MMR

Question 1

Aetiology of measles

Answer 1

Paramyxovirus

Question 2

Transmisison of measles

Answer 2

Resp droplets

Question 3

Why is the measles vaccine important?

Answer 3

Highly infectious - need ~98% herd immunity

Question 4

Clinical features of measles

Answer 4

• Prodrome 3-4 days = high fever + 3 C’s of measles:
  
  • Cough
  • Coryza
  • Conjunctivitis
  • • Koplik spots are pathognomonic of measles (look in mouth)
• Cephalocaudal, maculopapular rash2-3 days after initial Sx, red and blotchy
• Clinical improvement 48 hours after rash
• Occasionally diarrhoea

Question 5

Mx for measles

Answer 5

• Supportive
• Antibiotics if bacterial superinfection
• Vitamin A
• Ig available

Question 6

List some complications of measles

Answer 6

• Otitis media, sinusitis, mastoiditis
• Pneumonia
• TB reactivation
• Myocarditis
• Encephalitis- SSPE (subacute sclerosing panecephalitis)
• ADEM (acute disseminating encephalomyelitis)

Question 7

Mumps: classic sign

Answer 7

• Swelling due to parotids - most commonly bilateral

• Tender, febrile

Question 8

Complications of mumps

Answer 8

Many, inc infertility, encephalitis, meningitis, pancreatitis, myocarditis, miscarriage

Question 9

What is rubella

Answer 9

• =German measles = third disease

- self-limiting infection

Question 10

Organism causing rubella

Answer 10

Togavirus

Question 11

Clinical features of rubella

Answer 11

• Classically erythematous, fine maculopapular, discrete rash but can become confluent
  
  • Spreads from face to body to limbs
• May have no rash/symptoms
• Prodrome: fever, sore throat, red eyes, H/A, malaise, lymphadenopathy (post-auricular)

Question 12

Complications of rubella

Answer 12

• Main complications in pregnancy:
  
  • Congenital rubella syndrome
  • Highest risk in 1st trimester
  • Sensorineural hearing loss, IUGR, cataracts and retinopathy, CHD, microcephaly, neurodevelopmental delay, thrombocytopaenia, hep/splenomegaly