Description

• Measles (Rubeola) is an infectious disease caused by the measles virus
• It has no extra-human reservoir, vectors, or carrier state, thus making it a potentially eradicable disease and is caused by an RNA virus belonging to the Paramyxovirus family
• There are two phases of disease- a catarrhal (prodromal) stage and an exanthem stage
• The catarrhal stage is characterized by fever with conjunctivitis, coryza, cough, and pathognomonic Koplik spots on the buccal mucosa
• The exanthem stage is typically characterized by an erythematous maculopapular rash that originates behind the ears and spreads to the rest of the body towards the feet

Types

Prodromal phase

• High fever
• Dry cough
• Conjunctival congestion
• Koplik’s spot: greyish white spot on reddish areola, appearing 1-2 days before the appearance of the rash. First noticed opposite molar or premolar teeth

Exanthem stage 

• Rash which classically appears on the 5th day of fever
• It is maculopapular, appears first on the face, spreads to the trunk, and reaches legs 
• High fever
• Malaise 
• Generalized lymphadenopathy

 Complications

• Otitis media
• Bronchiectasis
• Sub sclerosing panencephalitis- rare, late complication
• Starts with poor school performance progressing to mental deterioration

Differential diagnosis

Rubella: 

• Similar to measles but is much milder
• Tender enlargement of lymph nodes of postauricular, suboccipital, anterior cervical regions and presence of arthralgia

Investigation

• Clinical interpretations -3Cs: Coryza, conjunctivitis, cough
• CBC - ↓leukocytes, ↓platelets
• IgM antibody elevated by 72 hr of the appearance of rash – Gold standard
• IgG antibodies 
• RT-PCR

Treatments

• No antiviral therapy currently effective
• Adequate oral fluids 
• Symptomatic treatment
• Vit A supplementation 

Ayurvedic Treatment 

• Jwaraghna, Deepana, Pachana

Kashayas 

• Amruthothara kashaya / Thiktaka kashaya/ Guduchyadi kashaya
  • Up to 1 year: for mother: 2 tsp sookshma choorna is boiled in 2 glass water, strained, and given to mother. If agni bala permits give 1 tsp thrice to the child
  • 1 year to 5 years: ½ tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 5 to 10 years: 1 tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 10-15 years: 1 ½ tsp powder boiled in 1 glass of water and given twice daily mixed with sugar or jaggery

Gutikas

• Sudarshanam gutika, Gopeechandanadi gutika
• 6 months to 1 year: ½ tab mixed with breast milk- given frequently throughout the day
• 1-5 years – 1 tab bd 
• 5-10 years -1 tab tds 

Arishta

• Amrutarishta, Punarnavasava, Saribadyasava ,Surasaasavam 
• Upto 2yrs- ½ tsp arista diluted with 1 tsp water
• 2-5 years- 2.5ml-5ml diluted with 5 ml boiled water
• 5-10 years- 10ml
• 10-15 years- 15ml

Department

Kaumarabhrithya