Disease severity and presentation in children with recent measles epidemic: Karachi, Pakistan

Introduction: Measles is an important vaccine preventable infection. Despite immunization the reported measles related deaths are increased globally. An estimated 164 000 people died from measles in 2008 mostly children under the age of five.

Objective: To determine the clinical features and disease severity of measles in children during recent epidemic, presenting to emergency department.

 Material and Method: The study was conducted at Emergency department (ED) of Aga Khan University from February 2012 to August 2012.The charts of the patients with the diagnosis of “measles” or “suspected measles” were reviewed retrospectively. Data was collected on variables like age, gender, duration of illness, vaccination status and history of contact with index measles case.  All the signs and symptoms like fever, rash, vomiting, irritability, drowsiness, and decrease intake were recorded. The duration of hospital stay and disease complications were recorded. Data would be entered and analyzed using SPSS version 19.0.

Results: Total 170 children presented to emergency department with suspected measles. The mean age was 22 months, with mostly children (76%) more than 9 month of age. Males were 53.5%. More than half were unvaccinated (53%). History of contact with measles was positive in 9.4%. Fever (67%) and cough (22.4%) were the most common presenting complaints. From ED 77% got admitted. Complications observed were acute gastroenteritis (48%), pneumonia (31.6%), otitis media (3%) and encephalitis(2.2%) respectively .

Conclusion: Measles is still a common reason for Emergency department visits in children. Improving vaccination in children can prevent morbidity and mortality related to this communicable disease.