Last Updated: 2019-08-27
Morbilli, first infectious disease.
- Highly contagious infectious disease caused by measles viruses.
- The measles virus is an approximately 140 nm RNA virus which belongs to the group of paramyxoviruses.
- Especially occurring in winter and spring.
- 1964 saw the introduction of live measles vaccination, which led to a significant decline in incidence.
- Children, adolescents and young adults are particularly affected.
- Worldwide 1580,000 deaths per year.
- Throughout Europe, there are 1 death per 3,000 reported illnesses.
- The measles virus has been eliminated in Scandinavia, Australia and North and South America.
- Transmission: droplet infection (speaking, coughing, sneezing).
- The risk of infection usually exists in the catarrhal stage or in the early exanthema stage.
- Incubation period: 10-14 days.
- In the keratinocytes and in the upper dermis giant cells, the Warthin-Finkeldey cells, are formed as a result of virus replication.
- 4 days after incubation period occurrence of an exanthema.
- Catarrhal prodromal stage:
- Reduced general condition, fever (up to 40°C), pharyngitis, tracheitis, dry cough, rhinitis, conjunctivitis and photophobia.
- After 2-3 days for 48 hours enoral pointlike, white mucous membrane changes (Koplik spots), which are not scratchable, occur in the area of the molar teeth.
- Enanthema: From the 3rd day, red spots appear in the area of the oral mucosa with a simultaneous drop in fever.
- Exanthematic stage
- Starting retroauricularly, spreading over neck and trunk, morbilliform, erythematous, partially confluent spots finally pass to the extremities.
- At the same time the fever starts to rise again, after 3-4 days the body temperature regresses.
- Especially in adults who are not vaccinated, there are foudroyant, sometimes lethal cases. These are characterized by somnolence, bloody stools, hyperpyrexia, cramps and circulatory disorders.
- Blood Count (Leukopenia).
- PCR from body fluids.
- In case of neurological symptoms, a neurological consil is essential.
- CSF puncture for neurological abnormalities. Note: In acute sclerosing panencephlitis with infaust prognosis, very high IgG titres are found in the cerebrospinal fluid.
- Thoracic x-ray in case of pulmonary symptoms (striped drawing).
- ELISA can be used to detect IgM antibodies from day 3 of the exanthema stage. In case of a 4-fold increase (2 steps) of the titre after 2 weeks, a measles infection can be assumed.
- Bronchopneumonia (approx. 4-5%)
- Otitis media (approx. 4-5%)
- Measles croup
- Lupus vulgaris (cutaneous scattering of tubercle bacteria)
- Measles encephalitis (1:100,000)
- Subacute sclerosing panencephalitis (SSPE)
After a measles infection has already occurred, a lifelong immunity exists.
- Cutts FT, Henao-Restrepo AM, Olivé JM. Measles elimination: progress and challenges. Vaccine 1999;17:S47-S52.
- Davidkin I, Valle M, Peltola H, et al. Etiology of Measles‐ and Rubella‐like Illnesses in Measles, Mumps, and Rubella–Vaccinated Children. The Journal of Infectious Diseases 1998;178:1567-70.
- Velangi, Tidman. Gianotti-Crosti syndrome after measles, mumps and rubella vaccination. British Journal of Dermatology 1998;139:1122-3.
- Bundesamt für Gesundheit - Masern. (2016). Bag.admin.ch. Retrieved 10 May 2016, from http://www.bag.admin.ch/themen/medizin/00682/00684/01087/index.html?lang=de