Nama : Akmal Apandi

Kelas : 2B

Nim : 8801220033

Sumarizing

Measles in Children

INTRODUCTION

Measles is a disease highest cause of death in children,very infectious, can be transmitted from the start
prodromal period (4 days before emergence rash) until approximately 4 days after the appearance of a
rash.1,2 Measles arises because exposed to droplets containing the virus measles. Since the measles
immunization program proclaimed, the number of cases decreased, however recently it has increased
again.

ETIOLOGY

Measles is an acute viral disease caused by RNA viruses of the genus Morbillivirus, family
Paramyxoviridae.1,5,6 This virus is from the same family as the mumps virus (mumps), parainfluenza
virus, human virus metapneumovirus, and RSV (Respiratory Syncytial Virus). The measles virus measures
100-250 nm and contains a single stranded RNA core covered with a protective layer of lipids. The
measles virus has 6 protein structures main. Protein H (Hemagglutinin) plays a role important in the
attachment of viruses to cells sufferer.

PATHOPHYSIOLOGY

The spread of infection occurs if droplets are inhaled in the air coming from the patient. Virus measles
enters through the respiratory tract and attaches to airway epithelial cells. Once attached, the virus
replicates and followed by spread to the lymph nodes regional. After this deployment, it happened
primary viremia followed by viral multiplication in reticuloendothelial system in the spleen, liver, and
lymph nodes. Virus multiplication also occurs in the initial place where the virus attaches. On the 5th day
up to the 7th infection, secondary viremia occurs throughout the body, especially in the skin and ducts
Respiratory. On the 11th day to the 1st day 14, the virus is in the blood, respiratory tract, and other
body organs, 2-3 days later the virus begins to decrease. During infection, viruses replicates in
endothelial cells, epithelial cells, monocytes, and macrophages.
GOVERNANCE

In measles without complications, management supportive, in the form of bed rest, antipyretic
(paracetamol 10-15 mg/kgBW/dose can be given up to every 4 hours), fluids adequate nutrition,
nutritional supplements and vitamins A.1,10,12 Vitamin A can function as immunomodulators that
enhance response antibodies to the measles virus. Giving Vitamin A can reduce the incidence
complications such as diarrhea and pneumonia.5 Vitamin A is given once per day for 2 days with the
following doses: 1.5-7,9,10,12

 200,000 IU in children aged 12 months or more

 100,000 IU in children aged 6 - 11 months
 50,000 IU in children less than 6 months
 Give additional vitamin A once single dose at an age appropriate dose Patients are given
between the 2nd week to 4th in children with symptoms vitamin A

deficiency In measles complicated by otitis media and/or bacterial pneumonia antibiotics can be given.
1,7,12 Complications of diarrhea Treat dehydration according to the degree the dehydration.

PREVENTION

Prevention is done by vaccination measles or MMR vaccination (Measles, Mumps, Rubella). According to
the immunization schedule IDAI recommendation in 2014, measles vaccine given at 9 months of age.
Furthermore, A booster vaccine can be given at age 2 year. If the MMR vaccine is given to 15 months
old, no measles vaccination is required at the age of 2 years. Next, repeat MMR given at the age of 5-6
years. 13 Doses measles vaccine or MMR vaccine 0.5 m subcutaneous.

This immunization is not recommended for pregnant women, children with primary immunodeficiency,
patients untreated tuberculosis, patient cancer or organ transplant, treatment long-term
immunosuppressives or children HIV-infected immunocompromised. HIV-infected child without severe
immunosuppression and without evidence of immunity to measles, can get measles immunization.

CONCLUSION

Measles is a very disease infection caused by the measles virus which is transmitted through
droplets.Clinical manifestations include fever, cough, colds, conjunctivitis, and rashes all over the body.
Management is generally supportive and accompanied giving vitamin A according to the patient's age.
Prevention is done by immunization measles vaccine or MMR vaccine.

DAFTAR PUSTAKA

1. Dubey AP. Measles. In: Parthasarathy A, Menon PSN, Gupta P, Nair MKC, Agrawal R, Sukumaran TU,
editors. IAP Textbook of Pediatrics. 5th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2013.
p. 250-1.
2. World Health Organization. Measles [Internet]. 2015 February [cited 2015 June 11]. Available from:
http://www.who.int/mediacentre/factsheets/fs286/en/
3. World Health Organization. Measles – The Americas [Internet]. 2015 February 13 [cited 2015 June
11]. Available from: http://www.who.int/csr/don/13-february-2015-measles/en/
4. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Profil pengendalian penyakit
dan penyehatan lingkungan tahun 2014. Jakarta; 2015. p. 25-7
5. Maldonado YA. Rubeola virus (measles and subacute sclerosing panencephalitis). In: Long SS,
Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious diseases. 4th ed. Churchill
Livingstone: Elsevier Inc.; 2012. p. 1137-44.
6. The American Academy of Pediatrics. Measles. Early release from red book® 2015 Report of the
Committee on Infectious Diseases [Internet]. 2015 February 20 [cited 2015 June 11].
Available from: http://redbook.solutions.aap.org/DocumentLibrary/2015RedBookMeasles.pdf
7. Cherry JD. Measles Virus. In: Cherry JD, Harrison GJ, Kaplan SL, Hotez PJ, Steinbach WJ, editors. Feigin
& Cherry’s textbook of pediatric infectious diseases. 7th ed. Philadelphia: Elsevier Inc.; 2014 (Vol 2.). p.
2373-94.
8. Soegijanto S, Salimo H. Campak. In: Ranuh IGNG, Suyitno H, Hadinegoro SRS, Kartasasmita CB,
Ismoedijanto, Soedjatmiko. Pedoman imunisasi di Indonesia. 4th ed. Jakarta: Badan Penerbit IDAI; 2011.
p. 341-5.
9. Khuri-Bulos N. Measles. In: Elzouki AY, Harfi HA, Nazer HM, Stapleton FB, Oh W, Whitley RJ, editors.
Textbook of clinical pediatrics. 2nd ed. Berlin: Springer; 2012. p. 1221-7.
10. World Health Organization. Treating measles in children [Internet]. 2004 [cited 2015 June 11].
Available from:http://www.who.int/immunization/documents/EPI_TRAM_97.02/en/
11. Info Imunisasi. Campak bisa dicegah dengan imunisasi [image on the Internet]. 2012 July 17 [cited
2015 June 11] Available from: http://infoimunisasi.com/headline/campak-bisadicegah-dengan-
imunisasi/
12. Pediatric Infectious Disease Society of the Philippines. Interim management guidelines for measles
[Internet]. 2013 [cited 2015 June 11]. Available from:
www.pidsphil.org/pdf/Journal_12312013/jo45_ja07.pdf

13. Ikatan Dokter Anak Indonesia. Jadwal imunisasi IDAI 2014 [Internet]. 2014 [cited 2015 June 11].
Available from: http://idai.or.id/public-articles/klinik/imunisasi/jadwal-imunisasi-idai-2014.html
14. Centers for Disease Control and Prevention. Measles. Epidemiology and prevention of vaccine-
preventable diseases [Internet]. 2015 [cited 2015 June 11]. Available from:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf