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High measles mortality in infancy related to intensity of exposure

P Aaby, J Bukh, G Hoff

    The Journal of Pediatrics
    |July 1, 1986
    PubMed

    Insights

    Measles infection in infants in West Africa showed higher mortality in secondary cases within households. Intensive exposure, particularly in younger infants, contributes significantly to measles infant mortality in developing nations.

    Area of Science:

    • Epidemiology
    • Public Health
    • Pediatrics

    Background:

    • Measles infection poses a significant threat to infants in West African urban communities.
    • Infant mortality rates from measles in developing countries are notably high.
    • The role of social patterns in disease transmission requires further investigation.

    Purpose of the Study:

    • To examine measles infection patterns and mortality in infants over a five-year period.
    • To identify risk factors associated with measles infection and mortality in infants.
    • To inform public health policies aimed at reducing measles infant mortality.

    Main Methods:

    • A longitudinal study was conducted over five years (1979-1983) in a West African urban community.
    • Infant measles cases were categorized as index (infected outside the home) or secondary (infected within the home).
    • Mortality rates and antibody levels were analyzed in relation to age and exposure status.

    Main Results:

    • Infants aged 0-11 months experienced higher measles mortality among secondary cases compared to index cases.
    • The proportion of secondary measles cases was significantly higher in infants (0-11 months) than in older children.
    • Mortality increased with age during the first year of life, correlating with declining maternal antibodies.
    • Even infants under 6 months, typically protected by maternal antibodies, showed signs of infection due to intensive exposure.

    Conclusions:

    • Intensive household exposure, driven by social transmission patterns, is a key factor in high infant measles mortality in developing countries.
    • Public health strategies should focus on modifying exposure conditions to mitigate measles risk in infants.
    • The decline of maternal measles antibodies contributes to increased mortality risk in infants as they age.

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