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MEASLES (RUBEOLA) VIRUS Genus Morbillivirus PARAMYXOVIRIDAE Paramyxovirinae Genus respirovirus: Genus Rubulavirus Genus morbillivirus Pneumovirinae Genus Pneumovirus RSV Genus Metapneumovirus MEASLES (RUBEOLA) VIRUS • Rubeola virus is the cause of measles infection • Measles is an acute, highly infectious disease characterized by: • a maculopapular rash, • fever and • respiratory symptoms. MEASLES (RUBEOLA) VIRUS Structure: • Its structure is similar to that of paramyxo-viruses, with one exception that the haemagglutinin neuraminidase spikes present on the viral envelope has: • Haemagglutinin activity • Lack neuraminidase activity. • One serotype only exist. Pathogenesis and Pathology: • Transmission occurs through droplet infection. • Virus multiplies locally in the respiratory epithelial cells, • The infection then spreads to the regional lymphoid tissue, where further multiplication occurs. Pathogenesis and Pathology: • Primary viraemia disseminates the virus, in the reticuloendothelial system. • A secondary viraemia seeds the epithelial surfaces of the body including: • the skin, • respiratory tract • conjunctiva. NOTE: The virus replicates in certain lymphocytes The hallmark of measles “measles rash” Reaction between INFECTED ENDOTHELIAL CELLS IMMUNE T CELLS Lining small blood vessels RASH Complications 1- Postinfectious encephalitis is believed to be immune mediated, occurs after rash. 2- Immunocompromised patients with measles may have continuing infection, resulting in death. Complications 3. Subacute sclerosing panencephalitis (SSPE): - occurs in 7 in 106 patients years after a measles infection, - SSPE results from ongoing replication of defective measles virus in the central nervous system. • Infection spreads directly from cell to cell without mature virus release. Laboratory Diagnosis: A. Direct detection of virus antigen in clinical specimens could be achieved by immuno fluorescent technique. B. Isolation: Specimens for viral isolation include nasopharyngeal swab and blood samples. Cell Line: Monkey or human kidney are appropriate cells for virus isolation. Out come: - Cytopathic effect in the form of multinucleated giant cells is detected. - Haemadsorption or - Immunofluorescence assays are used to confirm measles antigen in the inoculated cultures. C. Serology: • HAI is the most practical method. • CFT & • NT tests all may be used to measure measles antibodies Treatment: • Treatment is symptomatic. • No available antiviral drugs. Prevention and Control: • A live attenuated viral vaccine is available. TIME OF ADMINISTRATION: • The vaccine is administered subcutaneously either in a monovalent form (measles virus vaccine) at the age of nine months, and it is a part of the compulsory vaccination schedule in Egypt. • Or it may be administered at age of 15 months in combination with mumps and rubella vaccine (MMR vaccine). • The vaccine is safe and gives life long immunity. • Few side effects may be present. Live attenuated viral vaccines Are contra indicated in: pregnant & immune compromised host