Measles (rubeola) Explained Clearly by

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , /

hi welcome to another MedCram
lecture we’re going to talk about measles there’s been an outbreak of
measles recently so I want to talk about the clinical syndromes that measles can
cause the stages of infection the diagnosis and the treatment and I think
there’s some high-yield things that any healthcare provider should know first
thing you should know is that it’s a virus okay specifically it’s the Ruby
olla virus Ruby Ola now you may remember the MMR vaccine this is measles mumps
rubella rubella is German measles it’s a more milder type of disease this is the
first and the measles mumps rubella okay and it’s the Ruby ola virus it’s very
infectious in fact the estimate is is that if somebody has the virus during
it’s transmissible phase they can infect up to 12 to 18 people so it’s very
infectious as we’ve seen in the news and it can spread very rapidly now just to
be complete there are six different clinical syndromes that the Ruby Ola or
the measles virus can cause of course the first one is the classic type of
measles otherwise known as classic measles we’re gonna talk about that one
more that’s the you know your three C’s which we’ll get into the complex spots
which you’ve heard about we’ll talk about that one next one is called
modified measles modified measles is where someone who has been immunized in
the past but maybe don’t have a good antibody response may get a sort of a
lower-level classic measles it’s called modified measles usually the
onset is longer and the course is not as severe as would be with classic measles
so yeah it’s possible that you could be immunized against measles and still get
a measles type of syndrome but it’s a little bit less third one is called
atypical measles we don’t see it much anymore because it
has to do with people who got the dead virus vaccine now most
measles-mumps-rubella in fact all of them are a live virus this is why we
don’t give it to people who are immunocompromised but the dead virus
which was given back in the in the mid 60s would not give the proper immune
response and so it was possible for these people who were immunized with the
dead virus could get this atypical measles just something you should know
about a couple of other things or three other things that you can get is a post
infectious neurological symptoms so post infectious neurological okay these are
some of the things that you might hear about called a d e em that’s acute
disseminated encephalomyelitis and the other thing you may have heard about is
s s P E which is a subacute sclerosing pan encephalitis these are not good
these for complications will talk about those briefly the other way you can get
a severe measles I’m not going to talk much about that and then other
complications such as things called giant cell pneumonia P na is my
abbreviation for pneumonia and then you can even get something called a measles inclusion body encephalitis so these things here basically
four-five-six these are complications which we’ll talk about briefly later but
the one that I want to focus in on is the most common and that’s the classic
measles how are you going to be able to identify that in patients that you see
in the clinic in the emergency room etc so let’s talk about that there are four
stages of the infection of the measles virus and I’ve got them
abbreviated hair.i P E and R I stands for the incubation period P stands for
the prodrome e stands for the X anthem and R stands for recovery and immunity
so in the first phase called the incubation period so in queue vation the
patient is usually asymptomatic they don’t feel any symptoms very rarely will
they feel symptoms and the key here is that that can last from eight to ten
days okay so they’re walking around for eight to ten days and they don’t even
know that they’ve been infected now the prodrome is an interesting
period it’s here where you see the three C’s prodrome what the first thing that
comes on is constitutional symptoms such as fever and malaise and anorexia this
doesn’t mean that they’re skinny it just means that they don’t want to eat but
the other thing that you see here that’s very characteristic is something called
the three C’s and what are those three C’s you ought to know what those three
C’s are the three C’s Arkoff conjunctivitis that means that the area
around the eye is inflamed and it is red and the last C is coryza basically
another name for coryza is rhinitis or inflamed nasal mucosa so runny nose eyes
that are kind of red and cough so these are kind of nonspecific but if you see
those three together with fevers especially when you’re thinking about an
outbreak you want to think about that okay the next thing you want to think
about too is something that’s very classic that they’ll test you on in this
pro drum phase and those are complex spots now what a complex pot some people have
described this as grains of salt on a red background if you were to look in
someone’s mouth imagine the mouth is very inflamed and
it looks red back there and you can imagine either whitish grayish or bluish
so if I were to pick a color like that you would see these whitish grayish or
bluish spots right where the molars are on the buccal mucosa they could also see
it in in other mucosal areas genital is specifically but this is typically where
you see these complex spots now the interesting thing about complex spots is
that they usually show up 48 hours before the next stage which is the rash
or the example exposure known as an N anthem the rash is known as the eggs
anthem so if you see complex spots the rash is probably gonna be coming in
within the next 48 hours by the way the incubation period we said lasts about
eight to ten days the prodrome period usually lasts between two and eight days
but mostly it lasts about two days so if it’s lasting about two days and complex
spots usually pop up 48 hours before the next stage usually the prodrome comes on
with fevers malaise anorexic cough conjunctivitis coryza and complex spots
the thing you ought to know about copic spots is there’s nothing else that
causes them if you see complex spots it’s what we call pathognomonic for
measles okay now let’s talk about the rash the rash is a maculopapular rash okay and it starts on the head and moves
down it usually spares the palms and the soles which is important too to
understand now the other thing about this is that after the rash so that the
rash it’s usually about two to three days
after the rash there will be a fever or high fever which will then deaf for
vests and in fact after the rash appears usually clinical improvement occurs
about 48 hours after the rash appears so again another 48 hours so let’s review
that 48 hours we have to 48-hour marks be 48 hours before the rash appears is
when we’ll see the complex spots and 48 hours after the rash appears we’ll see
fevers but then they will start to go down if we don’t see resolution of
symptoms after 48 hours of the rash these people are at increased risk for
getting complications the other thing you should know is when the rash appears
is usually when the complex spots disappear finally let’s talk about
recovery usually this could last a couple of weeks but eventually the
patient is going to get better the COFF may persist for one or two weeks after
the infection but again if you start to see fevers beyond three four or five
days after the rash usually that may be leading toward a complication so fever
48 hours plus post rash equals questionable complications occurring let’s review the key portions here there
are four stages the incubation period lasts for more than a week when the
prodrome comes there’s fever malaise anorexia the three C’s complex spots
appearing 48 hours before the rash and then when the rash comes the complex
spots go away they’ll have fevers continuing but after
2 to 3 days of the rash the rash will then start to coalesce and then
basically slough off and then if fevers continue after 48 hours after the rash
that’s usually not a good sign finally the recovery phase is about 2 weeks
great in the next video we’re going to talk about the diagnosis and the
treatment of measles you

28 thoughts on “Measles (rubeola) Explained Clearly by

  1. Excellent video!! Providing training to my Corpsmen in reserve unit, this will be played for them. Outstanding info.

  2. excellent video! Thank you so much! Very clear and informative. I am not a medical professional but still i could understand everything and it was very useful for me.

  3. hi thamk u for very imformative videos.i just want to ask if at what stage do measles become contageous. thank you

  4. Prodorme->Rash-> fever… so when you say "if we don't see resolution of symptoms after 48hrs of rash.." at approx. 9:45 are you referring to prodromal symptoms? then at approx. 10:30 you say that fevers 48hrs after rash is concerning for complications? Maybe I m missing something (sorry measles and a lot of these infant exanthems..etc really confuse me) you said it is normal to have a fever 48hrs after rash early in your video but later you say this is concerning? thank you (a family medicine 3rd year resident).

  5. Simply excellent. Very grateful for clear, concise and well presented video. Thank you for the great channel. 12/8/2018 😊

  6. Healthcare is the sorcery of Babylon.Look up the word Pharmakia in the Strongs Concordance of the bible,in Hebrew and Greek.St Jude is a torture chamber for children.The witch doctrors are 33 degree Freemasons,and the children end up being human blood sacrfice to Satan,after they torture them first.Every disorder is a demon spirit or witchraft curse or spell,or a curse from God for the sins of the Fathers.The so called christian Nations are the Northern KIngdom of Israel,whom God divorced,and sent out of his sight and scattered them.WHY?For false god worshipmsacrafising to false gods(often their own children).Read psalm 106 and Daniel 9;3 KJV.Also they were into the occult and idolatry.This the Northern KIngdom of Israel is still doing to this very day.The majority.God sends generational curses down on his own people for their sins.Instead of repenting,they let their children die of diseases,that God could and would cure,if his people served him,

  7. So during the level IMPER, at P there is fever then at E another fever. does it mean fever at P goes away, then at E comes back or fever at P + fever at E are 2 different fevers…confused

  8. What exactly you mean during IMPER at E coalesce ( combine, fuse, mingle, blend ). 2 what exactly in English you are saying after Rash coalesce then (sla….. ?) off please rephrase it..

  9. Does the MMR given in the 60's make those people at risk? It seems like that would be the case since emphasis is only placed on children not adults.

  10. My 5 months old baby is having a measles .. she got infected by her brother .. they have all the sympyoms except they don't have fever at all …

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