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Published on: July 4, 2007
The clinical significance of measles: a review
Robert T Perry1, Neal A Halsey
1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract:
Forty years after effective vaccines were licensed, measles continues to cause death and severe disease in children worldwide. Complications from measles can occur in almost every organ system. Pneumonia, croup, and encephalitis are common causes of death; encephalitis is the most common cause of long-term sequelae. Measles remains a common cause of blindness in developing countries. Complication rates are higher in those <5 and >20 years old, although croup and otitis media are more common in those <2 years old and encephalitis in older children and adults. Complication rates are increased by immune deficiency disorders, malnutrition, vitamin A deficiency, intense exposures to measles, and lack of previous measles vaccination. Case-fatality rates have decreased with improvements in socioeconomic status in many countries but remain high in developing countries.
Insights
Measles vaccination remains critical as the disease still causes severe illness and death globally, particularly in unvaccinated children. Complications affect multiple organs and can lead to long-term disabilities or fatalities, especially in vulnerable populations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Despite the availability of effective measles vaccines for decades, measles continues to pose a significant global health threat, causing mortality and severe morbidity in children.
- Measles complications can impact nearly every organ system, with pneumonia, croup, and encephalitis being leading causes of death and long-term sequelae.
- The disease remains a primary cause of blindness in developing nations, highlighting persistent public health challenges.
Purpose of the Study:
- To review the persistent global impact of measles, forty years post-vaccine licensure.
- To identify key complications, risk factors, and demographic variations in measles severity.
- To underscore the ongoing need for effective measles prevention and control strategies worldwide.
Main Methods:
- This review synthesizes existing data on measles epidemiology, clinical manifestations, and outcomes.
- Analysis includes complication rates across different age groups and influencing factors.
- Socioeconomic impacts on case-fatality rates are also considered.
Main Results:
- Measles complications are widespread, affecting multiple organ systems and leading to significant mortality and morbidity.
- Encephalitis is the most common cause of long-term sequelae, while pneumonia and croup are frequent causes of death.
- Higher complication rates are observed in individuals younger than 5 and older than 20, with specific complications varying by age; risk is increased by immune deficiencies, malnutrition, vitamin A deficiency, high exposure, and lack of vaccination.
Conclusions:
- Measles remains a preventable yet dangerous infectious disease, necessitating continued global vaccination efforts.
- Vulnerable populations, including those with nutritional deficiencies or compromised immune systems, face increased risks.
- While socioeconomic improvements have reduced case-fatality rates in some regions, measles continues to disproportionately affect developing countries.
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