麻疹英文专题知识讲座培训课件

1、麻疹英文专题知识讲座麻疹英文专题知识讲座MEASLESKey pointsDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY Acute respiratory infectious disease caused by measles virus clinical feature: Fever, Cough, Runny nose, Conjunctivitis, Exanthem Specific sign: Kopliks Spots (a kind of enanthem )MEASLESKey pointsDIVISION OF DI

2、VISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY Classification: A RNA virus Genus: morbillivirus Family: paramyxoviridae Serotype: Only one Location: Nasopharyngeal secretions, Blood, Urine of patientsPathogenDIVISION OF INFECTIOUS DISEASPathogenDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYm

3、easles virusPathogenDIVISION OF INFECTIOUDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYEpidemiologyInfectious sources：Measles patients in acute stage Routes of transmission： Droplet sprayPopulation susceptibility：4.Epidemic features： It is susceptible to all the people without infection or inoc

4、ulation. The age of peak incidence was 6 months to 5 years old. The incidence of baby under 6m is lower. DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYRoutes of transmissionEpidemiologyDroplet sprayDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GAST

5、ROENTEROLOGYPrior to the use of vaccineAfter the use of vaccineMorbidity (1/100000)Major epidemics: 500-1000Mild epidemics: 4009.5 in 1990Peak seasonIn winter and springIn any time of a yearEpidemic cycleMajor epidemics appear by 2-4 yr intervalsEpidemic cycle disappeared, Sporadic cases increasedAg

6、e6m-5y (98%10y)Below 6m and above 5yClinical manifestationsTypical casessevere manifestationsmore complicationshigh mortality Atypical casesmild manifestationsless complicationsrarely deathEpidemiologyEpidemic FeaturesDIVISION OF INFECTIOUS DISEAS麻疹英文专题知识讲座培训课件麻疹英文专题知识讲座培训课件DIVISION OF INFECTIOUS DI

7、SEASE AND GASTROENTEROLOGY00 03Measles Vaccine Inoculation in whole China (1968)EpidemiologyMeasles cases of in-patients in CHCUMS DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathophysiology DIVISION OF INFECTIOUS DISEASRespiratory epithelium regional lymph nodesF

8、irst viremiaMonocytes/MacrophageSecond viremia Respiratory tract, conjunctiva, skin, etcVirus eliminationMeasles virusPathophysiology 1. Incubation period 10-14 days2. Prodromal period3-4 days3.Apparent manifestation period3-5 days4. Convalescent period3-5 daysRespiratory epithelium regionDIVISION O

9、F INFECTIOUS DISEASE AND GASTROENTEROLOGYPathologyDIVISION OF INFECTIOUS DISEASMultinucleated giant cell(Warthin-finkeldey giant cells)Pathology Cytopathic changePATHOGNOMONIC FOR MEASLES= 100m, several nucleus inside the cell, formed by confluence of several virus infected reticuloendothelial cells

10、In smears of the nasal mucosa in the prodromal stageMultinucleated giant cellPathoMultinucleated giant cellPathology Cytopathic changePATHOGNOMONIC PRESENTATION FOR MEASLESMultinucleated giant cellPathoDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathology Respiratory tract Skin Kopliks spotsD

11、IVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathology skinRed maculopapuleDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinical manifestations Typical manifestations Atypical manifestations DIVISION OF INFECTIOUS DISEASDIVISION OF

12、 INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsIncubation stage: 10-14daysProdromal stage: 3-4days The prodrome develops on the day symptom begins (fever) and lasts until rash appear. Fever Cough Coryza Conjunctivitis Kopliks spotsDIVISION OF INFECTIOUS DISEASDIVISION OF INFE

13、CTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsProdromal stage: 3-4days2. Fever The magnitude and pattern of fever are variable in patients, from a low-grade to moderate fever or a sudden high fever may occur. Cough Coryza They are not specific symptoms for measles, which are iden

14、tical to a common cold but catarrhal symptoms maybe more severe. Conjunctivitis May suggest measles before Kopliks spots. Kopliks Spots: Pathognomonic signDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationstypical facial appearance of measl

15、es in prodromal stage DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYExanthem stage: 3-5days Maculopapular rash: Fever: tempe

16、rature rises abruptly Catarrh: Other manifestations: enlarged lymph nodes, slight splenomegaly, gastrointestinal symptoms such as diarrhea and vomiting Typical clinical manifestationDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASTypical

17、 clinical manifestationsMaculopapular rashDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashThe rash usually starts on the upper lateral parts of the neck, b

18、ehind the ears, along the hairline, and on the posterior parts of the cheek. DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashIt become increasingly maculopapular as the rash spreads rapidly over the entire f

19、ace, neck, upper arms, and upper part of the chest within approximately the 24hr. DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROL

20、OGYTypical clinical manifestationsConvalescent stage: 3-5 days In uncomplicated cases, as the rash appears in the legs and feet the symptoms subside rapidly within about 3 days usually with an abrupt drop in temperature to normal. As the rash fades, branny desquamation and brownish discoloration (hy

21、perpigmentation) occur and then disappear within 2-3 weeks.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsBranny desquamation and brownish discoloration (hyperpigmentation) Convalescent stage:DIVISION OF INFECTIOUS DISEAS Temp Days 1-14

22、1234567891011121314Clinical periodsProdromal stageExanthem stageConvalescent stageCoryza and conjunctivitisKopliks spotsRashCoughBranny desquamation & hyperpigmentation Summary of typical clinical features414039383736 Temp Days 1-1412345678910DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinic

23、al manifestations Atypical manifestations DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinical manifestations Atypical manifestations Mild measles Measles in adults Severe measlesOccurs in the patient with partial immunityOccurs in the patients with immunocompromi

24、sedDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYComplicationsDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYComplications Pneumonia Subacute sclerosing panencephalitis (SSPE) & Encephalitis Laryngitis Exacerbation of tuberculosis Ma

25、lnutrition and Vitamin A deficiencythe most frequent complication of measles (1) Primary pneumonia (2) Secondary pneumonia DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYLab studiesDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYLab st

26、udies The white blood cell count tends to be low with a relative lymphocytosis. Multinucleated giant cells can be demonstrated in smears of the nasal mucosa during the prodromal stage. Testing of specific IgM in serum Measles virus isolationDIVISION OF INFECTIOUS DISEAS麻疹英文专题知识讲座培训课件DIVISION OF INFE

27、CTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Epidemiologic data Clinical data Laboratory dataDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Epidemiologic dataAgeSeasonHistory of contact with patientHistory of inoculationDIVISION OF INFECTIOUS DISEASDIVISION

28、 OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Clinical dataProdromal periodExanthem periodConvalescent periodKopliks spotsTypical rash; correlation of rash and fever; catarrhBranny desquamation and brownish discolorationDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENT

29、EROLOGYDifferential DiagnosisDifferential DiagnosisDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosis Rubella Roseola infantum Enterovirus infection Exanthem caused by drugs DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosis Rubella DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosis Rubella (German Measles )DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosisMeasle