麻疹英文专题知识讲座培训ppt课件

麻疹英文专题知识讲座麻疹英文专题知识讲座麻疹英文专题知识讲座MEASLESKey pointsDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYu Acute respiratory infectious disease caused by measles virusu clinical feature:Fever,Cough,Runny nose,Conjunctivitis,Exanthemu Specific sign:Kopliks Spots (a kind of enanthem)MEASLESKey pointsDIVISION OF DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY Classification:A RNA virus Genus:morbillivirus Family:paramyxoviridae Serotype:Only one Location:Nasopharyngeal secretions,Blood,Urine of patientsPathogenDIVISION OF INFECTIOUS DISEASPathogenDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYmeasles virusPathogenDIVISION OF INFECTIOUDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYEpidemiology1.Infectious sources：Measles patients in acute stage 2.Routes of transmission：Droplet spray3.Population susceptibility：4.Epidemic features：l It is susceptible to all the people without infection or inoculation.l The age of peak incidence was 6 months to 5 years old.l The incidence of baby under 6m is lower.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYRoutes of transmissionEpidemiologyDroplet sprayDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPrior to the use of vaccinePrior to the use of vaccineAfter the use of vaccineAfter the use of vaccineMorbidity Morbidity(1/100000)(1/100000)Major epidemics:500-1000Major epidemics:500-1000Mild epidemics:400Mild epidemics:4009.5 in 19909.5 in 1990Peak seasonPeak seasonIn winter and springIn winter and springIn any time of a yearIn any time of a yearEpidemic cycleEpidemic cycleMajor epidemics appear by Major epidemics appear by 2-4 yr intervals2-4 yr intervalsEpidemic cycle Epidemic cycle disappeared,Sporadic disappeared,Sporadic cases increasedcases increasedAgeAge6m-5y(98%10y)6m-5y(98%10y)Below 6m and above 5yBelow 6m and above 5yClinical Clinical manifestationsmanifestationsTypical casesTypical casessevere manifestationssevere manifestationsmore complicationsmore complicationshigh mortality high mortality Atypical casesAtypical casesmild manifestationsmild manifestationsless complicationsless complicationsrarely deathrarely deathEpidemiologyEpidemic FeaturesDIVISION OF INFECTIOUS DISEAS麻疹英文专题知识讲座培训ppt课件麻疹英文专题知识讲座培训ppt课件DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY00 03Measles Vaccine Measles Vaccine Inoculation in whole Inoculation in whole China(1968)China(1968)EpidemiologyMeasles cases of in-patients in CHCUMS DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathophysiology DIVISION OF INFECTIOUS DISEASRespiratory epithelium regional lymph nodesFirst viremiaMonocytes/MacrophageSecond viremia Respiratory tract,conjunctiva,skin,etcVirus eliminationMeasles virusPathophysiology 1.Incubation period 10-14 days2.Prodromal period3-4 days3.Apparent manifestation period3-5 days4.Convalescent period3-5 daysRespiratory epithelium regionDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathologyDIVISION OF INFECTIOUS DISEASMultinucleated giant cellMultinucleated giant cell(Warthin-finkeldey giant cells)(Warthin-finkeldey giant cells)Pathology Cytopathic changePATHOGNOMONIC FOR MEASLES=100m,several nucleus inside the cell,formed by confluence of several virus infected reticuloendothelial cellsIn smears of the nasal mucosa in the prodromal stageMultinucleated giant cellPathoMultinucleated giant cellMultinucleated giant cellPathology Cytopathic changePATHOGNOMONIC PRESENTATION FOR MEASLESMultinucleated giant cellPathoDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathology Respiratory tract Skin Kopliks spotsDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPathology skinRed maculopapuleDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinical manifestationsu Typical manifestationsu Atypical manifestations DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsIncubation stage:10-14daysProdromal stage:3-4days The prodrome develops on the day symptom begins(fever)and lasts until rash appear.l Feverl Coughl Coryzal Conjunctivitisl Kopliks spotsDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsProdromal stage:3-4days2.l Fever The magnitude and pattern of fever are variable in patients,from a low-grade to moderate fever or a sudden high fever may occur.l Cough l Coryza They are not specific symptoms for measles,which are identical to a common cold but catarrhal symptoms maybe more severe.l Conjunctivitis May suggest measles before Kopliks spots.l Kopliks Spots:Pathognomonic signDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationstypical facial appearance of measles in prodromal stage DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYExanthem stage:3-5daysl Maculopapular rash:l Fever:temperature rises abruptlyl Catarrh:l Other manifestations:enlarged lymph nodes,slight splenomegaly,gastrointestinal symptoms such as diarrhea and vomiting Typical clinical manifestationDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsDIVISION OF INFECTIOUS DISEASTypical clinical manifestationsMaculopapular rashDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashThe rash usually starts on the upper lateral parts of the neck,behind the ears,along the hairline,and on the posterior parts of the cheek.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashIt become increasingly maculopapular as the rash spreads rapidly over the entire face,neck,upper arms,and upper part of the chest within approximately the 24hr.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsappearing sequence of the rashDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsConvalescent stage:3-5 days uu In In uncomplicated uncomplicated cases,cases,as as the the rash rash appears appears in in the the legs legs and and feet feet the the symptoms symptoms subside subside rapidly rapidly within within about about 3 3 daysdays usually usually with with an an abrupt drop in temperature to normal.abrupt drop in temperature to normal.uu As As the the rash rash fades,fades,branny branny desquamationdesquamation and and brownish brownish discoloration discoloration(hyperpigmentation)(hyperpigmentation)occur occur and then disappear within 2-3 weeks.and then disappear within 2-3 weeks.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTypical clinical manifestationsBranny desquamation and brownish discoloration(hyperpigmentation)Convalescent stage:DIVISION OF INFECTIOUS DISEAS Temp Temp Days 1-14Days 1-141 12 23 34 45 56 67 78 89 91010 1111 1212 1313 1414Clinical Clinical periodsperiodsProdromal Prodromal stagestageExanthem stageExanthem stageConvalescent Convalescent stagestageCoryza and Coryza and conjunctivitisconjunctivitisKopliks spotsKopliks spotsRashRashCoughCoughBranny desquamation Branny desquamation&hyperpigmentation&hyperpigmentation Summary of typical clinical features414039383736 Temp Days 1-1412345678910DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinical manifestations Atypical manifestations DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYClinical manifestations Atypical manifestations 1.Mild measles2.Measles in adults3.Severe measlesOccurs in the patient with partial immunityOccurs in the patients with immunocompromisedDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYComplicationsDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYComplications1.Pneumonia2.Subacute sclerosing panencephalitis(SSPE)&Encephalitis3.Laryngitis4.Exacerbation of tuberculosis 5.Malnutrition and Vitamin A deficiencythe most frequent complication of measles(1)Primary pneumonia (2)Secondary pneumonia DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYLab studiesDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYLab studies The white blood cell count tends to be low with a relative lymphocytosis.Multinucleated giant cells can be demonstrated in smears of the nasal mucosa during the prodromal stage.Testing of specific IgM in serum Measles virus isolationDIVISION OF INFECTIOUS DISEAS麻疹英文专题知识讲座培训ppt课件DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Epidemiologic data Clinical data Laboratory dataDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Epidemiologic dataAgeSeasonHistory of contact with patientHistory of inoculationDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDiagnosis Clinical dataProdromal periodExanthem periodConvalescent periodKopliks spotsTypical rash;correlation of rash and fever;catarrhBranny desquamation and brownish discolorationDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential DiagnosisDifferential DiagnosisDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosisu Rubellau Roseola infantumu Enterovirus infectionu Exanthem caused by drugs DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosisu Rubella DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosis Rubella(German Measles)DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYDifferential diagnosisMeasles Roseola infantumThe rash typically appears when the elevated temperature has abated,and can last for only a few hours before subsiding.DIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPreventionDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYPreventionu Control of sources of infections u Abrupt the ways of transmissionu Protect the susceptible passive immunization active immunizationDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTreatmentDIVISION OF INFECTIOUS DISEASDIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGYTreatmentu Antipyretics for feveru Bed restu Maintenance of an adequate fluid intakeu Good nutrition and adequate vitamin A intakeu Humidification of the room u To keep the room comfortably warm than coolu Be protected from exposure to strong lightu Appropriate antibiotic therapyu Traditional Chinese medicine with antiviral effectsDIVISION OF INFECTIOUS DISEASictory over Diseasesictory