Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008–2013

Atti, Marta Luisa Ciofi degli; Filia, Antonietta; Bella, Antonino; Sisto, Annamaria; Reale, Antonino; Raponi, Massimiliano

doi:10.1097/inf.0000000000001609

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…Complications such as bronchopneumonia or encephalitis (one of the leading causes of death in developing countries) often contribute to deaths from measles [ 6 , 41 - 44 ]. In the PICU, hospitalization lasted an average of 7.1 days compared to 4.5 days in the general ward, consistent with previous reports [ 34 , 36 , 45 ].…”

Section: Discussionsupporting

confidence: 91%

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A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics

Alruqaie,

Al Qadrah,

Almansour

et al. 2023

Cureus

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BackgroundMeasles is a highly contagious viral disease that has recently made headlines due to outbreaks in several parts of the world. The disease can cause serious health complications, especially in young children, which has led to concerns about vaccination rates and public health policies. This study aims to investigate and describe the epidemiology, clinical characteristics, and outcomes of measles infection among children in Riyadh. MethodologyWe conducted a descriptive cross-sectional study among all pediatric patients with confirmed measles infection at a tertiary hospital from January 15, 2023, to March 15, 2023. We collected data including demographic characteristics, clinical presentations, and clinical outcomes. ResultsA total of 63 confirmed measles cases were reported. Most patients were under four years of age (82.7%), and 85.7% were unvaccinated. Adenovirus was the most common viral coinfection (12.7%). The most common complication was pneumonia (58.7%). Chest X-ray findings reported a localized right parenchymal infiltrate in 19% of patients and a patchy bilateral infiltrate in 15.9% of patients. In addition, 88.9% required hospital admission secondary to dehydration (47.6%) and hypoxia (41.3%). Among admitted patients, 17.5% were admitted to the pediatric intensive care unit (PICU), 9.5% were admitted due to respiratory failure, and 6.3% due to septic shock. Children under one year of age had a higher risk for PICU admission (p < 0.05). The mortality rate was 1.6%. ConclusionsMeasles is a serious disease that causes significant health effects and incurs high financial costs for public health systems. Vaccination remains the most effective way to prevent measles outbreaks and reduce their impact on individuals and communities.

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Section: Discussionsupporting

confidence: 91%

“…In this study, the hospitalization rate was relatively high at 88.9%. It is worth noting that rates of hospitalization as low as 20% or as high as 70% have been observed in other studies [ 36 - 39 ]. We found that children under four years old were determined to be three times more likely to be hospitalized than older children.…”

Section: Discussionmentioning

confidence: 74%

A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics

Alruqaie,

Al Qadrah,

Almansour

et al. 2023

Cureus

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“…There was need for PICU admission in 1.9% of children due to severe complications, such as ARDS, sepsis and altered mental status and there was one death. Need for ICU hospitalization and deaths especially in children with underlying diseases have also been described in other studies in developed countries [2,29,36].…”

Section: Plos Onementioning

confidence: 57%

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

et al. 2021

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Background and aim A measles outbreak occurred in Greece during 2017–2018 affecting mainly pediatric population. The aim of the study was to describe the epidemiological and clinical characteristics of the cases diagnosed in the major pediatric tertiary hospital of Athens, where 26.5% of national pediatric measles cases were diagnosed and treated. Methods This is a retrospective study of children 0–16 years old, who presented at the emergency department and/or were hospitalized with clinical presentation compatible with measles and diagnosis was confirmed with molecular detection of the measles RNA in pharyngeal swabs. Epidemiological, clinical and laboratory characteristics were retrieved from medical records and analyzed. Results A total of 578 children with measles were identified during the study period. 322 (55.7%) were male with median age 36 months (range:1–193), while the largest number of documented cases (251; 43.4%) were children aged 1–5 years. Most children (429/578; 74.2%) belonged to the Roma minority and only 64 (11.1%) had Greek origin. 497 (91.5%) children were unvaccinated and 37 (6.8%) were partially vaccinated with measles vaccine. Hospitalization was required for 342 (59.2%) children, whereas one or more complications were reported in 230 (67.2%) of them. Most frequent complications were elevated transaminases (139; 40.6%), acute otitis media (72; 21%), dehydration (67; 19.6%) and pneumonia (58; 16.9%). 11 children (3.2%) required intensive care admission for altered mental status/status epilepticus (3), sepsis (2) and ARDS (6). 119/342 (34.8%) children were treated with antibiotics because of possible or confirmed bacterial coinfection. One death was reported, concerning an 11-month-old unvaccinated infant, with underlying dystrophy, who died of sepsis. Conclusion Measles is not an innocent viral infection, as it is still characterized by high morbidity and complications rates. Unvaccinated or partially vaccinated populations could trigger new outbreaks, resulting in significant cost in public health. To avoid future measles outbreaks, high vaccination coverage should be achieved, as well as closing immunity gaps in the population and ensuring high-quality measles surveillance.

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“…In our setting, the proportion of measles cases reported by hospital wards was unexpectedly high, although this was not necessarily related to the presence of clinical complications. In this regard, however, it must be stressed that hospitalized patients were significantly younger than the cases in the community [ 21 – 23 ], most of them were children aged ≤5 years, and this may have potentially reflected a justifiable high-level attention in respect to this population group.…”

Section: Discussionmentioning

confidence: 99%

Case-based surveillance of measles in Sicily during 2012-2017: The changing molecular epidemiology and implications for vaccine strategies

et al. 2018

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Following the indication of the World Health Organization, a national plan for the elimination of measles was approved in Italy and this included the improvement of the molecular surveillance of measles viruses and the interruption of indigenous transmission of the disease. Nevertheless, large outbreaks continue to occur in almost all regions of the country, including Sicily. Here we describe the epidemiology and molecular dynamics of measles viruses as a result of the measles surveillance activity carried out by the “Reference Laboratory for Measles and Rubella” in Sicily over a 5-year period. Biological samples of 259 suspected measles cases were tested for viral RNA detection and a total of 223 (86.1%) were classified as laboratory confirmed. The median age of confirmed measles cases was 21.0 years and about half of them were adults aged 19 years and older. Overall, one-third of the patients showed clinical complications and these latter were more common among adults than children (44.9% vs. 25.7%). The vast majority of measles cases were unvaccinated (94.2%, n = 210). The phylogenetic analysis of 221 measles virus nucleotide sequences revealed sporadic detections of genotypes D4 and H1, while endemic circulation of genotypes D8 and B3 was documented. Genotype D8 was associated with epidemics occurred between 2013 and 2016, whereas genotype B3 was more recently introduced into Sicily characterizing the current measles outbreak. The results of this study confirm the autochthonous co-circulation of viral variants belonging to different genotypes during the study period, and emphasizes the need of measles surveillance programmes in order to investigate the viral dynamics, the pathways of disease transmission, and to eventually adapt the development of successfull vaccine formulations.

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Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008–2013

Abstract: Hospitalizations of children with measles continue to occur in European areas where elimination has not been achieved. Children with chronic diseases represent a vulnerable population that is at higher risk of hospitalization.

Cited by 8 publications

References 25 publications

A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics

A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

Case-based surveillance of measles in Sicily during 2012-2017: The changing molecular epidemiology and implications for vaccine strategies

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