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Further predictive indices of clinical severity of measles
Abstract:
Predictive indices for the outcome of measles were sought from a clinical and immunological study. A poor outcome was defined as death or persistence of bronchopulmonary disease 6 weeks after onset. The 47 Black children studied were well nourished and lymphopenic (absolute lymphocyte count less than 2 000/mm3) in the first 2 days of the exanthem. The latter feature has previously been shown to carry a poor prognosis. Eight of the children recovered fully, 5 died and 34 had residual lung changes at 6 weeks. Other factors which could be related to prognosis in this group of children already at risk of severe disease were more extensive pneumonia and normal or minimally reduced serum complement C3 levels early in the course of the disease. A less than twofold rise in haemagglutinin-inhibiting antibody titre was also associated with a poor prognosis.
Insights
Predicting measles outcomes in Black children is crucial. Lymphopenia and extensive pneumonia early in the disease, along with a minimal antibody response, indicate a poor prognosis for measles patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Measles can lead to severe complications, particularly in at-risk populations.
- Identifying predictive factors for measles outcome is essential for timely intervention.
- Previous studies suggest lymphopenia is associated with poor measles prognosis.
Purpose of the Study:
- To identify clinical and immunological predictive indices for measles outcome in Black children.
- To define poor measles outcome as death or persistent bronchopulmonary disease at 6 weeks.
Main Methods:
- A clinical and immunological study was conducted on 47 Black children with measles.
- Data collected included absolute lymphocyte count, pneumonia extent, serum complement C3 levels, and antibody titers.
- Prognosis was assessed based on mortality and the presence of residual lung changes at 6 weeks.
Main Results:
- Lymphopenia (absolute lymphocyte count < 2,000/mm3) was observed in the early stages of the exanthem.
- Eight children recovered fully, 5 died, and 34 had residual lung changes at 6 weeks.
- Factors associated with poor prognosis included extensive pneumonia, normal/minimally reduced serum complement C3 levels, and a less than twofold rise in haemagglutinin-inhibiting antibody titer.
Conclusions:
- Early lymphopenia is a significant predictor of poor measles outcome in this cohort.
- Extensive pneumonia and specific immunological markers (complement C3, antibody response) further refine prognosis.
- These findings aid in identifying children at high risk for severe measles complications.