Measles virus - Revision history

Aidan: /* Microbiology */

2026-02-09T15:24:37Z

Microbiology

← Older revision		Revision as of 15:24, 9 February 2026
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⚫	*Highly contagious virus that causes a '''triad of cough, coryza, and conjunctivitis'''

	==Background==		==Background==

		⚫	* Highly contagious virus that causes a '''triad of cough, coryza, and conjunctivitis'''

	===Microbiology===		===Microbiology===

	*~~Enveloped RNA~~ ''Morbillivirus'' ~~in the Paramyxoviridae family~~		*''Morbillivirus''
			*Enveloped [[Baltimore classification::(-)ssRNA virus\|negative-sense single-stranded RNA virus]] in the [[Family::Paramyxoviridae\|Paramyxoviridae]] family
	**Family includes parainfluenza, RSV, measles, mumps
	*Eight structural proteins: F, C, H (haemagglutination), L (large), M (matrix), N (nucleoprotein), P (phosphopolymerase), and V		*Eight structural proteins: F, C, H (haemagglutination), L (large), M (matrix), N (nucleoprotein), P (phosphopolymerase), and V
	**N, P, and L complex with RNA		**N, P, and L complex with RNA

Aidan: /* Differential Diagnosis */

2023-09-27T22:37:21Z

Differential Diagnosis

← Older revision		Revision as of 22:37, 27 September 2023
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	*[[Kawasaki syndrome]]		*[[Kawasaki syndrome]]
	*[[Scarlet fever]]		*[[Scarlet fever]]
	*[[Roseola]]		*[[Roseolavirus\|Roseola]]
	*~~Infectious~~ [[mononucleosis]]		*[[Infectious mononucleosis]]
			*[[Rickettsioses]]
	*[[Rickettsia species\|Risckettsial infections]]
	*[[Enterovirus\|Enteroviral infections]]		*[[Enterovirus\|Enteroviral infections]]
	*[[Adenovirus\|Adenoviral infections]]		*[[Adenovirus\|Adenoviral infections]]

Aidan: /* Infection Control */

2020-09-23T13:55:26Z

Infection Control

← Older revision		Revision as of 13:55, 23 September 2020
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	*Need to do contact tracing, including people up to two hours after any room they were in		*Need to do contact tracing, including people up to two hours after any room they were in
	*All contacts should be quarantined at home regardless of symptoms		*All contacts should be quarantined at home regardless of symptoms
			**Susceptible contacts should be placed in airborne precautions from 5 days after first exposure to 21 days after last exposure

	===Post-Exposure Prophylaxis (PEP)===		===Post-Exposure Prophylaxis (PEP)===

Aidan: /* Post-Exposure Prophylaxis (PEP) */

2020-08-21T22:29:18Z

Post-Exposure Prophylaxis (PEP)

← Older revision		Revision as of 22:29, 21 August 2020
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	\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-		\|-
	\|Immunocompromised individuals ~~≥6 months old~~		\|Immunocompromised individuals
	\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-
	\|Susceptible immunocompetent people ≥12 months old
	\| colspan="2" \|MMR
	\|-		\|-
	\|People with confirmed immunity		\|People with confirmed immunity

Aidan: /* Catch-Up */

2020-08-17T17:03:03Z

Catch-Up

← Older revision		Revision as of 17:03, 17 August 2020
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	*Vaccination in the presence of passive antibody		*Vaccination in the presence of passive antibody

	=== Catch-Up ===		====Catch-Up====

	* 2 doses of MMR at least 4 weeks apart		*2 doses of MMR at least 4 weeks apart

	==Further Reading==		==Further Reading==

Aidan: /* Vaccination */

2020-08-17T17:02:22Z

Vaccination

← Older revision		Revision as of 17:02, 17 August 2020
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	*Exposure to light or heat		*Exposure to light or heat
	*Vaccination in the presence of passive antibody		*Vaccination in the presence of passive antibody

			=== Catch-Up ===

			* 2 doses of MMR at least 4 weeks apart

	==Further Reading==		==Further Reading==

Aidan: /* Complications */

2020-08-16T22:26:05Z

Complications

← Older revision		Revision as of 22:26, 16 August 2020
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	*Respiratory involvement, either as primary infection of with bacterial superinfection		*Respiratory involvement, either as primary infection of with bacterial superinfection
	**Otitis media, pneumonia (on CXR, even if uncomplicated)		**[[Otitis media]], [[pneumonia]] (on CXR, even if uncomplicated)
			*Acute [[encephalitis]] in 1 in 1000-2000 patients, with new fevers, headaches, seizures, and altered level of consciousness
	*Acute encephalitis, which can have sequelae
			**Likely from hypersensitivity to virus in the brain rather than from direct infection
	**~~Blindness~~, corneal scarring		**Sequelae include blindness, corneal scarring
⚫	*Hepatitis
			*Chronic encephalitis, also called subacute sclerosing panencephalitis
		⚫	*[[Hepatitis]]
	*Complications are more common in adults who are infected		*Complications are more common in adults who are infected

	===Subacute ~~sclerosing~~ ~~panencephalitis~~ (SSPE)===		===Subacute Sclerosing Panencephalitis (SSPE)===

	*Degenerative neurological condition caused by persistent CNS infection despite immune response		*Degenerative neurological condition caused by persistent CNS infection despite immune response
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	===Special Populations===		===Special Populations===
	====Modified ~~measles~~====		====Modified Measles====

	*Patients with passive immunity to measles may present with a milder form		*Patients with passive immunity to measles may present with a milder form
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	*The prodrome, Koplik spots, and rash are often absent, and it is sometimes subclinical		*The prodrome, Koplik spots, and rash are often absent, and it is sometimes subclinical

	====Atypical ~~measles~~====		====Atypical Measles====

	*Patients with prior immunization with killed vaccine (no longer on market, since 1960s) may have an atypical presentation		*Patients with prior immunization with killed vaccine (no longer on market, since 1960s) may have an atypical presentation
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	==Prevention==		==Prevention==
	===Infection ~~control~~===		===Infection Control===

	*Infectious period is 5 days prior to until 4 days after onset of rash		*Infectious period is 5 days prior to until 4 days after onset of rash
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	*All contacts should be quarantined at home regardless of symptoms		*All contacts should be quarantined at home regardless of symptoms

	===Post-~~exposure~~ ~~prophylaxis~~ (PEP)===		===Post-Exposure Prophylaxis (PEP)===

	*Use either MMR vaccine or immune globulin in susceptible people		*Use either MMR vaccine or immune globulin in susceptible people
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	*Can be associated with anaphylaxis in patients with true egg allergy		*Can be associated with anaphylaxis in patients with true egg allergy

	====Vaccine ~~failure~~====		====Vaccine Failure====

	*Improper storage >4º C		*Improper storage >4º C

Aidan: /* Atypical measles */

2020-08-16T22:22:11Z

Atypical measles

← Older revision		Revision as of 22:22, 16 August 2020
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	*Prodrome of fever and pain for 1 to 2 days		*Prodrome of fever and pain for 1 to 2 days
	*Rash follows, but moves peripherally to centrally, and have varied form (urticarial, maculopapular, hemorrhagic, vesicular)		*Rash follows, but moves peripherally to centrally, and have varied form (urticarial, maculopapular, hemorrhagic, vesicular)
	**Can mimic ~~vaicella~~, RMSF, HSP, drug eruption, or toxic shock syndrome		**Can mimic [[varicella]], [[RMSF]], [[HSP]], [[drug eruption]], or [[toxic shock syndrome]]
	*Fever continues, with edema, interstitial pneumonia, hepatitis, and occasionally pleural effusion		*Fever continues, with edema, interstitial pneumonia, hepatitis, and occasionally pleural effusion
	*More prolonged course, with very high antibody titres		*More prolonged course, with very high antibody titres
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	{\| class="wikitable"		{\| class="wikitable"
	!rowspan=2 \|Population		! rowspan="2" \|Population
	!colspan=2 \|Time since measles exposure		! colspan="2" \|Time since measles exposure
	\|-		\|-
	!≤72 hours		!≤72 hours
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	\|-		\|-
	\|Susceptible infants <6 months old		\|Susceptible infants <6 months old
	\|colspan=2\|IMIg 0.5 mL/kg		\| colspan="2" \|IMIg 0.5 mL/kg
	\|-		\|-
	\|Susceptible immunocompetent infants 6-12 months old		\|Susceptible immunocompetent infants 6-12 months old
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	\|-		\|-
	\|Susceptible immunocompetent people ≥12 months old		\|Susceptible immunocompetent people ≥12 months old
	\|colspan=2\|MMR		\| colspan="2" \|MMR
	\|-		\|-
	\|Susceptible pregnant people		\|Susceptible pregnant people
	\|colspan=2\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-		\|-
	\|Immunocompromised individuals ≥6 months old		\|Immunocompromised individuals ≥6 months old
	\|colspan=2\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\| colspan="2" \|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-		\|-
	\|Susceptible immunocompetent people ≥12 months old		\|Susceptible immunocompetent people ≥12 months old
	\|colspan=2\|MMR		\| colspan="2" \|MMR
	\|-		\|-
	\|People with confirmed immunity		\|People with confirmed immunity
	\|colspan=2\|None		\| colspan="2" \|None
	\|}		\|}

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	*Vaccination in the presence of passive antibody		*Vaccination in the presence of passive antibody

	== Further Reading ==		==Further Reading==

	* [https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#pep Measles vaccine: Canadian Immunization Guide]. Public Health Agency of Canada.		*[https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#pep Measles vaccine: Canadian Immunization Guide]. Public Health Agency of Canada.

	[[Category:Paramyxoviridae]]		[[Category:Paramyxoviridae]]

Aidan: /* Clinical Manifestations */

2020-08-05T14:07:46Z

Clinical Manifestations

← Older revision		Revision as of 14:07, 5 August 2020
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	==Clinical Manifestations==		==Clinical Manifestations==

	*Incubation period 10-14 days (range up to 21 days), followed by several days of prodrome that includes fever, anorexia, cough, coryza, and conjunctivitis		*Incubation period [[Usual incubation period::10 to 14 days]] (range [[Incubation period range::up to 21 days]]), followed by several days of prodrome that includes fever, anorexia, cough, coryza, and conjunctivitis
	**Can be mistaken for common cold or for Kawasaki disease		**Can be mistaken for common cold or for Kawasaki disease
	**Koplik spots appear at end of prodrome		**Koplik spots appear at end of prodrome

Aidan: /* Post-exposure prophylaxis (PEP) */ formatting

2020-07-20T00:09:37Z

Post-exposure prophylaxis (PEP): formatting

← Older revision		Revision as of 00:09, 20 July 2020
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	{\| class="wikitable"		{\| class="wikitable"
	!Population		!rowspan=2 \|Population
			!colspan=2 \|Time since measles exposure
			\|-
	!≤72 hours		!≤72 hours
	!73 hours to 6 days		!73 hours to 6 days
	\|-		\|-
	\|Susceptible infants <6 months old		\|Susceptible infants <6 months old
	\|IMIg 0.5 mL/kg		\|colspan=2\|IMIg 0.5 mL/kg
	\|IMIg 0.5 mL/kg
	\|-		\|-
	\|Susceptible immunocompetent infants 6-12 months old		\|Susceptible immunocompetent infants 6-12 months old
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	\|-		\|-
	\|Susceptible immunocompetent people ≥12 months old		\|Susceptible immunocompetent people ≥12 months old
	\|MMR		\|colspan=2\|MMR
	\|MMR
	\|-		\|-
	\|Susceptible pregnant people		\|Susceptible pregnant people
	\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\|colspan=2\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-		\|-
	\|Immunocompromised individuals ≥6 months old		\|Immunocompromised individuals ≥6 months old
	\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg		\|colspan=2\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|IVIg 400 mg/kg (preferred) or IMIg 0.5 mL/kg
	\|-		\|-
	\|Susceptible immunocompetent people ≥12 months old		\|Susceptible immunocompetent people ≥12 months old
	\|MMR		\|colspan=2\|MMR
	\|MMR
	\|-		\|-
	\|People with confirmed immunity		\|People with confirmed immunity
	\|None		\|colspan=2\|None
	\|None
	\|}		\|}