Understanding Measles in Hospitalized Adults: Insights into the Recent Romanian Epidemic, Clinical Presentation and...

Measles remains a significant public health concern in Romania, with recurrent ongoing nationwide outbreaks despite the availability of the measles-mumps-rubella (MMR) vaccine. This study investigates the epidemiological, clinical, and sociocultural dimensions of measles among Romanian adults, with a particular focus on a vulnerable group, the Roma population.

We conducted a retrospective cohort study using clinical data from a tertiary hospital in Bucharest, Romania. The study included adult patients hospitalized with measles between July 2023 and April 2024. In a subsequent phase, we carried out a cross-sectional survey among hospitalized measles patients to assess their perception and understanding of measles and the MMR vaccine, with particular attention to responses from Roma participants.

A retrospective investigation of 100 hospitalized adult patients with laboratory-confirmed diagnoses of measles demonstrated frequent complications such as hepatic involvement (85/100), pneumonia (68/100), and respiratory failure (21/100). Only 6/100 of patients were fully vaccinated. Rhabdomyolysis was significantly more common in unvaccinated individuals and women. No deaths were recorded, and no ICU admissions occurred. Among the hospitalized patients, 49 adults responded to a vaccine centered questionnaire. We report a notable vaccine hesitancy, particularly among the Roma respondents. Socioeconomic factors such as low income, limited education, and lack of health insurance were significantly associated with negative perceptions of the MMR vaccine. A statistically significant association was observed between Roma ethnicity and the belief that the MMR vaccine causes autism.

These findings highlight the urgent need for targeted public health interventions with culturally adapted education campaigns to improve vaccination coverage and thereby protect vulnerable adult populations in Romania.