measles, mumps & rubella
DESCRIPTION
brief introduction to epidemiology, epidemiological triad and prevention of measles, mumps & rubella.TRANSCRIPT
Measles, Mumps & Rubella
Izatty Lim0308188
13 June 2014
EPIDEMIOLOGICAL TRIAD
DISTRIBUTION PREVENTION
MEASLES Occurrence
o Worldwideo interruption of transmission achieved in the United States & other parts of the
Western Hemisphere.
Reservoiro human diseaseo no known animal reservoiro asymptomatic carrier state has not been documented.
Transmissiono primarily person to person via large respiratory dropletso Airborne transmission via aerosolized droplet nuclei has been documented in
closed areas for up to 2 hours after a person with measles occupied the area.
Incubation Period o 7 – 18 days
Communicabilityo highly communicable, >90% secondary attack rates among susceptible persons. o Infectious period: from 4 days before to 4 days after rash onseto Maximum communicability during prodromal phase
EPIDEMIOLOGICAL TRIAD OF MEASLES
Agento Measles virus.
• only one antigenic type of measles virus.
• rapidly inactivated by heat, light, acidic pH, ether, and trypsin
• short survival time (<2 hours) in the air or on objects and surfaces
Hosto Human
• Unvaccinated young children & pregnant women• Poorly nourish• insufficient vitamin A• Weakened immune systems
Environmento Developing countries – Africa & Asiao Countries with low per capita incomes and weak
health infrastructureso Countries experiencing or recovering from a
natural disaster or conflicto dry seasons in tropical zoneso Overcrowded places
DISTRIBUTION In developed countries during the pre-vaccine era,
o >90% of children acquired measles by age 15. o Following implementation of routine childhood vaccination at age 12 to 15 months,
the age of peak measles incidence in the United States shifted to six months of age.
Measles as a significant cause of morbidity and mortalityo In 2000, measles was estimated to cause approximately 31 - 39.9 million illnesses
worldwide with an estimated 733,000 - 777,000 deaths, making it the 5th most common cause of death in children under five years of age.
DISTRIBUTION
Worldwide reported measles incidence rate per 100 000 population, 2004
DISTRIBUTION
MUMPS Occurrence
o worldwide.
Reservoiro human diseaseo persons with asymptomatic infection can transmit the virus, but
no carrier state is known to exist.
Transmissiono airborne transmission o direct contact with infected droplet nuclei or saliva.
Incubation Periodo 16 - 18 days
Communicabilityo Contagiousness similar to that of influenza & rubella
• less than that for measles & varicellao Infectious period: from 3 days before to the 4th day of onset of
symptoms
EPIDEMIOLOGICAL TRIAD OF MUMPS
Agento Mumps virus
• One antigenic type• rapidly inactivated by
formalin, ether, chloroform, heat, and ultraviolet light
Hosto Human
• Failure to be immunized completely
• children between 2-12 years of age
• Weakened immune system Environment
o Africa, general Indian subcontinent region, and Southeast Asia- very low rate of vaccination
o Late winter & springo Small, enclosed roomo Crowded places
RUBELLA Occurrence
o worldwide.
Reservoiro human diseaseo Infants with congenital rubella syndrome(CRS) may shed rubella virus for an
extended period, • But a true carrier state has not been describe.
Transmissiono person to person via airborne transmissiono droplets shed from the respiratory secretions of infected persons
• asymptomatic cases o no evidence of insect transmission
Incubation Periodo 14 – 21 days
Communicabilityo only moderately contagious. o most contagious when the rash first appearso Infectious period: from 7 days before to 5–7 days or more after rash onset.o Infants with CRS shed virus from body secretions for up to 1 year
• may transmit rubella to persons caring
EPIDEMIOLOGICAL TRIAD OF RUBELLA
Agento rubella virus
• Do not require vector• relatively unstable • inactivated by lipid solvents,
trypsin, formalin, ultraviolet light, low pH, heat
Hosto Human
• infants and young toddlers who have not received the vaccine
• women of childbearing age do not have immunity to the disease
Environmento WHO African and South-East Asian
regions- vaccine coverage is lowesto Late winter early springo Small, enclosed roomo Crowded placeso Schools or day care centre o Shopping mall
DISTRIBUTION
PREVENTION
Rubellao Rubella vaccine (Meruvax)o Keep distance from infected
person
Measleso Measles vaccine
• 2 doses • 1st dose at age 12 -15 months• 2nd dose at 4 – 6 years old
o Keep distance from infected person
Mumpso Mumps vaccine (Paramyxovirus)
• Last at least 12 yearso Keep distance from infected person
Combined MMR introduced in Malaysiao 2002
INCIDENCE TIME SERIES FOR MALAYSIA
References Epidemiology
o https://sites.google.com/site/epidemiology12/measleso https://sites.google.com/site/epidemiology12/rubellao https://sites.google.com/site/epidemiology12/mumps
WHO Health Topicso http://www.emro.who.int/health-topics/measles/disease-and-epidemiology.html o http://www.emro.who.int/health-topics/rubella/disease-and-epidemiology.html o http://www.who.int/topics/mumps/en/
Epidemiology and transmission of measleso http://www.uptodate.com/contents/epidemiology-and-transmission-of-measles
Vaccine Knowledge Project o http://www.ovg.ox.ac.uk/measleso http://www.ovg.ox.ac.uk/rubella
Rubella Viruso http://www.stanford.edu/group/virus/toga/2000/c.html
WHO Incidence time series for Malaysiao http://apps.who.int/immunization_monitoring/globalsummary/incidences?c=MYS
History of Vaccineo http://www.historyofvaccines.org/content/articles/mumps
References Epidemiology and Prevention of Vaccine-
Preventable Diseaseso http://www.cdc.gov/vaccines/pubs/pinkbook/meas.htmlo http://www.cdc.gov/vaccines/pubs/pinkbook/rubella.htmlo http://www.cdc.gov/vaccines/pubs/pinkbook/mumps.html
Measles Prevention and Control in Malaysiao http://jknns.moh.gov.my/v1/images/borang/cdc/
r.Measles-Prevention%20and%20Control%20in%20Malaysia.pdf
Lippincott’s Guide to Infectious Diseases Harrison’s Infectious Diseases
o By Kasper, D. L., & Fauci, A. S. (2010)
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