Measles-related Hospitalizations and Complications in Japan, 2007-2008

Abstract

Objective In the present study we aim to describe the clinical features and related complications of severe measles requiring hospitalization in Japan in 2007 and 2008. Methods We extracted the records of patients diagnosed with measles between July and December in 2007 and 2008 from the Diagnosis Procedure Combination (DPC) inpatient database and the verified age distribution of patients with measles requiring hospitalization and the rate of measles-related complications. We also examined the rate of measles patients who were pregnant or had malignancies. Results We identified 1,037 inpatients in 377 hospitals; 879 in 158 in 2008. Overall, 554 (53.4%) were male. Patient age distribution showed two peaks; !4 years (21%) and 15-29 years (45%). Ninety (8.7%) patients had pneumonia, 22 (2.1%) had encephalitis, 7 (0.7%) had intestinal complications, 7 (0.7%) had conjunctivitis, 6 (0.6%) had meningitis, and 4 (0.4%) had otitis media. Patients aged !14 years were significantly more likely to have pneumonia (16.4%; p<0.001). The rate of encephalitis was relatively low in patients aged! 14 years (0.9%) compared with those aged 15-29 years (3.0%) and those aged "30 years (2.0%); the difference was not statistically significant (p=0.141). Of 31 pregnant women, 10 had spontaneous abortion or stillbirth. Twenty-eight patients had malignancies. Conclusion The present study adds important information to our knowledge of the clinical features of severe measles. Follow-up monitoring of the trends of this distressing disease using the DPC database will be essential.

La rougeole en France

“…Cette sous-déclaration a sans doute fluctué dans le temps, probablement différente selon l'âge et plus importante pour les cas vus en médecine libérale que pour ceux vus à l'hôpital. D'autre part, un meilleur taux de déclaration des cas vus à l'hôpital expliquerait aussi probablement en partie les proportions plus élevées de complications graves que nous avons observées par comparaison avec les données de la littérature ; la même remarque inverse peut être faite concernant la faible part des complications habituellement vues en ville comme les otites et les diarrhées [11,12]. À noter que les hospitalisations exposent au risque de transmission nosocomiale comme décrit récemment [13], et ceci doit conduire au renforcement du rattrapage des vaccinations parmi les professionnels de santé selon les recommandations vaccinales actuelles [4].…”

Rash in a 15 month old girl

“…The highest rates of complications and death occur in children under 5 years and in adults. [40][41][42] In 2008, an estimated 164 000 deaths were caused by measles worldwide. 43…”

“…47 Pneumonia is reported in from 7% of inpatients to more than 50% of paediatric patients. 42 45 46 Otitis media is most common in younger patients and is not seen in those over 30 years. 42 Gastrointestinal complications include nausea and vomiting (34%) and diarrhoea (18%).…”

Dermatological Signs and Symptoms of Measles: A Prospective Case Series and Comparison with the Literature

“…Since there exists a vaccine against the disease, it is nowadays not as common as it used to be. However, vaccination compliance has decreased dramatically, and therefore measles still produces outbreaks and can become dangerous in various circumstances [1]. Not only for that reason is it important to recognize the clinical presentation in an early stage.…”