Measles is a highly contagious acute viral infection, transmitted by the airborne route (inhalation of respiratory droplets spread by infected individuals). The disease azelaic acid cream no prescription mainly affects children under 5 years of age and can be prevented by immunization.
Permethrin cream online For more information, refer to the MSF handbook Management of a measles epidemic.
Clinical features
The average incubation period is 10 days.
Prodromal or catarrhal phase (2 to 4 days)
    High fever (3940°C) with cough, coryza (nasal discharge) and/or conjunctivitis (red and watery eyes).
  Ivermectin tablets  Koplik's spots: tiny bluishwhite spots on an erythematous base, found on the inside of the cheek. This sign is specific of measles infection, but may be absent at the time of examination. Observation of Koplik's spots is not required for diagnosing measles.

Eruptive phase (4 to 6 days)
   Dexamethasone 0.5mg On average 3 days after the onset of symptoms: eruption of erythematous, nonpruritic maculopapules, which blanch with pressure. The rash begins on the forehead then spreads downward to the face, neck, trunk (2nd day), abdomen and lower limbs (3rd and 4th day).
    As the rash progresses, prodromal symptoms subside. In the absence of complications, the fever disappears once the rash reaches the feet.
   Order lamisil online The rash fades around the 5th day in the same order that it appeared (from the head to the feet).
The eruptive phase is followed by skin desquamation during 1 to 2 weeks, very pronounced on pigmented skin (the skin develops a striped appearance).
In practice, a patient presenting with fever and erythematous maculopapular rash and at least one of the following signs: cough or coryza or conjunctivitis, is a clinical case of measles.

Complications
Most measles cases experience at least one complication:
    Respiratory and ENT: pneumonia, otitis media, laryngotracheobronchitis
    Ocular: purulent conjunctivitis, keratitis, xerophthalmia (risk of blindness)
    Gastrointestinal: diarrhoea with or without dehydration, benign or severe stomatitis
    Neurological: febrile seizures; rarely, encephalitis

  Betamethasone Cream  Acute malnutrition, provoked or aggravated by measles (postmeasles period) Pneumonia and dehydration are the most common immediate causes of death.
Poliomyelitis is an acute viral infection due to a poliovirus (serotypes 1, 2 and 3). Humantohuman transmission is direct (faecaloral) or indirect (ingestion of food and water contaminated by stool). Humans are the only reservoir of the virus. In principle the disease can be eradicated by mass vaccination with oral polio vaccine (OPV).
    In endemic areas, epidemics usually affect children under 5 years of age. In nonendemic areas, where vaccination coverage is low, young adults are most commonly affected.
Clinical features

    In more than 90% of cases, infection is asymptomatic.
 Amoxicillin tablets Nonparalytic form: a nonspecific febrile illness with muscle pain, headache, vomiting, backache; no neurological involvement.
As spontaneous recovery usually occurs within 10 days, diagnosis is rarely made outside epidemic contexts.
    Paralytic form: in less than 1% of cases, after the nonspecific signs, the patient develops rapid onset (from the morning to the evening) asymmetrical acute flaccid paralysis, predominantly of the lower limbs, with ascending progression. The muscles become soft with diminished reflexes. Sensation is maintained. The disease is life threatening if paralysis involves the respiratory muscles or muscles of swallowing. Initial urinary retention is common. Gastrointestinal disturbances (nausea, vomiting, diarrhoea), muscle pain and meningeal symptoms may also occur.
Laboratory
Look for the polio virus in stool samples. The virus is excreted for one month after infection, but only intermittently; therefore, 2 samples must be collected with an interval of 48 hours.

Treatment
  Amoxicillin usa  Hospitalise patients with the paralytic form: rest, prevent bed sores in bedridden patients, give analgesics (do not give IM injections to patients in the febrile phase), ventilate patients with respiratory paralysis.
    Physiotherapy once the lesions are stable to prevent muscle atrophy and contractures.
    Care for sequelae: physiotherapy, surgery and prosthetics.