DISEASE

CHICKEN POX
Varicella

MEASLES
Rubeola

GERMAN MEASLES
Rubella

MUMPS
Infectious Parotitis

DIPTHER

CAUSE

Varicella-zoster virus

RNA virus

Virus

Coryneb
diphther

INCUBATION
Communicabili
ty

10-21 days
5 days after onset of
rash and until all
lesions are crusted.

8-12 days
From 4 days before to
5 days after rash
appears.

14-23 days
During prodromal
period and for 5 days
after appearance of
rash.

Rubulavirus in the
Paramyxoviridae
family
16-18 days
1-2 days before
swelling to 5 days
after onset of swelling.

ROUTE

Airborne, droplet
infection; direct or
indirect contact. Dry
scabs are no
infectious.

Direct contact;
airborne by droplets
and contaminated
dust.

Direct or indirect
contact with salivary
secretions of infected
person. Droplet.

MAJOR
SYMPTOMS

General malaise,
slight fever, anorexia,
headache. Successive
crops of macules,
papules, vesicles,
crusts. These may all
be present at the
same time. Itching of
the skin. Generalized
lymphadenopathy.

TREATMENT

Oral acyclovir should

be considered for
otherwise healthy
people at increased
risk (e.g. people older
than 12 yr of age,
individuals with
pulmonary disorders).
IV antiviral therapy is
recommended for
immunocompromised
children.

Local application of
heat or cold to
salivary glands to
reduce discomfort.
Liquids or soft foods
are given. Foods
containing acid may
increase pain. Bed rest
until swelling
subsides.

A single
preferred
antitoxin
administ
basis of
diagnosi
culture r
available
sensitivi
serum).
Equipme
suctionin
available
emergen
tracheos
necessa

TREATMENT
continued

Symptomatic. Prevent
child from scratching.
Keep fingernails short
and clean. Sedation
may be necessary. Use
soothing lotions to
allay itching. If
secondary infections
occur, antimicrobials
may be given. Do no
give aspirin because
of high risk for reye
syndrome. Salicylate
therapy should be

Coryza, conjunctivitis,
and photophobia are
present before rash.
Koplik spots in mouth,
hacking cough, high
fever, rash, and
enlarged lymph nodes.
Rash consists of small
reddish brown or pink
macules changing to
papules; fades on
pressure. Rash begins
behind ears, on
forehead or cheeks,
progresses to
extremities, and last
about 5 days.
Symptomatic. Keep
child in bed until fever
and cough subside.
Light in room should
be dimmed. Keep
hands from eyes.
Irrigate eyes with
physiologic saline
solution to relieve
itching. Tepid baths
and soothing lotion
relieve itching of skin.
Encourage fluids
during fever. Humidify
the childs room.
Antimicrobial therapy
given for
complications.
Vitamin A
supplementation is
recommended once
daily for 2 days to
reduce mortality.
Immunoglobulin (IG)
can help prevent or
modify measles within
6 days of exposure.

Direct contact with

secretions of nose and
throat of infected
person; airborne by
contaminated dust
particles.
Fetus may contract
rubella in utero if
mother has disease;
slight fever, mild
coryza. Rash consists
of small pink or pale
red macules closely
grouped to appear as
scarlet blush that
fades on pressure.
Rash fades in 3 days.
Swelling of posterior
cervical and occipital
lymph nodes. No
Koplik spots or
photophobia as in
measles.
Symptomatic. Bed rest
until fever subsides.
Children should be
excluded from school
or daycare for 7 days
after onset of rash.

Infants with congenital

rubella should be
considered contagious
until 1yr of age unless
cultures are
repeatedly negative.

Children are excluded

from school or
daycare for 9 days
from onset of parotid
gland swelling. Mumps
vaccine should be
given at least 2wk
before or 3mos after
administration of IG or
blood transfusion.

Antimicr
with ery
penicillin
given fo
addition
Strict be
Prevent
Cleansin
gargles m
ordered.
diet. Gav
parenter
administ
fluids ma

Salivary glands are

chiefly affected.
Parotid, sublingual,
and submaxillary
glands may be
involved. Swelling and
pain occur in these
glands either
unilaterally or
bilaterally. Child may
have difficulty
swallowing, headache,
fever, and malaise.

2-7 days
In untrea
organism
present
from the
throat an
and skin
6wk afte
Droplets
respirato
infected
carrier; c
discharg
lesions.
Local an
manifest
Membra
in nose o
site of b
invasion
brassy c
stridor. T
organism
malaise
Toxin ha
renal, ne
cardiac t

stopped in a child who

is exposed to
varicella.
COMPLICATIO
NS

Bacterial
superinfection;
thrombocytopenia,
arthritis, encephalitis,
nephritis, Reye
syndrome (with aspirin
use).

necessa
respirato
obstruct
Vary with severity of
disease: otitis media,
pneumonia,
tracheobronchitis,
nephritis. Encephalitis
with permanent brain
damage may occur.
Death from respiratory
and neurologic
complications.
Subacute sclerosing
panencephalitis
(SSPE), a rare
degenerative central
nervous syndrome
(CNS) disease, may
occur. The mean
incubation period is 7
yr after measles
illness.

Chief danger of
disease is damage to
fetus if mother
contracts infection
during first trimester
of pregnancy. Neonate
may have congenital
rubella syndrome with
permanent defects
(e.g. cataracts,
cardiovascular
anomalies, deafness,
microcephaly, mental
retardation). Virus can
be isolated from
blood, urine, throat,
cerebrospinal fluid,
lens, and other
involved organs.
Infants may shed virus
for 12-18 months.
Severe complications
are rare. Encephalitis
may occur.

Complications are less

frequent in children
than in adults.
Meningoencephalitis,
inflammation of
ovaries or testes, or
deafness may occur.

Local inf
grade fe
gradual
complica
severe n
(bull nec
airway o
myocard
peripher
neuropa