Clinical and epidemiological features of measles in children hospitalized during two outbreaks (2005–2006 and 2017–2018) in Ukraine
DOI:
https://doi.org/10.14739/2310-1210.2019.6.186607Keywords:
measles, children, epidemiologic studiesAbstract
Aim. The purpose of this study was to find out the clinical and epidemiological features of measles in children during the outbreak of 2017–2018.
Materials and methods. A retrospective study of 230 case histories of children suffering from measles hospitalized in the Kyiv Children's Clinical Hospital was conducted during two epidemic outbreaks in 2005–2006 and 2017–2018.
Results. In 2017–2018, the majority of hospitalized children with measles (62.9 %) were school age children. Compared to 2006, the mean age of patients has increased significantly, the proportion of children in the first year of life has significantly decreased and the percentage of children of primary school age (6 to 11 years old) has increased. Compared to 2005–2006, an increase in the duration of fever (from 6.60 to 7.26), shortening of prodromal period (from 3.68 to 2.96) and prolongation of rash period (from 4.97 to 5.88) are characteristic of the course of measles in 2017–2018. Leukopenia was observed in almost every fifth patient. In 14.3 % of patients in 2017–2018, the course of the disease was complicated (the vast majority was associated with respiratory tract organs). Compared to 2005-2006, the structure of patients with measles in 2017–2018 had the proportion of vaccinated patients decreased and, respectively, the percentage of unvaccinated individuals increased: the proportion of unvaccinated patients was 72.1 %; unknown vaccination status – 2.9 %. Approximately 10.0 % of children had only one administration of a measles vaccine.
Conclusions. During the current outbreak, school age children and adolescents prevail in the age structure of ill children hospitalized with measles. Compared to 2005–2006, an increase in the duration of fever, shortening of prodromal period and prolongation of rash period are characteristic of the course of measles in 2017–2018. Changes in the clinical and epidemiological features of the disease may be associated with changes in the spectrum of circulating strains of measles virus.
References
World Health Organization (WHO) (2018). Measles. Key facts. Retrieved from https://www.who.int/news-room/fact-sheets/detail/measles
Santibanez, S., Hübschen, J., Ben Mamou, M., Muscat, M., Brown, K., & Myers, R. et al. (2017). Molecular surveillance of measles and rubella in the WHO European Region: new challenges in the elimination phase. Clinical Microbiology And Infection, 23(8), 516-523. doi: 10.1016/j.cmi.2017.06.030
World Health Organization (WHO) (2018). Ukraine restores immunization coverage in momentous effort to stop measles outbreak that has affected more than 12 000 this year. Retrieved from http://www.euro.who.int/en/countries/ukraine/news/news/2018/05/ukraine-restores-immunization-coverage-in-momentous-effort-to-stop-measles-outbreak-that-has-affected-more-than-12-000-this-year
Ludlow, M., McQuaid, S., Milner, D., de Swart, R., & Duprex, W. (2015). Pathological consequences of systemic measles virus infection. The Journal Of Pathology, 235(2), 253-265. doi: 10.1002/path.4457
de Vries, R., & de Swart, R. (2014). Measles immune suppression: functional impairment or numbers game? Plos Pathogens, 10(12), e1004482. doi: 10.1371/journal.ppat.1004482
Laksono, B., de Vries, R., McQuaid, S., Duprex, W., & de Swart, R. (2016). Measles Virus Host Invasion and Pathogenesis. Viruses, 8(8), 210. doi: 10.3390/v8080210
Laksono, B., Grosserichter-Wagener, C., de Vries, R., Langeveld, S., Brem, M., & van Dongen, J. et al. (2018). In Vitro Measles Virus Infection of Human Lymphocyte Subsets Demonstrates High Susceptibility and Permissiveness of both Naive and Memory B Cells. Journal Of Virology, 92(8), e00131-18. doi: 10.1128/jvi.00131-18
Grammens, T., Schirvel, C., Leenen, S., Shodu, N., Hutse, V., Mendes da Costa, E., & Sabbe, M. (2017). Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. Eurosurveillance, 22(17). doi: 10.2807/1560-7917.es.2017.22.17.30524
Ge, Y., Zhai, X., Zhu, Y., Wang, X., Xia, A., Li, Y., & Zeng, M. (2017). Measles Outbreak in Pediatric Hematology and Oncology Patients in Shanghai, 2015. Chinese Medical Journal, 130(11), 1320-1326. doi: 10.4103/0366-6999.206358
Griffin, D. (2014). Measles virus and the nervous system. Neurovirology, 123, 577-590. doi: 10.1016/b978-0-444-53488-0.00027-4
Fisher, D., Defres, S., & Solomon, T. (2015). Measles-induced encephalitis. QJM, 108(3), 177-182. doi: 10.1093/qjmed/hcu113
Wendorf, K., Winter, K., Zipprich, J., Schechter, R., Hacker, J., & Preas, C. et al. (2017). Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated. Clinical Infectious Diseases, 65(2), 226-232. doi: 10.1093/cid/cix302
Sati, S., Banga, S., & Bhadouria, S. (2018). Fulminant Hepatic Failure in Measles in a 6-Month-Old Child. International Journal Of Clinical Pediatrics, 7(1-2), 17-18. doi: 10.14740/ijcp294w
Caseris, M., Houhou, N., Longuet, P., Rioux, C., Lepeule, R., & Choquet, C. et al. (2014). French 2010–2011 measles outbreak in adults: report from a Parisian teaching hospital. Clinical Microbiology And Infection, 20(4), O242-O244. doi: 10.1111/1469-0691.12384
Jackson, B., & Black, R. (2017). Available studies fail to provide strong evidence of increased risk of diarrhea mortality due to measles in the period 4-26 weeks after measles rash onset. BMC Public Health, 17(S4). doi: 10.1186/s12889-017-4745-2
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