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[Complications in children with measles]
C Avila-Figueroa1, S Navarrete-Navarro, M Martínez-Aguilar
1Departamento de Investigaciones Epidemiológicas, Hospital Infantil de México Federico Gómez.
Abstract:
Ongoing immunization campaigns have significantly reduced the incidence of measles. To evaluate the efficacy of vaccination policies, however, it is necessary to analyze disease indicators of mortality and of morbidity such as medical complications and sequelae. We reviewed the hospital experience at Hospital Infantil de Mexico regarding children with measles who necessitated hospitalization between January 1976 and December 1989. During this 14 year period, 176 patients with measles were hospitalized; the majority of the cases corresponded to the period between 1985 and 1989. Fifty five percent of the cases corresponded to children under one year of age. Of those older than 12 months, 81% lacked an immunization history. Eighty percent were from Mexico city or from the neighboring state of Mexico. The mayor complications included: respiratory tract infections such as pneumonia (50.8%), diarrhea (18.2%), and less frequent: laringotracheitis, otitis media, myocarditis and pyodermitis. More than 70% were significantly (grade II or III) malnourished. Twenty three patients died, for a mortality of 13%. The factors more likely related to measles mortality were; age less than two years, undernutrition, and more than two medical complications associated. This report emphasizes that medical complications and mortality are more likely to occur in very young unimmunized, malnourished children.
Insights
Measles vaccination campaigns have reduced incidence, but unimmunized, malnourished children under two years old remain at high risk for severe complications and mortality. This highlights the need for continued vaccination efforts and nutritional support.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Context:
- Measles incidence has declined due to immunization campaigns.
- Evaluating vaccination policy efficacy requires analyzing mortality and morbidity indicators.
- Hospital Infantil de Mexico data from 1976-1989 provides insight into measles hospitalizations.
Purpose:
- To analyze measles-related mortality and morbidity in hospitalized children.
- To identify risk factors associated with severe measles outcomes.
- To assess the impact of immunization status and nutritional status on measles severity.
Summary:
- A review of 176 hospitalized measles cases (1976-1989) found most were under one year old and unvaccinated.
- Common complications included pneumonia and diarrhea; over 70% of patients were malnourished.
- Mortality was 13%, with younger age, undernutrition, and multiple complications being key risk factors.
Impact:
- Highlights that very young, unimmunized, and malnourished children face the highest risk of measles complications and death.
- Underscores the critical importance of sustained immunization programs and nutritional interventions.
- Provides data supporting targeted public health strategies for measles prevention in vulnerable populations.