Thursday, January 23, 2014

What is Tigdas, Measles or Rubeola ?


Tigdas, Measles, Rubeola  is an infectious disease considered  as one of the most contagious conditions affecting 9 out of 10 people in susceptible domestic contacts. Rubeola (Measles) is one of the Viral Exanthems that also includes, Rubella (German Measles or 3 day measles, "tigdas hangin"), Roseola Infantum and Erythema  Infectiosum (Human Parvovirus). It mostly involve the young ones but people off all ages can be also be affected.
The Morbillivirus is the responsible  etiologic agent and transmission is by droplets of nasophayngeal secretions thru coughing, sneezing and physical contact. Incubation period usually ranges from 7-18 days with the usual average of  10 days after exposure to the virus. The first usual sign is high grade fever, often above 39 degree Centigrade and lasting for 4-7 days. The prodromal phase is marked by the classic triad of Cough, Conjunctivitis and Coryza ( 3 C"s) with accompanying anorexia, photophobia, irritability and body malaise.

The rash usually spreads from forehead to trunk in about 1-2 days duration which on the average develops about 14 days after exposure to the virus. The rash may be slightly elevated and mild pruritus may also occur.

The treatment of measles is  generally supportive care  which means control of body temperature by antipyretics (Paracetamol), good hydration and replacement of fluids lost thru moisture evaporation in skin, emesis and diarrhea (Oral Rehydrating Salts "ORS"). Pruritus may be controlled with antihistamines (Cetirizine, Diphenhydramine etc.). It is also noteworthy to mention that Vitamin A supplements have been associated with a marked reduction (about  50%) in morbidity and mortality and regarded essential in preventing blindness and eye damage.

The usual complication of measles is Pneumonia, occuring about 3-10% of affected patients followed by Ear Infection (Otitis Media), severe dehydration, Pneumonitis and in severe cases, Encephalitis occuring in 1 out of 1000 measles cases and causing death in 1-2 % of affected patients.