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Factors associated with fatal cases of measles. A retrospective autopsy study
Abstract:
Clinical and laboratory records at Red Cross War Memorial Children's Hospital, Cape Town, for the period 1976-1982 were reviewed to determine factors associated with fatal cases of measles. Pneumonia was found to be the commonest lethal complication of measles. Supervening infections by both viral (especially adenovirus and herpesvirus) and bacterial (especially Klebsiella species and Pseudomonas) agents played a prominent role in causing the deaths of children who had recently been infected with measles. Severe malnutrition was present with almost equal frequency among those dying of measles and those dying from other causes, but was significantly (P less than 0,02) less common in measles patients who survived. Peripheral lymphopenia and depletion of T-cell zones in the lymph nodes and spleen were more common in those who died from measles than in others.
Insights
Fatal measles cases in children were often caused by secondary infections like pneumonia, particularly from Klebsiella and Pseudomonas. Severe malnutrition was less common in survivors, while lymphopenia indicated poorer outcomes in fatal measles.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Measles remains a significant cause of childhood mortality globally.
- Understanding factors contributing to fatal measles cases is crucial for improving clinical management.
Purpose of the Study:
- To identify factors associated with fatal measles cases in children.
- To elucidate the role of complications and host factors in measles mortality.
Main Methods:
- Retrospective review of clinical and laboratory records.
- Analysis of data from Red Cross War Memorial Children's Hospital (1976-1982).
Main Results:
- Pneumonia was the most frequent lethal complication of measles.
- Supervening viral (adenovirus, herpesvirus) and bacterial (Klebsiella, Pseudomonas) infections were prominent causes of death.
- Severe malnutrition was less frequent in measles survivors compared to fatal cases.
- Peripheral lymphopenia and depletion of T-cell zones were observed more in fatal measles cases.
Conclusions:
- Secondary infections, particularly bacterial pneumonia, are key determinants of fatal measles outcomes.
- Host immune status, indicated by lymphopenia and T-cell zone depletion, plays a role in measles mortality.
- Malnutrition is a significant factor, though less prevalent in survivors of measles.