UNIT 15 MEASLES, TUBERCULOSIS :
AND WHOOPING COUGH
Structure
15.1 Introduction
15.2 Measles
15.2.1 The Dise-What causes it? Who gets it? How and when docs it spread?
15.2.2 Symptoms and Complications
15.2.3 Revention and Management
15.3 Tuberculosis
15.3.1 The D i s e s W h a t causes it? Who gets it? How and when does it spread?
15.3.2 Symptoms and Complications
15.3.3 Revention and Management
15.4 Whooping cough
15.4.1 The Dise-What causes it? Who gets it? How and when docs it spread?
15.4.2 Symptoms and Complications
15.4.3 Revention and Management
15.5 Let Us Sum Up
15.6 Glossary
15.7 Answers to Check Your Progress Exercises
15.1 INTRODUCTION
You are aware that children are very prone to infections. The infections are caused by
microorganisms which are very minute and can be seen only through a microscope.
Measles, tuberculosis, whooping cough are three such infectious diseases commonly
found in children. What is the causative agent? How does it spread? How do we
identify these diseases? What can we do to prevent our children from getting these
diseases. This unit provides answer to these crucial questions.
In this unit we will learn about the causes, complications, prevention control measures
for each of these infectious diseases.
Objectives
After studying this unit; you will be able to :
identify the cause and mode of spread of measles, tuberctrlosis and whooping
cough,
enumerate the symptoms and complications of measles, tuberculosis and whooping
cough, and
discuss the steps to manage and prevent these diseases and also educate the
community about preventive measures.
15.2 MEASLES
Measles is a viral disease which generally attacks children, around one year of age. It
is one of the important and common childhood infections. Measles is endemic in most
of the countries of the world. In India, every year about 14 million children suffer
from measles. It is estimated that 20,000 children die every year in our country due to
complications from measles.
, \
-Common Infectious Diseases 15.2.1 The Disease--What causes it? Who gets it? How and when
,' does it spread?
What causes measles?
The disease is caused by the measles virus. Viruses you know are microorganisms
which can be seen only through sophisticated microscope.
Who gets the disease?
Age : The disease is common in childhood. Most of the children have an attack of
measles by the time they complete the age of 3 years. In about a third of all cases
with measles, it occurs under the age of one year.
Socio-Economic Factors : Measles is particularly severe amongst poor communities.
Of many adverse influences of poor socio-economic status on child, poor nutrition,
both before and during the attack of measles, plays a major part in the severity and
outcome of the infection. Epidemics tend to occur at 2 to 4 year intervals in crowded
large cities, particularly in the urban slum areas. In conditions of poor environment,
children get measles at an earlier age. In middle income families, it occurs later
around the school age.
Sex : Incidence of measles is equal among both the sexes.
Seasons : The disease is more prevalent in winter.
How does it Spread?
It is spread through droplets (either during coughing or sneezing) or direct contact
with secretions from nose or throat or urine of persons infected with measles. It is
one of the most readily transmissible of the communicable diseases. Articles recently
contaminated with saliva or nasal discharges may also convey infection. An attack of
measles in the cause of pregnant women may lead to abortion.
Incubation period : The disease takes, on an average, about 10 days varying from 8
to 13 days, to occur from the time of exposure to a patient with measles to the onset
of fever. The skin rash appears about 14 days after exposure to an infected child.
Period of communicability : The disease is communicable from the beginning of
onset of fever to 4-6 days after appearance of the skin rash. Measles is very
infections and about 90 per cent of susceptible family members coming in contact
with the patient (family contacts) acquire the disease. In other words, other children,
who had not got measles earlier, in the household of the patient are likely to catch
the disease.
Susceptibility : Practically all persons are susceptible. After an attack, a person
usually acquires permanent immunity. In otherwords, an individual suffers from
measles only once in life time. Infants born of mothers who have had the disease are
ordinarily immune (i.e. do not develop the disease) for approximately the first 6
months of life.
15.2.2 Symptoms and Complications
Measles is an acute (short and sudden onset) communicable disease. It starts as mild
fever, cough and running nose. There will be conjunctivitis (reddening of the eyes). If
you examine the inside of mouth, you can find characteristic greyish white spots on a
red base on the mucous membrane of the mouth (a membrane, secreting mucus,
lining the mouth), A day or tpo later typical skin rash (eruptions on the skin) which
is dusky red in colour appears i.e. third to seventh day after the onset of fever. The
rash appears first on the face and spreads to the body and generally lasts for 4-5
days. Measles is rather severe among children who are malnourished.
What are the complications of measles ?
Measles is an important public health problem because it leaves the children in a
debilitated condition (very weak). Common complication after an attack of measles is
severe respiratory infection leading to broncho-pneumonia (infection of the lungs)
which may end in death. One of the commonest complications is severe diarrhoea
which quite often leads to malnutrition. Measles and nutritional status of the child are
very closely associated. If you carefully question the mothers of the children suffering
frcm severe forms of malnutrition, always, they would tell you that the children
, Merdles, Tuberclllosls and
suffering from severe forms of malnutrition, almost always, they would tell you that
Wboopb Cough
the children had measles in the recent past Because of loss of appetite and severe
diarrhoea, the children recovering from the measles often develop severe forms of
malnuuition. You might recall reading about the effect of measles on nutritional status
of children in unit 20, block 5, of course 1.
Middle ear infection, mental retardation can also occur as complications after an
attack of measles. Measles is known to conVibute to the damage of the cornea (black
portion of the eye) leading to blindness. Measles also aggravates Vitamin A deficiency
in children and leads to blindness.
15.2.3 Prevention and Management
Prevention/control measures for measles are discussed below:
Prevention of measles through vaccination : Vaccination is the simplest and best
method to prevent measles. Normally all children at 12 months of age or as soon
thereafter as possible are given measles immunisation. A single injection protects
95 per cent of susceptible children from the disease for over 12 years and probably
for life. After vaccination majority have minimal infection with minimal symptoms
such as fevers, cough, running nose and even rash. A single dose of 0.5 ml-of
reconstituted freeze-dried vaccine is given intramuscularly (in the muscle). Normally,
immunity develops 11 to 12 days after vaccination.
Next, a word about how to treat measles ?
Management of Measles : There is no specific treatment for measles. Antipyretics
i.e. medicines to control fever, bed rest and adequate fluid intake are the basic
requirements. The important aspect in management is control of secondary bacterial
infection by using suitable antibiotics. Complications such as pneumonia and middle '
ear infections require appropriate treatment with antibiotics. The nutritional status of
the child must be maintained properly. Children who are breast-fed and unable to suck
due to soreness of mouth may be fed breast milk with a spoon after expression of the
same from the mothers breast. For those children who are not breast-fed, soft diets in
the form of pomdges can be given. Children suffering from measles lose considerable
weight and during the recovery period weight gain is slow. Children recovering from
measles should be given adequate diet to stimulate faster weight gain. The child
should be fed more frequently i.e. 5-6 times a day. The diet should'include cereals
like rice or wheat, pulses (dal) and green vegetables. The child should also be given
atleast one glass of milk every day. The diet should be cooked soft and preferably be
fed by the mother or elder member. Other dietary considerations for management of
measles discussed in unit 20, block 5 of course 1 are applicable here as well. Go
through those considerations carefully.
Points to Remember : given below presents the salient features of measles :
f
POINTS TO REMEMBER
Measles
Measles, an acuk communicable disease is an important public health
problem.
It is caused by measles virus.
It spreads through droplets or direct contact with secretions from nose. throat
or urine of persons infected with measles.
The disease has an incubation period of about 10 days.
The simplest and best method to prevent measles is vaccination.
Treatment of secondary infections and complications is the best way to
manage measles.
Maintain the nutritional status of the child by providing good nutritious food.
, iC
Common lafectioun Dlseamea Check Your Progress Exercise 1
1) Prepare a flow chart for the. step-by-step progress of measles in a child.
2) Prepare a talk to educate mothers about prevention and management of measles.
...............................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
15.3 TUBERCULOSIS
Tuberculosis is a common disease that is found almost everywhere. It is important as
a cause of disability and death in many parts of the world. In developing countries
such as India, you should expect a higher prevalence of tuberculosis in the under-five
age group, as a result, of geater opportunities of exposure to the disease. In other
words, it is likely to occur more frequently in these age group. It is estimated that
there would be atleast 9-10 million cases of pulmonary (lung) tuberculosis as well.
15.3.1 The Disease-What causes It? Who gets it? How and when
does it spread?
Tuberculosis is caused by Mycobacterium tuberculosis, a non-motile. slender. acid-
fast bacillus. Two strains-human and bovine-are of importance to man. Human
source is responsible for the vast majority of cases of India. The bacillus can be seen
by examination of sputum or other secretions under a microscope after using
appropriate staining procedures.
Who gets the disease?
Age : Tuberculosis can occur at any age. Recent surveys in India show that it occurs
more in older age groups than the younger groups.
Sex : In India, tuberculosis is more prevalent among males over 45 years of age than
among females. In females however, the peak prevalence is below 35 years.
Socio-Economic Factors : The disease occurs more frequently in families belonging
to low income groups. In Western countries a decline in death rates due to
tuberculosis has occurred with an increase in standard of living. Communities living
in substandard houses which are ill ventilated and have inadequate floor space are
likely to suffer more from the disease. Miners and textiles workers are more prone to
disease. Oveccrowding as in the slum areas of the cities helps in the rapid spread of
the disease.
Certain social customs such as indiscriminate spitting, smoking of hukka, purdah
system also help in the spread of the infection. Tuberculosis has a social stigma. This
attitude leads to concealment of the disease and consequent delay in diagnosis of
cases with increased risk of spreading the disease to others.
AND WHOOPING COUGH
Structure
15.1 Introduction
15.2 Measles
15.2.1 The Dise-What causes it? Who gets it? How and when docs it spread?
15.2.2 Symptoms and Complications
15.2.3 Revention and Management
15.3 Tuberculosis
15.3.1 The D i s e s W h a t causes it? Who gets it? How and when does it spread?
15.3.2 Symptoms and Complications
15.3.3 Revention and Management
15.4 Whooping cough
15.4.1 The Dise-What causes it? Who gets it? How and when docs it spread?
15.4.2 Symptoms and Complications
15.4.3 Revention and Management
15.5 Let Us Sum Up
15.6 Glossary
15.7 Answers to Check Your Progress Exercises
15.1 INTRODUCTION
You are aware that children are very prone to infections. The infections are caused by
microorganisms which are very minute and can be seen only through a microscope.
Measles, tuberculosis, whooping cough are three such infectious diseases commonly
found in children. What is the causative agent? How does it spread? How do we
identify these diseases? What can we do to prevent our children from getting these
diseases. This unit provides answer to these crucial questions.
In this unit we will learn about the causes, complications, prevention control measures
for each of these infectious diseases.
Objectives
After studying this unit; you will be able to :
identify the cause and mode of spread of measles, tuberctrlosis and whooping
cough,
enumerate the symptoms and complications of measles, tuberculosis and whooping
cough, and
discuss the steps to manage and prevent these diseases and also educate the
community about preventive measures.
15.2 MEASLES
Measles is a viral disease which generally attacks children, around one year of age. It
is one of the important and common childhood infections. Measles is endemic in most
of the countries of the world. In India, every year about 14 million children suffer
from measles. It is estimated that 20,000 children die every year in our country due to
complications from measles.
, \
-Common Infectious Diseases 15.2.1 The Disease--What causes it? Who gets it? How and when
,' does it spread?
What causes measles?
The disease is caused by the measles virus. Viruses you know are microorganisms
which can be seen only through sophisticated microscope.
Who gets the disease?
Age : The disease is common in childhood. Most of the children have an attack of
measles by the time they complete the age of 3 years. In about a third of all cases
with measles, it occurs under the age of one year.
Socio-Economic Factors : Measles is particularly severe amongst poor communities.
Of many adverse influences of poor socio-economic status on child, poor nutrition,
both before and during the attack of measles, plays a major part in the severity and
outcome of the infection. Epidemics tend to occur at 2 to 4 year intervals in crowded
large cities, particularly in the urban slum areas. In conditions of poor environment,
children get measles at an earlier age. In middle income families, it occurs later
around the school age.
Sex : Incidence of measles is equal among both the sexes.
Seasons : The disease is more prevalent in winter.
How does it Spread?
It is spread through droplets (either during coughing or sneezing) or direct contact
with secretions from nose or throat or urine of persons infected with measles. It is
one of the most readily transmissible of the communicable diseases. Articles recently
contaminated with saliva or nasal discharges may also convey infection. An attack of
measles in the cause of pregnant women may lead to abortion.
Incubation period : The disease takes, on an average, about 10 days varying from 8
to 13 days, to occur from the time of exposure to a patient with measles to the onset
of fever. The skin rash appears about 14 days after exposure to an infected child.
Period of communicability : The disease is communicable from the beginning of
onset of fever to 4-6 days after appearance of the skin rash. Measles is very
infections and about 90 per cent of susceptible family members coming in contact
with the patient (family contacts) acquire the disease. In other words, other children,
who had not got measles earlier, in the household of the patient are likely to catch
the disease.
Susceptibility : Practically all persons are susceptible. After an attack, a person
usually acquires permanent immunity. In otherwords, an individual suffers from
measles only once in life time. Infants born of mothers who have had the disease are
ordinarily immune (i.e. do not develop the disease) for approximately the first 6
months of life.
15.2.2 Symptoms and Complications
Measles is an acute (short and sudden onset) communicable disease. It starts as mild
fever, cough and running nose. There will be conjunctivitis (reddening of the eyes). If
you examine the inside of mouth, you can find characteristic greyish white spots on a
red base on the mucous membrane of the mouth (a membrane, secreting mucus,
lining the mouth), A day or tpo later typical skin rash (eruptions on the skin) which
is dusky red in colour appears i.e. third to seventh day after the onset of fever. The
rash appears first on the face and spreads to the body and generally lasts for 4-5
days. Measles is rather severe among children who are malnourished.
What are the complications of measles ?
Measles is an important public health problem because it leaves the children in a
debilitated condition (very weak). Common complication after an attack of measles is
severe respiratory infection leading to broncho-pneumonia (infection of the lungs)
which may end in death. One of the commonest complications is severe diarrhoea
which quite often leads to malnutrition. Measles and nutritional status of the child are
very closely associated. If you carefully question the mothers of the children suffering
frcm severe forms of malnutrition, always, they would tell you that the children
, Merdles, Tuberclllosls and
suffering from severe forms of malnutrition, almost always, they would tell you that
Wboopb Cough
the children had measles in the recent past Because of loss of appetite and severe
diarrhoea, the children recovering from the measles often develop severe forms of
malnuuition. You might recall reading about the effect of measles on nutritional status
of children in unit 20, block 5, of course 1.
Middle ear infection, mental retardation can also occur as complications after an
attack of measles. Measles is known to conVibute to the damage of the cornea (black
portion of the eye) leading to blindness. Measles also aggravates Vitamin A deficiency
in children and leads to blindness.
15.2.3 Prevention and Management
Prevention/control measures for measles are discussed below:
Prevention of measles through vaccination : Vaccination is the simplest and best
method to prevent measles. Normally all children at 12 months of age or as soon
thereafter as possible are given measles immunisation. A single injection protects
95 per cent of susceptible children from the disease for over 12 years and probably
for life. After vaccination majority have minimal infection with minimal symptoms
such as fevers, cough, running nose and even rash. A single dose of 0.5 ml-of
reconstituted freeze-dried vaccine is given intramuscularly (in the muscle). Normally,
immunity develops 11 to 12 days after vaccination.
Next, a word about how to treat measles ?
Management of Measles : There is no specific treatment for measles. Antipyretics
i.e. medicines to control fever, bed rest and adequate fluid intake are the basic
requirements. The important aspect in management is control of secondary bacterial
infection by using suitable antibiotics. Complications such as pneumonia and middle '
ear infections require appropriate treatment with antibiotics. The nutritional status of
the child must be maintained properly. Children who are breast-fed and unable to suck
due to soreness of mouth may be fed breast milk with a spoon after expression of the
same from the mothers breast. For those children who are not breast-fed, soft diets in
the form of pomdges can be given. Children suffering from measles lose considerable
weight and during the recovery period weight gain is slow. Children recovering from
measles should be given adequate diet to stimulate faster weight gain. The child
should be fed more frequently i.e. 5-6 times a day. The diet should'include cereals
like rice or wheat, pulses (dal) and green vegetables. The child should also be given
atleast one glass of milk every day. The diet should be cooked soft and preferably be
fed by the mother or elder member. Other dietary considerations for management of
measles discussed in unit 20, block 5 of course 1 are applicable here as well. Go
through those considerations carefully.
Points to Remember : given below presents the salient features of measles :
f
POINTS TO REMEMBER
Measles
Measles, an acuk communicable disease is an important public health
problem.
It is caused by measles virus.
It spreads through droplets or direct contact with secretions from nose. throat
or urine of persons infected with measles.
The disease has an incubation period of about 10 days.
The simplest and best method to prevent measles is vaccination.
Treatment of secondary infections and complications is the best way to
manage measles.
Maintain the nutritional status of the child by providing good nutritious food.
, iC
Common lafectioun Dlseamea Check Your Progress Exercise 1
1) Prepare a flow chart for the. step-by-step progress of measles in a child.
2) Prepare a talk to educate mothers about prevention and management of measles.
...............................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
15.3 TUBERCULOSIS
Tuberculosis is a common disease that is found almost everywhere. It is important as
a cause of disability and death in many parts of the world. In developing countries
such as India, you should expect a higher prevalence of tuberculosis in the under-five
age group, as a result, of geater opportunities of exposure to the disease. In other
words, it is likely to occur more frequently in these age group. It is estimated that
there would be atleast 9-10 million cases of pulmonary (lung) tuberculosis as well.
15.3.1 The Disease-What causes It? Who gets it? How and when
does it spread?
Tuberculosis is caused by Mycobacterium tuberculosis, a non-motile. slender. acid-
fast bacillus. Two strains-human and bovine-are of importance to man. Human
source is responsible for the vast majority of cases of India. The bacillus can be seen
by examination of sputum or other secretions under a microscope after using
appropriate staining procedures.
Who gets the disease?
Age : Tuberculosis can occur at any age. Recent surveys in India show that it occurs
more in older age groups than the younger groups.
Sex : In India, tuberculosis is more prevalent among males over 45 years of age than
among females. In females however, the peak prevalence is below 35 years.
Socio-Economic Factors : The disease occurs more frequently in families belonging
to low income groups. In Western countries a decline in death rates due to
tuberculosis has occurred with an increase in standard of living. Communities living
in substandard houses which are ill ventilated and have inadequate floor space are
likely to suffer more from the disease. Miners and textiles workers are more prone to
disease. Oveccrowding as in the slum areas of the cities helps in the rapid spread of
the disease.
Certain social customs such as indiscriminate spitting, smoking of hukka, purdah
system also help in the spread of the infection. Tuberculosis has a social stigma. This
attitude leads to concealment of the disease and consequent delay in diagnosis of
cases with increased risk of spreading the disease to others.
