Airborne precautions – N95 respirators
Definition
Global considerations
Etiology
Epidemiology
Pathogenesis
Airborne transmission – virus can remain for several hours
Immune responses
?????? ????? 4~6???.
Approach to the patient
Clinical manifestations
??? 8-12?
???? ?? ??
3C (cough, coryza, conjunctivitis), fever, Kopliks’ spot (?? 1-2? ? ???? ?? ??? ?? ??)
??? 3-5?
??? 7?
2-3? ? ?? ?? ??. ?? ?? +/-4??? ??
? ???? ???? 24hr ? ?? ??, 3??? ???.
Maculopapular ??, ???, ??. ??? ?? ?? ????!
???
?? ?? + ?? ???? + 7-10? ? desquamation (???x)
???? ?? ?? ??. Vit.A supplement? ??? ??. ??? ????, ??? anti x
Differential diagnosis
Scarlet fever
Caused by S.pyogenes. presents with pharyngitis, fever, and an erythematous, sandpaper-like rash.
Rubella
Relatively mild (eg, low-grade fever, patient is well-appearing) and shorter in duration
The rubella rash does not darken as does measles.
Diagnosis
- Serologic testing
- Measle IgM antibody (+)
- Measle IgG antibody? 2-4? ? 4? ?? ?? ?.
Treatment
Vitamin A
Deficiency – at greater risk for complications such as pneumonia, encephalitis, or blindness.
?Morbidity and mortality rates for patients with severe measles through the promotion of APCs and regeneration of epithelial cells (eg, in the gut, lungs, and retina)
Complications
Pulmonary (m/c)
Primary measles pneumonia
Secondary bacterial infection (AOM, pneumonia)
????, ??????, ??? ??
Neurologic (rare)
?? ?: encephalitis
?? ?: acute disseminated encephalomyelitis, ADEM
?? ?: subacute sclerosing panencephalitis, SSPE
Oligonal bands of measles virus antibodies are found in the CSF of these patients.
Prognosis
Prevention
????? 12~15?? MMR, 4~6?? ?? ??
????? gamma globulin ???.
• 6?? ?? : ??? measles? ?? ??? ?? ?
• 6-12??, ?S : ???? 6? ?? Ig
• 12?? ?? : 3? ?? ??? ?? (????)
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