「Measles」の版間の差分

1970-80s sub-Saharan children mortality &50%, majority of which owing to measles
1880s devastating measles outbreak in Fiji introduced by foreign ships resulted in 20-30% of Fijian population died from measles

complications

acute overwhelming infection in the first week
secondary bacterial pneumonia in the second week
- S. pneumoniae
- S. aureus
- air trapping is a feature - possible pneumothorax
secondary viral infection
- HSV
- RSV
- adenovirus
post-measles syndrome
- malnutrition
- immune paralysis, immunomodulation

isolation, theoretically good but useless in reality
effective treatment with vit. A and antimicrobials
- vit. A and antimicrobials for secondary bacterial infection can reduce mortality
vaccination
- maternal passive immunity wane in 6-9 months after birth
  - rational for the first vaccination after 9 months of age
- 10% of primary vaccine failure in the first vaccination
  - rational for the second vaccination

@@ 14行目: / 14行目: @@
 ==relation with malnutrition==
 *still controversial, malnutrition first or measles first
+==risk for death from measles==
+*vit. A deficiency
+*malnutrition - causation controversial
+*in larger outbreak
+*in larger household contact
+*younger children
+*HIV positive children
+===etiology of child death===
+*acute overwhelming infection in the first week
+*secondary bacterial pneumonia in the second week
+**''S. pneumoniae''
+**''S. aureus''
+**air trapping is a feature - possible pneumothorax
+*secondary viral infection
+**HSV
+**RSV
+**adenovirus
+*post-measles syndrome
+**malnutrition
+**immune paralysis, immunomodulation
 ==strategies to control==