DENOMINATION

• The measles,
• Viral exanthema,
• Viriasis exantemática.

DEFINITION

The measles are an illness produced by the infection of a virus (mixovirus) that is very contagious, and that study with a clinical picture in three phases, an initial period of incubation practically without symptoms, a precocious phase with intense reddening of the oral mucous membrane and of the gullet and a big ocular, pharyngeal and nasal cold.

BROADCAST. YOU CAUSE

The cause of the measles is a mixovirus of the genre of the Morbilivirus and of the family Paramyxoviridae. The infection is transmitted by the nasal and oral secretions or of an infected person and the incubation is 8 to 14 days before the appearance of the symptoms. The contagion is high from a patient who is in initial phase, later although with minor intensity, also viruses of the measles are eliminated the first 5 days of the period exantemático. The transmission takes place by air.

The infection can cause epidemics in the winter months and spring, differences between sexes do not exist.

As soon as the illness was spent immunity is acquired of by life, another way of generating an immunity is to surrender to the vaccination of the measles.

SYMPTOMS

The initial symptoms are the fever raised during the first 2 days, which descends towards the end to climb again to the beginning of the exanthema. Other of the most significant symptoms is the appearance of the rinitis and of the conjunctivitis with inconveniences intense with the light, lagrimeo, reddening of the conjunctive ones and sometimes ocular purulent secretions. A dry cough appears and irritativa that can go so far as to produce croup pictures sarampionoso.
The aspect of the face is typical for the red eyes and the distension of eyelids.

In this phase there appears the reddening of the oral mucous membrane, with a few typical spots called of Koplik that appear in the internal face of the lips and of the cheeks at level of the molars. An aspect has small grains of salt that can come out with a language oppressor.

From the fourth day it raises the fever again and exanthema appears ell maculopapuloso that begins in the face, behind the ears, in the wings of the nose, about the mouth and in the chin, in hours it is spreading to the trunk, and on the following day towards the extremities. Never fond of the palms and plants and if it produces intense itch.

To 3 days the spots become major to the 2 and come together, the fever sends and the general state improves. To the fourth day of the period exantemático the cutaneous injuries begin clearing up following the same topographic sequence that during his establishment and a thin descamación of the skin produces to, progressively, herself.

DIAGNOSIS

The clinical picture is very clear, and especially that it appears inside an epidemic, in which several cases appear simultaneously. Laboratory studies can be done to verify the existence of the virus of the measles or of antibodies antivirus of the same one.

TREATMENT

The measles do not have a specific treatment. The symptoms must talk each other to relieve the fever and the discomfort, there is recommended the rest, the paracetamol and a humid ambience and scarce environmental light by the photophobia.

Due to the association of the measles with the Reye syndrome, it is recommended to avoid the acetilsalicílico acid as treatment of the fever.
For the cough it is possible to administer some anti-cough-suppressant one.
For the itch of the skin there can be applied lotions of menthol or of calamine.

PROGNOSIS AND COMPLICATIONS

The resolution of the picture in 2 weeks is the habitual thing when complications do not appear.
The complications of the measles happen fundamentally in not vaccinated patients or with other associate problems.

Other respiratory declarations are the average earache, the mastoiditis, and the pictures of laryngitis with crupp.
The sharp encephalitis postsarampionosa affects to one of the 1.000 cases of measles and she is produced by direct action of the virus on the SNC. The symptomatology appears during the period exantemático in the shape of convulsions, drowsiness and irritability.

PREVENTION

The most normal thing the application of the vaccine is with attenuated viruses. The vaccination age is 15 months after life, in the form of the viral triple vaccine that includes simultaneously that of the German measles and that of the parotiditis, with revaccination at the age of 12 of age. The vaccine is contra-indicated in the pregnant woman and in the patients with immune alterations (inmunodepresión).

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