Adult Measles – Case Reports of a Highly Contagious Disease

  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
  • Claudia Krönert Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
  • Torello Lotti Department of Dermatology, University of Rome “G. Marconi”, Rome, Italy
  • Aleksandra Vojvodic Military Medical Academy of Belgrade, Belgrade, Serbia
  • Uwe Wollina Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
Keywords: Measles, Viral exanthema, Vaccination, Maculopapular rash, Encephalopathy, Thromboytopenia, Pneumonia

Abstract

BACKGROUND: Measles is highly contagious and is caused by the RNA morbillivirus. The best protection is active immunisation in early childhood. Without immunisation morbidity and mortality of measles are high. In recent years, an increasing number of adult measles has been recognised in Europe.

CASE REPORTS: We report here on two adult patients – a 40-year-old male and a 55-year-old female – who presented with fever, fatigue, cough, coryza, conjunctivitis and maculopapular rash. The suspicion of adult measles infection was confirmed by positivity for IgM antibodies against measles virus and reverse-transcriptase polymerase chain reaction in blood and urine. Patients were isolated, and the treatment was symptomatic. In the younger patient, complete recovery was achieved within two weeks. In the older patient, an acute encephalopathy developed after initial improvement characterised by cognitive impairment.

CONCLUSIONS: In patients presenting with fever and maculopapular rash and fatigue, measles should be considered even in adult patients. Early diagnosis with subsequent isolation and registration of patients are important measures to prevent local outbreaks of the disease.

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References

Magaña LC, Espinosa A, Marine RL, Ng TFF, Castro CJ, Montmayeur AM, Hacker JK, Scott S, Whyte T, Bankamp B, Oberste MS, Rota PA. Complete Genome Sequences of Mumps and Measles Virus Isolates from Three States in the United States. Genome Announc. 2017; 5(33):e00748-17. https://doi.org/10.1128/genomeA.00748-17 PMid:28818890 PMCid:PMC5604763

De Jong JG, Winkler KC. Survival of measles virus in air. Nature. 1964; 201:1054-5. https://doi.org/10.1038/2011054a0 PMid:14191599

Koplik H. The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane. Arch Pediatr. 1962; 79:162-5.

Aziz J. Rash Inside the Mouth. Am Fam Physician. 2017; 95(11):729-730.

Zhang Y, Yu YS, Zang GQ. Maculopapular rash and Koplik's spots in adult measles. Rev Soc Bras Med Trop. 2015; 48(2):231. https://doi.org/10.1590/0037-8682-0236-2014 PMid:25992944

Moss WJ. Measles. Lancet. 2017; 390(10111):2490-2502. https://doi.org/10.1016/S0140-6736(17)31463-0

Rota PA, Moss WJ, Takeda M, de Swart RL, Thompson KM, Goodson JL. Measles. NatRev Dis Primers. 2016; 2:16049. https://doi.org/10.1038/nrdp.2016.49 PMid:27411684

Robert-Koch-Institut. Impfempfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch Institut. Epid Bull 2013; 34:313-343.

Matysiak-Klose D, Wicker S; für die Nationale Verifizierungskommission Masern Röteln (NAVKO) in Deutschland. Measles in Germany: An Epidemiological Analysis and First Measures for Containment. Dtsch Med Wochenschr. 2017; 142(23):1767-1772. https://doi.org/10.1055/s-0043-117973 PMid:29145682

Eichner L, Wjst S, Brockmann SO, Wolfers K, Eichner M. Local measles vaccination gaps in Germany and the role of vaccination providers. BMC Public Health. 2017; 17(1):656. https://doi.org/10.1186/s12889-017-4663-3 PMid:28807023 PMCid:PMC5557556

Palamara MA, Visalli G, Picerno I, DI Pietro A, Puglisi G, Marano F, D'Andrea G, Facciolà A. Measles outbreak from February to August 2017 in Messina, Italy. J Prev Med Hyg. 2018; 59(1):E8-E13.

Béraud G, Abrams S, Beutels P, Dervaux B, Hens N. Resurgence risk for measles, mumps and rubella in France in 2018 and 2020. Euro Surveill. 2018; 23(25). https://doi.org/10.2807/1560-7917.ES.2018.23.25.1700796 PMid:29945697 PMCid:PMC6152239

Wiese-Posselt M, Tertilt C, Zepp F. Vaccination recommendations for Germany. Dtsch Arztebl Int. 2011; 108(45):771-9; quiz 780. https://doi.org/10.3238/arztebl.2011.0771 PMid:22163258 PMCid:PMC3230171

Ananiev J, Vassilev I, Arabadzhiev G, Ramdan V, Chokoeva AA, Tchernev G, Wollina U. Measles induced death in Eastern Europe. Acta Med Bulg. 2016; 41(2):67-74. https://doi.org/10.1515/amb-2014-0025

Watanabe S, Shirogane Y, Sato Y, Hashiguchi T, Yanagi Y. New Insights into Measles Virus Brain Infections. Trends Microbiol. 2019; 27(2):164-175. https://doi.org/10.1016/j.tim.2018.08.010 PMid:30220445

Kumar R, Kumar A, Dubey A, Misra PK. Acute encephalopathy associated with measles. Indian J Pediatr. 1989; 56(3):349-54. https://doi.org/10.1007/BF02722298 PMid:2807470

Published
2019-06-30
How to Cite
1.
Koch A, Krönert C, Lotti T, Vojvodic A, Wollina U. Adult Measles – Case Reports of a Highly Contagious Disease. Open Access Maced J Med Sci [Internet]. 2019Jun.30 [cited 2020Oct.23];7(18):3009-12. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2019.540

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