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Infectious diseases. Measles. Etiology. Infectiousness. Epidemiology. Pathology (most important)

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39. Measles. Etiology. Infectivity. Epidemiology. Pathology

Measles is an acute contagious disease characterized by periods of:

1) incubation, lasting 10-12 days, sometimes accompanied by individual symptoms;

2) prodromal, during which enanthema (Koplik spots) appears on the mucous membrane of the cheeks and pharynx, body temperature rises, conjunctivitis, rhinitis develop, and a painful cough grows;

3) final, accompanied by maculopapular rashes on the face, neck, torso, arms and legs and high body temperature.

Etiology. The measles RNA virus belongs to the Paramyxoviridae family of the Morbillivirus genus. Only one antigenic type of virus is known, which is similar in structure to the causative agent of infectious parotitis and parainfluenza. During the prodromal period and in the first days after the onset of the rash, it is found in the discharge from the nasopharynx, blood and urine. The virus can be grown on tissue cultures of the renal epithelium of a human embryo or rhesus monkey. Cytological changes observed after 5-10 days of cultivation are the appearance of multinuclear giant cells with intranuclear inclusions. By the time the rash appears, specific antibodies circulate in the blood of patients.

Infectivity. Measles is spread by airborne droplets. The virus is localized in the respiratory tract of the patient. The maximum risk of infection exists during the prodromal period.

Susceptible individuals are most likely to become infected before the first case is diagnosed. An infected person becomes dangerous to others on the 9th-10th day after contact, less often - on the 7th day, therefore, isolation of patients and persons in contact with them is necessary from the 7th day after contact. 5 days after the disappearance of the rash, quarantine is removed.

Epidemiology. Measles is ubiquitous. The source of infection is only a sick person. The route of transmission of the measles virus is airborne, but the transmission of infection through objects and a third person should also be taken into account.

Natural susceptibility to measles can be considered universal, with the exception of children of the first 3 months of life with innate immunity obtained from a mother who had measles or was vaccinated.

Pathology. The most characteristic changes in the skin, mucous membranes of the nasopharynx, bronchi, intestines and conjunctiva. Exudate and proliferating mononuclear and few polymorphonuclear cells appear around the capillaries. Lymphoid tissue is hyperplastic. On the skin, these changes are most pronounced around the sebaceous glands and hair follicles.

Koplik's spots are composed of serous exudate and proliferating endothelial cells, similar to those in areas of skin rashes. Often develops diffuse inflammation of the mucous membrane of the oral cavity, pharynx, spreading to the lymphoid tissue of the mucous membranes of the trachea and bronchi.

Author: Pavlova N.V.

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