SAQ 159 – Infectious Diseases – measles diagnosis and management

Question 2. measles diagnosis and management.

a. Clinical case definition

• Morbilliform rash.
• Upper respiratory symptoms, including conjunctivitis or Koplik spots.
• Fever at the onset of the rash.

b. Rash features

• Fever is present at onset.
• Usually appears on day 3-4.
• Florid, confluent, erythematous maculopapular or morbilliform rash.
• Begins on the head, neck, or behind the ears and spreads over the body, including palms and soles.
• May herald clinical recovery and may desquamate.

c. Non-susceptible groups

• Infants under 6 months if the mother is immune.
• Children aged 1-4 years who have received at least one measles vaccine.
• People with two documented measles vaccinations.
• People born before 1966, with laboratory-confirmed prior measles, or with measles IgG present.

d. Additional management

• Notify public health and hospital infection control.
• Use airborne isolation, ideally a negative-pressure room, with appropriate staff PPE.
• Give vitamin A as recommended for children under 12 months.
• Arrange contact tracing and post-exposure prophylaxis for susceptible contacts.
• Provide exclusion, complication, and return advice; manage at home if otherwise well.