Title: Children, rash, and fever...is it measles?
题目：儿童，皮疹，发热。。。是麻疹吗？

Author 作者: Walid Hammad
翻译：江利冰 校对：肖锋

General Information:
基本资料：
This year there have been over 280 cases of measles in the US, spanning 18 states; early recognition is key to preventing transmission.
今年在美国已经发现了超过280例麻疹，跨越了18个州；早期识别是防止传播的关键。
Remember the 3 c's for recognition:
请记住3c用于识别麻疹：
Cough, Coryza (runny nose), Conjunctivitis + febrile rash
咳嗽，鼻炎（流鼻涕），结膜炎 + 发热性皮疹
-Incubation period is 10-12 days
潜伏期为10-12天。
-Symptoms usually start with fever, followed by rash 2-3 days later starting from the hairline and spreading to the trunk and extremities
症状通常以发热开始，2-3后开始出现皮疹，首先出现在发际逐渐蔓延到躯干和四肢。
-Completion of the first series of vaccines provides 90-95% immunity from measles
完成第一个系列疫苗接种，可以获得对麻疹90-95%的免疫力。
 
Relevance to the EM Physician:
与急诊科医生相关：
-Immediately place any patient suspected of having measles on airborne precautions
迅速对任何怀疑麻醉的患者进行空气传染隔离。
-Look for koplik spots on the oral mucosa (commonly described as appearing like small grains of salt)
寻找口腔黏膜上的口腔麻疹粘膜斑 （通常被描述为像一些小的盐颗粒。
-Complications include diarrhea, otitis media, “measles croup,” pneumonia, encephalitis (1/1000 cases), and death (2-3/1000 cases)
并发症包括腹泻，中耳炎，“麻疹性喉炎”，肺炎，脑炎（1/1000例），死亡（2-3/1000例）
-Post exposure prophylaxis (PEP) is recommended for unvaccinated exposed individuals and is effective up to 72 hours after exposure; however, vaccination is contraindicated in pregnant women
对于未接种的暴露个体推荐进行暴露后的预防（PEP)，而且在暴露后的72h内进行有效；但是孕妇是接种痘苗的禁忌症。
 
Bottom Line:
要点：
-The incidence of measles is rising sharply in the US. Vaccination, early detection, and post exposure prophylaxis for exposed individuals is key to reversing this trend.
 麻疹的发生率在美国急剧上升。接种疫苗，早期发现以及暴露后个体的暴露后预防是逆转这种趋势的关键。
References 参考文献：

1.  CDC. Measles-January 1-May 23, 2014. MMWR 2014; 63;(1-4).
2.  CDC. Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2013;62(RR04);1-34.
3.  CDC. Measles Questions and answers. http://www.immunize.org/catg.d/p4209.pdf
4.  CDC. Measles Rubeola.  http://www.cdc.gov/measles/index.html
5.  Perry and Halsey. Clinical Significance of Measles: A Review. J Infect Dis. 2004  May 1;189 Suppl 1:S4-16.