Measles, Mumps, and Roseola
Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management
Definition
Measles, mumps, and roseola are viral exanthematous infections primarily affecting children, each with distinct clinical presentations and complications.
Aetiology
- Measles: caused by the measles virus (paramyxovirus), transmitted via respiratory droplets.
- Mumps: caused by the mumps virus (paramyxovirus), spread through saliva and respiratory secretions.
- Roseola (exanthem subitum): caused by human herpesvirus 6 (HHV-6), transmitted via respiratory droplets.
Pathophysiology
- Measles virus infects the respiratory tract and disseminates via lymphatic and blood spread, causing a widespread rash.
- Mumps primarily affects the salivary glands, pancreas, and CNS.
- Roseola features viral replication in T lymphocytes, causing high fever followed by a characteristic rash.
Risk Factors
- Unvaccinated individuals (measles and mumps preventable by MMR vaccine).
- Close contact with infected individuals.
- Young age (infants and young children).
- Immunosuppression (increased severity of illness).
Signs and Symptoms
- Measles:
- High fever, coryza, cough, conjunctivitis (3 C's).
- Koplik spots (white lesions on buccal mucosa).
- Maculopapular rash, starting on the face and spreading downwards.
- Complications: pneumonia, encephalitis, SSPE (subacute sclerosing panencephalitis).
- Mumps:
- Painful parotid gland swelling (often bilateral).
- Fever, headache, and malaise.
- Complications: orchitis (in males), aseptic meningitis, pancreatitis.
- Roseola:
- High fever lasting 3-5 days, resolving before rash onset.
- Maculopapular rash appears on the trunk, spreading to the extremities.
- Complications: febrile seizures.
Investigations
- Measles: PCR or serology (IgM and IgG for measles virus).
- Mumps: serum IgM for mumps virus or PCR from saliva.
- Roseola: clinical diagnosis; PCR for HHV-6 in unclear cases.
Management
1. Supportive Care:
- Paracetamol or ibuprofen for fever and discomfort.
- Hydration and rest.
2. Measles-Specific Management:
- Vitamin A supplementation to reduce complications.
- Isolation to prevent spread.
3. Mumps-Specific Management:
- Scrotal support and analgesia for orchitis.
- Monitor for complications (e.g., meningitis, pancreatitis).
4. Prevention:
- MMR vaccine (measles, mumps prevention).
- Good hygiene and isolation of affected individuals.
5. Referral:
- Paediatrics: if complications such as encephalitis, meningitis, or severe dehydration occur.
- Public health: for notifiable disease reporting (measles and mumps).