麻疹英文专题知识讲座培训课件

麻疹英文专题知识讲座MEASLESKeypointsDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGY

Acuterespiratoryinfectiousdisease

causedbymeaslesvirusclinicalfeature:Fever,Cough,Runnynose,Conjunctivitis,ExanthemSpecificsign:Koplik’sSpots(akindofenanthem)DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGY

Classification:ARNAvirusGenus:morbillivirus

Family:paramyxoviridae

Serotype:Onlyone

Location:Nasopharyngealsecretions,Blood,UrineofpatientsPathogenPathogenDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYmeaslesvirusDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYEpidemiologyInfectioussources：Measlespatientsinacutestage

Routesoftransmission：DropletsprayPopulationsusceptibility：4.Epidemicfeatures：Itissusceptibletoallthepeoplewithoutinfectionorinoculation.Theageofpeakincidencewas6monthsto5yearsold.Theincidenceofbabyunder6mislower.DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYRoutesoftransmissionEpidemiologyDropletsprayDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYPriortotheuseofvaccineAftertheuseofvaccineMorbidity(1/100000)Majorepidemics:500-1000Mildepidemics:4009.5in1990PeakseasonInwinterandspringInanytimeofayearEpidemiccycleMajorepidemicsappearby2-4yrintervalsEpidemiccycledisappeared,SporadiccasesincreasedAge6m-5y(98%<10y)Below6mandabove5yClinicalmanifestationsTypicalcasesseveremanifestationsmorecomplicationshighmortalityAtypicalcasesmildmanifestationslesscomplicationsrarelydeathEpidemiologyEpidemicFeaturesDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGY0003MeaslesVaccineInoculationinwholeChina(1968)EpidemiologyMeaslescasesofin-patientsinCHCUMS

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYPathophysiology

RespiratoryepitheliumregionallymphnodesFirstviremiaMonocytes/MacrophageSecondviremiaRespiratorytract,conjunctiva,skin,etcViruseliminationMeaslesvirusPathophysiology

1.Incubationperiod10-14days2.Prodromalperiod3-4days3.Apparentmanifestationperiod3-5days4.Convalescentperiod3-5daysDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYPathologyMultinucleatedgiantcell(Warthin-finkeldeygiantcells)Pathology–CytopathicchangePATHOGNOMONICFORMEASLESΦ=100μm,severalnucleusinsidethecell,formedbyconfluenceofseveralvirusinfectedreticuloendothelialcellsInsmearsofthenasalmucosaintheprodromalstageMultinucleatedgiantcellPathology–CytopathicchangePATHOGNOMONICPRESENTATIONFORMEASLESDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYPathology

RespiratorytractSkin

Koplik’sspotsDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYPathology–skinRedmaculopapuleDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYClinicalmanifestationsTypicalmanifestationsAtypicalmanifestations

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsIncubationstage:10-14daysProdromalstage:3-4daysTheprodromedevelopsonthedaysymptombegins(fever)andlastsuntilrashappear.

FeverCough

CoryzaConjunctivitis

Koplik’sspotsDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsProdromalstage:3-4days2.

FeverThe

magnitudeandpatternoffeverarevariableinpatients,fromalow-gradetomoderatefeverorasuddenhighfevermayoccur.Cough

Coryza

Theyarenotspecificsymptomsformeasles,whichareidenticaltoacommoncoldbutcatarrhalsymptomsmaybemoresevere.ConjunctivitisMaysuggestmeaslesbeforeKoplik’sspots.

Koplik’sSpots:

PathognomonicsignDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationstypicalfacialappearanceofmeaslesinprodromalstageDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsTypicalclinicalmanifestationsDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYExanthemstage:3-5days

Maculopapularrash:

Fever:

temperature

rises

abruptlyCatarrh:Othermanifestations:enlargedlymphnodes,slightsplenomegaly,gastrointestinalsymptomssuchasdiarrheaandvomitingDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsTypicalclinicalmanifestationsMaculopapularrashDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsappearingsequenceoftherashTherashusuallystartsontheupperlateralpartsoftheneck,behindtheears,alongthehairline,andontheposteriorpartsofthecheek.DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsappearingsequenceoftherashItbecomeincreasinglymaculopapularastherashspreadsrapidlyovertheentireface,neck,upperarms,andupperpartofthechestwithinapproximatelythe24hr.DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsappearingsequenceoftherashDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsConvalescentstage:3-5days

Inuncomplicatedcases,astherashappearsinthelegsandfeetthesymptomssubsiderapidlywithinabout3daysusuallywithanabruptdropintemperaturetonormal.Astherashfades,brannydesquamationandbrownishdiscoloration(hyperpigmentation)occurandthendisappearwithin2-3weeks.DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYTypicalclinicalmanifestationsBrannydesquamationandbrownishdiscoloration(hyperpigmentation)Convalescentstage:Temp℃Days1-141234567891011121314ClinicalperiodsProdromalstageExanthemstageConvalescentstageCoryzaandconjunctivitisKoplik’sspotsRashCoughBrannydesquamation&hyperpigmentation

Summaryoftypicalclinicalfeatures414039383736DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYClinicalmanifestationsAtypicalmanifestations

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYClinicalmanifestationsAtypicalmanifestations

MildmeaslesMeaslesinadultsSeveremeaslesOccursinthepatientwithpartialimmunityOccursinthepatientswithimmunocompromisedDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYComplicationsDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYComplications

Pneumonia

Subacute

sclerosing

panencephalitis(SSPE)&EncephalitisLaryngitisExacerbationoftuberculosisMalnutritionandVitaminAdeficiencythemostfrequentcomplicationofmeasles

(1)Primarypneumonia

(2)Secondarypneumonia

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYLabstudiesDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYLabstudies

Thewhitebloodcellcounttendstobelowwitharelativelymphocytosis.

Multinucleatedgiantcellscanbedemonstratedinsmearsofthenasalmucosaduringtheprodromalstage.TestingofspecificIgMinserumMeaslesvirusisolationDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDiagnosisEpidemiologicdataClinicaldata

LaboratorydataDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDiagnosisEpidemiologicdataAgeSeasonHistoryofcontactwithpatientHistoryofinoculationDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDiagnosisClinicaldataProdromalperiodExanthemperiodConvalescentperiodKoplik’sspotsTypicalrash;correlationofrashandfever;catarrhBrannydesquamationandbrownishdiscolorationDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDifferentialDiagnosisDifferentialDiagnosisDIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDifferentialdiagnosis

Rubella

Roseola

infantum

Enterovirusinfection

Exanthemcausedbydrugs

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDifferentialdiagnosisRubella

DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDifferentialdiagnosisRubella(GermanMeasles

)DIVISIONOFINFECTIOUSDISEASEANDGASTROENTEROLOGYDifferentialdiagnosisMeasles