209.4 📌 章末速蚘

  • Measles: paramyxovirus, R0 12-18 (most contagious), 3 C’s prodrome, Koplik spots, cephalocaudal rash; pneumonia + SSPE + immune amnesia
  • Vitamin A for measles (WHO)
  • Mumps: parotitis main; complications orchitis (~ 20% males), aseptic meningitis, hearing loss
  • Rubella: mild adult; CRS in 1st trimester maternal (hearing loss + cataracts + cardiac PDA + microcephaly + “blueberry muffin”)
  • MMR: live attenuated, 2-dose 12-15 mo + 4-6 yr, 97% measles + rubella efficacy, 88% mumps
  • Contraindications: pregnancy + severe immunocompromise
  • 2024-2025 outbreaks: USA + Europe + Asia rising; vaccine hesitancy major driver
  • Post-exposure: MMR < 72 hr or IG < 6 days
  • SSPE: 5-15 yr post-measles, fatal
  • Immune amnesia: measles wipes pre-existing antibody — argument for vaccination
  • Americas eliminated 2015 (re-introductions occur)