10.Measles麻疹.ppt

MEASLES Fen Hua Chen, M.D.,PhD. Department of Pediatrics, The Third Affiliated Hospital Sun Yat-sen University Measles is… an acute viral infection characterized by a maculopapular rash erupting successively over the neck, face, body, and extremitis and accompanied by a high fever. ETIOLOGY Measles virus An RNA virus of the genus Morbillivirus in the family of Paramyxoviridae One serotype, human’s only host Stable antigenicity Rapidly inactivated by heat and light Survival in low temperature. EPIDEMIOLOGY Infection sources Patients of acute stage and viral carriers of atypical measles Transmission Highly contagious, approximately 90% of susceptible contacts acquire the disease. Respiratory secretions: maximal dissemination of virus occurs by droplet spray during the prodromal period (catarrhal stage). Contagious from 5 days before symptoms, 5 days after onset of rash Seasons: in the spring, peak in Feb-May PATHOGENESIS AND PATHOLOGY Portal of entry Respiratory tract and regional lymph nodes Enters bloodstream (primary viraemia) ? monocyte – phagocyte system ? target organs (secondary viraemia) Target organs The skin; the mucous membranes of the nasopharynx, bronchi, and intestinal tract; and in the conjunctivae, ect Resulting In----- 1) Koplik spots and skin rash: serous exudation and proliferation of endothelial cells of the capillaries, vasculitis 2) Conjunctivis PATHOGENESIS AND PATHOLOGY 3) Laryngitis, croup, bronchitis :general inflammatory reaction 4) Hyperplasia of lymphoid tissue: multinucleated giant cells (Warthin-Finkeldey reticuloendothelial giant cells) may be found 5) Interstitial pneumonitis: Hecht giant cell pneumonia. 6) Bronchopneumonia: due to secondary bacterial infections 7) Encephalomyelitis: perivascular demyelinization occurs in areas of the brain and spinal cord. 8) Subacute sclerosing panencephalitis(SSPE): degeneration of the cortex an