Koplik’s spots are the prodromic viral manifestation of measles especially on the first day of rash. They are named so after Henry Koplik an American who first gave a description of these symptoms. Measles is a virus known as RNA paramyxovirus that naturally occurs to only humans and no signs of infection to other animals. It is a serious infection in that the dentists are very much keen to its examination so as to reduce the risk of unnecessary spread of measles infection during the process of dental surgery. Koplik’s spots are among the early manifestations of measles.
Measles is one of the highly infectious diseases which are spread through aerosols of infected nasopharyngeal secretions. And therefore there is need to undertake early immunization especially before school to ensure safety from infections that may occur unknowingly. It is associated with high mortality as well as morbidity. These two instances are more pronounced in the developing world where thousands of children die due to this infection. Where there is malnutrition, the mortality rate due to measles is quite high where in some of the African countries the percentage goes to around 15%. It is however sad to note that of the world’s population that has suffered and died due to measles infections, the children have been the largest number counting to millions.
The clinical features of measles always occur among children who have not yet reached school going age. The incubation period is 10 to 14 days, however it should be noted that patients are infectious for approximately 7 days before the rash forms. The rash is preceded by prodrome, and this is characterized by fever, runny nose, and cough. Thereafter, Koplik’s spots will appear and these are the real indicators that the patient has a measles infection. These typically involve irregular patchy erythema with central minute bluish-white specks with the appearance of “grains of salt”. Between 14 to 18 days after infection, a rash will appear; initially being manifested behind the ears, on the fore head and the neck which spread to involve the whole body. However, this rash will fade after72 hours but will leave behind significant post-inflammatory pigmentation that can take 6 to 8 weeks to fade. It is worth noting that the patient is no longer infectious after the rash has manifested. There will however be complications with 18 to 30 days of infection which include transient immune suppression. This can be life threatening in children who are immune compromised, more so those who are malnourished.
Measles is self limiting in majority of patients in that there is limited or no specific antiviral therapy, however, prompt action is required so as to limit the number of patients affected by this disease. Therefore, one should immediately alert a doctor on recognition of some of these symptoms due to the fact that measles is a highly infectious disease. Koplik’s spots are the first signs which occur in the early stages of measles infection and it recommended that the moment they are detected, you alert a doctor.
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