosis or Zika virus infection. Conclusion: At least a 3-5 day delay in the diagnosis was observed (even after the appearance of the rash in some patients), due to non-awareness of its occurrence, unfamiliarity of measles in adults, non-specific nature of the illness and non-availability of rapid diagnostics, risking transmission to the immune-compromised or non-immune staff or patients. Identification of the source of infection in these sporadic adult cases and their virologic surveillance and molecular epidemiology will be important to interrupt the transmission and to achieve the targeted elimination of measles from Sri Lanka by 2020.
Clinical and Laboratory evaluation of measleslike rash in children and young adults
Brazilian Journal of Microbiology, 2000
A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases), scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.
Measles Outbreak in a Rural Area of a Developing Country: A Case Control Study
Pakistan Journal of Public Health, 2018
Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Ep...
BMC Pediatrics
Background Measles is a recurrent health problem in both advanced and developed countries. The World Health Organization (WHO) recommends anti-measles immunoglobulin M (Ig M) as the standard method of detecting the virus; however, many areas still present the inability to perform a serology test of anti-measles IgM. Therefore, a typical clinical feature is necessary to establish the diagnosis of measles. The objective of this study was to evaluate hyperpigmented rash and other clinical features as the diagnostic tools with respect to measles, especially in an outbreak setting. Methods In this observational diagnostic study, the inclusion criteria were as follows: between 6 and 144 months of age, fever, maculopapular rash for 3 days or more, accompanied by a cough, or coryza, or conjunctivitis. Those with a prior history of measles vaccination (1–6 weeks) were excluded, in addition to those with histories of corticosteroid for 2 weeks or more and immunocompromised conditions. The sam...
International Journal of Infection, 2018
Introduction: Measles is a highly contagious viral disease, which affects mostly children and rarely adults, which results in a more severe presentation. After a prodromal phase (malaise, anorexia, and the classic triad of conjunctivitis, cough, and coryza and a high fever), enanthem (Koplik spot) appears at buccal mucosa and then, typical erythematous maculopapular rash happens. There are several reports of atypical measles in the adults who have been immunized by killed type vaccine, therefore, prior history of vaccination with the original killed-virus among individuals who present with maculopapular rash and fever do not rule out measles. Case Presentation: Here we report a 44-year-old woman with fever, chills, myalgia, odynophagia, exudative pharyngitis, bilateral parotitis, anterior cervical lymphadenopathy, tender splenomegaly, conjunctival suffusion and disseminated pruritic erythematous maculopapular, as well as a petechial rash all over her body. She was evaluated mainly for infectious mononucleosis, acute human immunodeficiency virus infection, and acute viral hepatitis, when all investigations were negative for possible diagnoses, although she mentioned immunization against measles, evaluations for measles were done and she had positive IgM antibody with high titer and also positive measles virus RT-PCR. Conclusions: The aim of this report is to emphasize that physicians should be aware of the atypical measles syndrome and entertain the diagnosis of measles in adults with a febrile illness and rash in order to make the most accurate diagnosis and prevent complications.
Seroprevalence of measles virus infection among children in Zamfara state
Bayero Journal of Pure and Applied Sciences, 2019
INTRODUCTION Measles virus is highly contagious and causes a disease characterized by high fever, cough, coryza, conjunctivitis, and appear generalized maculopapular rash with koplik spots appearing on the buccal mucosa 1 before rash onset and may be noticeable for an additional 1-2days after rash onset. Infection confers lifelong immunity (Goodson 2011). Measles virus is a spherical enveloped, non-segmented virus with a single stranded, negative sense RNA genome a member of the genus Morbillivirus within the family Paramyxoviridae. Humans are the only natural host for measles virus (Griffin, 2007), other primates such as monkey can experimentally infected (Maldonado Lamb and Parks 2007). The causative agent is generally transmitted by aerosolized secretions deposited on upper respiratory tract mucosal surfaces transmitted through the conjunctivae (Mbug et al., 2003; Vries et al., 2012). to local respiratory tract replication; infection ABSTRACT Measles is a highly contagious disease characterized by fever, malaise, coryza, conjunctivitis, cough and maculopapular rashes. Although it is a vaccine preventable disease, it however continues to be one of the present day scourges of the developing worl The study is a cross sectional involving children 10 years and below who were randomly selected by multistage cluster sampling from hospital each in local government areas from the three geopolitical zones of Zamfara state, Nigeria to determine the ser measles specific IgM antibodies and the possible risk factors associated with the acquisition of the infection. Following informed consent a total of two hundred and twenty four (224) blood sample was collected. Study subjects were interview questionnaires. Serum samples were analyzed using ELISA IgM kit (Diagnostic Automation and Cortez, Calabasas, CA, USA), in accordance with the manufacturer's guidelines. Of the 224 serum samples screened 43.3% were positive for mea indicating an active infection. The results shows decrease in sero the highest prevalence recorded in age group 0 (25.0%). Males had slightly higher pre result was not statistically significant, (P>0.05). Previous exposure to measles and crowded environment revealed significant association (P< 0.05).However no association was observed in relation to vaccination status and contact with infected individuals (P>0.05). This study confirms the presence of measles and indicate measles endemicity in the study area. However the study shows a reduction in measles burden among vaccinated children. Its presence among unvaccinated children might be an indication of insufficient
Measles, one of the most infectious viral diseases of humans nearly all susceptible individuals in the absence of vaccination, is spread by the respiratory route and remains a major cause of mortality in children, particularly in developing countries. It is caused by measles virus (MV), which is an enveloped virus belonging to the genus morbillivirus of the family-paramyxoviridae. Measles is usually characterized by prodrome fever, maculopapular rash with one or a combination of coryza, cough, conjunctivitis and Koplik's spot. The study was conducted in some part of the NorthWest Nigeria with the aim to determine the seroprevalence of measles IgM and possible risk factors associated with the acquisition of the infection. A total of 725 children aged 0 to 10 years were selected for the study across the three states (Kano, Katsina and Zamfara). Measles-specific IgM antibodies were screened qualitatively using commercial ELISA IgM kit (Diagnostic Automation and Cortez, Calabasas, CA, USA). Measles IgM specific antibodies were detected in 334(44.4%) of the subjects. A higher prevalence of 53.2% was found in the age group 0-2years, and the least 21.4% in age group 8-10 years. There was a significant association between measles virus infection and age (P=0.001). Females show slightly higher prevalence 46.7% than males 42.1%, though there was no significant association (P=0.03). With respect to the parental occupation and education status, there was a significant association (P> 0.05) while vaccination status, number of vaccinations, travel history and contact history shows no significant statistical association (P> 0.05). However, in relation to previous measles history and crowded environment, statistically significant association was observed (P< 0.05). This is an indication that measles still persist in this part of the country despite the availability of safe and cost effective vaccine its persistence and burden is worrisome as observed in vaccinated and non-vaccinated children especially under five. Abstract Measles, one of the most infectious viral diseases of humans nearly all susceptible individuals in the absence of vaccination, is spread by the respiratory route and remains a major cause of mortality in children, particularly in developing countries. It is caused by measles virus (MV), which is an enveloped virus belonging to the genus morbillivirus of the family-paramyxoviridae. Measles is usually characterized by prodrome fever, maculopapular rash with one or a combination of coryza, cough, conjunctivitis and Koplik's spot. The study was conducted in some part of the NorthWest Nigeria with the aim to determine the seroprevalence of measles IgM and possible risk factors associated with the acquisition of the infection. A total of 725 children aged 0 to 10 years were selected for the study across the three states (Kano, Katsina and Zamfara). Measles-specific IgM antibodies were screened qualitatively using commercial ELISA IgM kit (Diagnostic Automation and Cortez, Calabasas, CA, USA). Measles IgM specific antibodies were detected in 334(44.4%) of the subjects. A higher prevalence of 53.2% was found in the age group 0-2years, and the least 21.4% in age group 8-10 years. There was a significant association between measles virus infection and age (P=0.001). Females show slightly higher prevalence 46.7% than males 42.1%, though there was no significant association (P=0.03). With respect to the parental occupation and education status, there was a significant association (P> 0.05) while vaccination status, number of vaccinations, travel history and contact history shows no significant statistical association (P> 0.05). However, in relation to previous measles history and crowded environment, statistically significant association was observed (P< 0.05). This is an indication that measles still persist in this part of the country despite the availability of safe and cost effective vaccine its persistence and burden is worrisome as observed in vaccinated and non-vaccinated children especially under five.
C Cl li in ni ic ca al l m ma an ni if fe es st ta at ti io on ns s, , c co om mp pl li ic ca at ti io on ns s, , a an nd d h ho os sp pi it ta al li iz za at ti io on ns s o of f m me ea as sl le es s i in n c ch hi il ld dr r e en n i in n T Ti ik kr r i it t t te ea ac ch hi in ng g h ho os sp pi it ta al l Tikrit Medical Journal 2009; 15(1):86-92 86