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Measles (Eradication (Programmatic feasibility (Vaccine is safe and…
Measles
Eradication
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Defn: interruption of endemic transmission globally (c/w elimination: interruption of endemic transmission locally/regionally)
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Impact on health systems: need campaign to add value (e.g. also deliver anti-helminthic med, vitamin A, insecticide treated bed nets)
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The post-measles era: consider non-human primate reservoirs (low risk), persistent infections (low risk), transmission of vaccine-derived virus (low), laboratory risk
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PH control
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Contacts
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Education what to look for, call ahead
Vaccine:
Vaccination failure: cold chain breach, misadministration
Primary vaccine failure: Failure to mount immune response to measles vaccine. maternal ab to baby interfere with vaccine given in bub (thought to be 9 months). Second dose required for this reason.
Secondary vaccine failure: 2 doses of measles vaccine given, may still get attenuated disease in outbreak settings. Waning immunity.
Challenges: immunity gaps, transmissibility during the prodromal period, maternal immunity less robust post vaccine c/w wild infection
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Complications: otitis media, bronchopneumonia, encephalitis, subacute sclerosing panencephalitis
At risk: immunocompromise, malnourished (esp vit A deficiency), under 5 years of age, pregnant women
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Basic reproduction number (Ro): number secondary cases that a single infected case would cause in a fully susceptible population (Measles =18)
Effective reproductive number (Re): basic reproduction number discounted by the fraction of the host population that is susceptible (x). Aim Re < 1
Re = R0x
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One of the most highly communicable infectious diseases. Short survival time in air or on objects. Ro = 18 (no of secondary cases when an infectious person is introduced into a population)
Clinical presentation: prodrome of 2-4 days of fever, conjunctivitis, coryza and cough. Koplik spots may present. Maculpapular (non-itchy) rash appears 2-7 days post prodrome.