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CME IDENTIFICATION #1: MEASLES (RUBEOLA)
OVERVIEW:
As is evident in the news, there has been an increase in significant measles outbreaks in the United States. Most recently an outbreak linked to exposure at Disneyland in California, the source patient likely a visitor from outside of the United States. According to the cdc, in January 84 cases across 14 states were identified. In 2014 a record number of cases were documented: 644 cases across 27 states.
EDUCATIONAL/GAP ANALYSIS:
In 2000 the USA declared elimination of measles (ie. absence of continuous disease transmission for 12 months). Physicians over a broad spectrum of specialties including pediatrics, emergency medicine, family practice and internal medicine would benefit from re-education regarding measles. For those physicians who have been practicing for at least 15 years, they have unlikely ever seen or examined a patient with measles. There are bulletins and information regarding measles on the CDC website, however when a web search is performed for CME regarding measles minimal courses can be found, and many are several years old.
LEARNING OBJECTIVES:
Clinicians should re-familiarize themselves with the following aspects of Measles (Rubeola):
- Epidemiology: Increased outbreaks since 2014, increased risk of complications in children < 5yo or adults > 20 yo
- Presentation: fever, cough, coryza, conjunctivitis, koplik spots, rash
- Complications: Pneumonia, Encephalitis, Low birth weight babies in pregnant women infected, fatality
- Transmission sources in the US: unvaccinated individuals, visitors from out of country
- Identification: Visual stimuli of examples of rash and Koplik Spots seen secondary to Rubeola
POTENTIAL REFERENCES:
http://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-measles
http://redbook.solutions.aap.org/book.aspx?bookid=886
MeSH Medical 