Evaluation of Pediatric Measles Cases in 2019: Single Center Experience (original) (raw)
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A Single-Center Evaluation of Pediatric Measles Cases in Istanbul, Türkiye, in 2019
Japanese Journal of Infectious Diseases
Although measles can be prevented and eliminated by vaccination, it is a highly contagious viral disease that can lead to serious complications, disability, and death. The aim of this retrospective study was to evaluate the characteristics of measles cases in a single center. All children with clinically suspected measles who attended the Pediatric Clinic at Esenler Maternity and Child Health Hospital in Istanbul, Türkiye, between January 1 and June 30, 2019 were included in the analysis. None of the children with measles were fully vaccinated. The incidence and duration of conjunctivitis were significantly higher in the unvaccinated group than in the partially vaccinated group (P = 0.027 and P = 0.019, respectively). Unvaccinated patients had a significantly lower median leukocyte count (P = 0.019) and significantly higher median C-reactive protein level (P = 0.021). The vitamin A level and leukocyte count were moderately positively correlated (r = 0.698; P = 0.008). Children should be fully vaccinated in order to prevent measles.
VACCINATION STATUS OF CHILDREN PRESENTING WITH MEASLES: A SINGLE CENTER STUDY QR code
Objective: The objective of the study was to determine the frequency of vaccinated children among measles cases coming to a Tertiary Care Hospital Setting: The study was conducted in Department of Pediatric Medicine, the study was conducted in Department of Pediatric Medicine, Children Hospital, Faisalabad Study design: Descriptive Cross Sectional Study duration: Six months after approval of synopsis Results: In our study, 81.54%(n=106) were between 1-6 years of age while 18.46%(n=24) were between 7-12 years of age, mean + SD was calculated as 4.55+2.24 years, 59.23%(n=77) were male while 40.77%(n=53) were females, frequency of vaccinated children in measles was recorded in 64.62%(n=84). Conclusion: We concluded that the frequency of measles is high among vaccinated children. So, it is recommended that every patient who present with measles, should be sort out for vaccination history. However, it is also required that every setup should have their surveillance in order to know the frequency of the problem.
Letter to the editor: PREVALENCE OF MEASLES IN VACCINATED AND NON-VACCINATED CHILDREN
2015
Measles is a highly infectious and contagious disease of the respiratory system caused by Morbilivirus which belongs to family Paramyxoviridae (Hashiguchi et al., 2011). The disease is a common cause of childhood morbidity and mortality across the globe, particularly in developing countries and has been characterized by high fever, cough, conjunctivitis, coryza, malaise and maculopapular rash along with erythematous patches throughout the body (Ellison, 1931; Yanagi et al., 2006; Fazlalipour et al., 2008). Measles infection has been controlled by introduction of live attenuated measles vaccine in United States and Europe (Gindler et al., 2004). However, measles is still affecting the developing countries due to insufficient coverage and improper handling of vaccines (Poland and Jocobson, 1994; Muscat et al., 2009). Historically, immunization against vaccine preventable diseases (VPDs) in children has been started by WHO in 1974, and it was initiated in Pakistan during 1978 (Ali, 2000; Bugvi et al., 2014). In general the vaccine coverage against VPDs in Pakistan ranged between 56 to 88 % which significantly varied among various Provinces (Sheikh et al., 2011). Recently, increased number of measles outbreaks with high morbidity and mortality has been observed in various regions of Pakistan during recent years (Khan and Khan, 2012; Khan and Qazi, 2014). These particular episodes of higher incidence of measles were started in Thatta, Mirpurkhas and Jacobabad Districts of Sindh Province by the end of 2012, which later on spread towards Punjab Province (Khan and Khan, 2012; Khan and Qazi, 2014). The spread of measles was reported to be higher in both rural as well as developed cities of Pakistan along with high incidence of mortality and morbidity (Khan and Qazi, 2014). The important factors considered for these outbreaks were associated with vaccination failure due to several reasons i.e. low vaccination coverage, malnutrition and vitamin-A deficiencies, poor vaccination facilities in remote and rural areas, mishandling of vaccines and lack of immunization awareness among parents due to lower levels of education in various areas of country (Cohen et al., 2009; Khan and Khan, 2012; Khan and Qazi, 2014). To combat the situation extensive supplementary immunization activities have been initiated which targets the chil
Risk Factors Associated with Complicated Measles in Children
2016
Aim: To determine the risk factors associated with complicated measles in children. Study design: It was a descriptive cross sectional study. Duration: Six months from 1 st January 2013 to 30 th June 2013. Settings: Department of Pediatrics, Teaching Hospital D.G Khan Medical College. Methods: A total of 100 cases fulfilling the inclusion/exclusion criteria were enrolled in the study. Results: In this study out of 100 patients54 (54%) were male cases and 46 (46%) female cases. Risk factors in complicated measles were recorded as: malnutrition (56%), nonvaccinated (78%), young age (age less then 5 years) (80%), immune deficiency (cases with history of recurrent infections) (12%) and vitamin A deficiency (cases with bitot spots on bulbar conjuctiva (3%). Conclusion: Younger age, poor socio economic status leading to over crowding and malnutrition, nonvaccination and immune deficiency were commonest risk factors of complicated measles.
Pakistan Armed Forces Medical Journal, 2016
Objective: To determine the different demographic parameters, associated morbidity and mortality of measles cases admitted in a paediatric unit of a teaching hospital.Study Design: Descriptive cross sectional study.Place and Duration of Study: Pediatrics department Combined Military Hospital Kharian from October 2012- September 2013.Material and Methods: All patients admitted with diagnosis of measles according to World Health Organization (WHO) definition of clinical measles up to 12 years of age were included. Detailed history and clinical examination was done. Required information regarding study parameter was collected on a pre designed proforma. Different complications in relation to age, vaccination and nutritional status were assessed. Statistical data was analyzed by SPSS version 17.Results: Among total 68 patients, 48(70.58%) were male and 20 (29.41%) female. Mean age was 21.26 (± 26.95) months. Thirty four (50%) patients were between 6-8 (completed) months of age, 3 (4.41 ...
International Journal of Medicine and Public Health
Background: Measles has been a major public health concern leading to death among children despite availability of safe and cost-effective vaccines. Global push to improve vaccine coverage resulted in an 84% reduction in deaths. However, data from the year 2016 still reveals that there were 89, 780 measles deaths globally. 1 Aim: To study the epidemiological determinants influencing measles in children previously immunized with measles vaccine. Objectives: To determine the proportion of measles infected cases with history of prior measles immunization. To compare clinical profile of patients with and without history of prior measles immunization. Setting and design: Record based, Retrospective Cross sectional Study. Materials and Methods: A retrospective study was conducted using hospital records from an infectious disease hospital situated in Greater Mumbai. The study was carried out over duration of 1 year. Records of all cases admitted for measles from January 2013 to December 2013 were studied in detail. Sampling technique used was universal sampling. Total sample size was 471. Majority of the cases were admitted based on the WHO clinical definition while for a few suspicious cases Measles specific IgM was carried out. Statistical analysis used: Chi square test. Results: Out of 471 case records reviewed for measles, 47% children were vaccinated for measles. Percentage of undernourished children who received the immunization was 48%. A statistically significant association was observed for age, gender and duration of disease amongst those who were immunized for measles (p<0.01). Conclusion: A significant percentage of children despite immunization suffered from measles. Age, gender and nutrition were found to play a vital role in acquisition of measles both in the vaccinated and unvaccinated children.
Measles related complications and the role of vitamin A supplementation
The Indian Journal of Pediatrics, 2008
Objective. Measles is associated with high rate of complications and contributes to a major proportion of childhood morbidity and mortality. The role of vit A supplementation (VAS) in the case management of measles and prevention of complications is partially understood and not sufficiently supported by epidemiological data. This paper analyses the possible role of vit A supplementation in prevention of measles related complications and associated fatality. Methods. A cross sectional study was carried out during an outbreak of measles in Shivpuri, India. A total population of 193,000 was covered by house to house visit and, the caregivers of total 1204 measles cases, including 214 cases with complications, were interviewed using a semi structured interview schedule. The analysis of data was done using Epi Info. Results. The attack rate of 6.7% and rate of complications at 17.8% were found in this investigation. The coverage with routine measles vaccine and the vit A supplementation was 18.3% and 28.9% respectively. The management of measles cases was poor with only 15.8% cases receiving therapeutic doses of vit A. Both complications and case fatality rate was higher amongst children who had not received vit A supplementation in previous 6 months (p<0.05). Measles vaccine also found to have preventive effect on development of complications (p<0.05). Conclusion. Routine vit A supplementation and measles vaccination reduce the chances of complications amongst cases of measles. The role of VAS becomes more important when the case management is poor. While, measles is frequently associated with complications in the Indian setting, there is a need of enhancing the efforts to improve the delivery of vit A supplementation and measles vaccine to the children in rural areas.
Measles-related hospitalizations and associated complications in jerusalem, 2018-2019
Clinical Microbiology and Infection, 2019
Objectives: The 2018 measles outbreak in Israel affected >2000 people in Jerusalem. The aim of the study was to describe clinical features and complications of hospitalized measles patients in Jerusalem, as related to age group and risk factors. Methods: All individuals hospitalized with measles in the three main hospitals in Jerusalem during March 2018 to February 2019 were included. Demographic, clinical and laboratory data were analysed. Results: Of 161 hospitalized individuals, 86 (53.4%) were <5 years old, 16 (10%) were 5 years but <20 years old, and 59 (36.6%) were 20 years old. Most, 114/135 (85%), were unvaccinated. Immunocompromised state was identified in 12/161 (7.5%) patients, 20/161 (12.4%) had other underlying comorbidities, and four were pregnant. Hypoxaemia on admission was a common finding in all age groups. Hepatitis was more common among adults 20 years old (33/59, 59%). Measles-related complications were noted in 95/161 (59%) patients, and included pneumonia/pneumonitis (67/161, 41.6%), which was more common in young (<5 years) children, diarrhoea (18/161, 11.2%), otitis (18/161, 11.2%), and neurological complications (6/161, 3.7%)dthe latter occurring more frequently in the 5-to 20-year age group. Two of the 12 immunocompromised patients died of measles-related complications. A high readmission rate (19/161, 11.8%) within 3 months was documented among hospitalized measles patients. Conclusion: The burden of hospitalization, as well as the high rate of short-and long-term complications observed in hospitalized patients, underscore the importance of maintaining a high measles vaccine coverage, with enhanced targeting of unvaccinated population pockets.
Measles, one of the most infectious viral diseases of humans nearly all susceptible individuals in the absence of vaccination, is spread by the respiratory route and remains a major cause of mortality in children, particularly in developing countries. It is caused by measles virus (MV), which is an enveloped virus belonging to the genus morbillivirus of the family-paramyxoviridae. Measles is usually characterized by prodrome fever, maculopapular rash with one or a combination of coryza, cough, conjunctivitis and Koplik's spot. The study was conducted in some part of the NorthWest Nigeria with the aim to determine the seroprevalence of measles IgM and possible risk factors associated with the acquisition of the infection. A total of 725 children aged 0 to 10 years were selected for the study across the three states (Kano, Katsina and Zamfara). Measles-specific IgM antibodies were screened qualitatively using commercial ELISA IgM kit (Diagnostic Automation and Cortez, Calabasas, CA, USA). Measles IgM specific antibodies were detected in 334(44.4%) of the subjects. A higher prevalence of 53.2% was found in the age group 0-2years, and the least 21.4% in age group 8-10 years. There was a significant association between measles virus infection and age (P=0.001). Females show slightly higher prevalence 46.7% than males 42.1%, though there was no significant association (P=0.03). With respect to the parental occupation and education status, there was a significant association (P> 0.05) while vaccination status, number of vaccinations, travel history and contact history shows no significant statistical association (P> 0.05). However, in relation to previous measles history and crowded environment, statistically significant association was observed (P< 0.05). This is an indication that measles still persist in this part of the country despite the availability of safe and cost effective vaccine its persistence and burden is worrisome as observed in vaccinated and non-vaccinated children especially under five. Abstract Measles, one of the most infectious viral diseases of humans nearly all susceptible individuals in the absence of vaccination, is spread by the respiratory route and remains a major cause of mortality in children, particularly in developing countries. It is caused by measles virus (MV), which is an enveloped virus belonging to the genus morbillivirus of the family-paramyxoviridae. Measles is usually characterized by prodrome fever, maculopapular rash with one or a combination of coryza, cough, conjunctivitis and Koplik's spot. The study was conducted in some part of the NorthWest Nigeria with the aim to determine the seroprevalence of measles IgM and possible risk factors associated with the acquisition of the infection. A total of 725 children aged 0 to 10 years were selected for the study across the three states (Kano, Katsina and Zamfara). Measles-specific IgM antibodies were screened qualitatively using commercial ELISA IgM kit (Diagnostic Automation and Cortez, Calabasas, CA, USA). Measles IgM specific antibodies were detected in 334(44.4%) of the subjects. A higher prevalence of 53.2% was found in the age group 0-2years, and the least 21.4% in age group 8-10 years. There was a significant association between measles virus infection and age (P=0.001). Females show slightly higher prevalence 46.7% than males 42.1%, though there was no significant association (P=0.03). With respect to the parental occupation and education status, there was a significant association (P> 0.05) while vaccination status, number of vaccinations, travel history and contact history shows no significant statistical association (P> 0.05). However, in relation to previous measles history and crowded environment, statistically significant association was observed (P< 0.05). This is an indication that measles still persist in this part of the country despite the availability of safe and cost effective vaccine its persistence and burden is worrisome as observed in vaccinated and non-vaccinated children especially under five.
Virulence, 2020
A large measles epidemic has been ongoing in Romania and many European countries, since 2016. We report case-based surveillance data for all patients (n = 1371) with laboratory-confirmed and epidemiologically-confirmed measles hospitalized in a major infectious diseases hospital in Bucharest Romania during the first three years of the current measles epidemic (July 2016-July 2019). More than half of the patients (57.6%) had ages below 5 years; 6% (n = 82) had preexisting comorbidities. Only 1.5% of the patients had been fully vaccinated, 5.9% had received only one vaccine dose, while 92.8% had not been vaccinated at all against measles. The rate of measlesrelated complications was 93.4%; complications occurred more frequently among patients who were not eligible for vaccination due to young age or underlying diseases, and among children, who developed pneumonia and enterocolitis more frequently than adults. The median hospital length-of-stay was 6 days. Eight cases (0.6%) required intensive care and mechanical ventilation, and three deaths (0.2%) were recorded. Measles disproportionately affects patient groups who are not eligible for vaccination. During the current epidemic in Romania, 98.5% of the patients hospitalized for measles had not been vaccinated and among these, 75.7% would have been eligible for vaccination. For the remaining pool of unvaccinated children, supplementary immunization activities are urgently needed.