Characteristics of Children with Measles Hospitalized at dr. R. D. Kandou Hospital Manado in 2014-2016
Novie H. RampenganMarsino RondoIren A. SantosoRonald Immanuel OttaySuryadi N. N. TaturaT. H. Rampengan
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Abstract:
Background :
Measles, also known as rubeola or morbilli, is a highly infectious illness caused
by the rubeola virus. Complications from measles are fairly common and are
more likely to be worse for patients who have weak immune systems.
Material:
This study was a retrospective descriptive study. Data obtained from medical
records of patients with measles who were hospitalized at Prof. Dr. R. D.
Kandou Hospital, Manado in the period 2014 to 2016.
Results:
There were 113 patients who hospitalized, consist of 51 girls (45.1%) and 62
boys (54.9%). The distribution of age was 33 children (29.2%) aged 0-5 years,
62 children (54.9%) aged 5-10 years, 14 children (12.4%) aged 10-15 years and
4 children (3.5%) aged 15-18 years. Complic~tions most frequently encountered
was bronchopneumonia in 48 cases (42.5%), diarrhea in 46 cases (40.7%) and
febrile seizures in 19 cases (16.8%). Nutritional status in patients who have been
especially good nutrition present in 85 cases (75.2%), under nutrition in 23 cases
(20.4%) and obesity in 5 cases (4.4%). Length of hospitalization as 7
days was found almost in most cases with total 87 (77%) and the rest for more
than 7 days was found in 26 cases (23%). Number of patients with measles immunization were 76 cases (67.3%) ,booster 23 cases and 14 cases without
measles immunization (20.3 % VS 12.4%). There was 22 patients with
immunization (28.9%) have complications, From cases with booster 4 (17.4%)
of them have complications and without immunization 6 (42.9%) of them have
complications.
Conclusion :
Most complications found were bronchopneumonia followed by diarrhea.Keywords:
Medical record
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Objective
To investigate the epidemiological characteristics and clinical manifestations of measles in Nanjing in the past decade, and provide scientific basis for formulating relevant prevention and control measures.
Methods
Clinical and epidemiological data of 5 171 hospitalized measles patients in Nanjing Second Hospital from 2008 to 2017 were retrospectively analyzed.
Results
Of 5 171 measles patients, the male to female ratio was 1.43:1, and the numbers of patients increased in 2009, 2013 and 2015, especially in 2015 (2 641 cases) . The epidemic showed seasonal distribution, and the incidence peak was in April (1 279 cases) . Patients under 2 years old were the main population, accounting for 63.41%, and adult measles cases accounted for 29.78%. Most patients (97.50%) had typical rash manifestations, and 44.82% of the patients had complications including pneumonia, liver damage, laryngitis and cardiac insufficiency. Laryngitis and cardiac insufficiency were commonly seen in infants under 1 year old (68.87% and 89.31%) . Liver damage was commonly seen in adult measles patients (77.36%) .
Conclusions
Children are susceptible to measles, while adults still occupy a high proportion. Patients may present with typical rash and various complications. In addition to the measles vaccine immunization for school-age children, we should also focus on adult intensive immunization work, so as to prevent and control the outbreak of measles.
Key words:
Measles; Rash; Complication
Laryngitis
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Ongoing immunization campaigns have significantly reduced the incidence of measles. To evaluate the efficacy of vaccination policies, however, it is necessary to analyze disease indicators of mortality and of morbidity such as medical complications and sequelae. We reviewed the hospital experience at Hospital Infantil de Mexico regarding children with measles who necessitated hospitalization between January 1976 and December 1989. During this 14 year period, 176 patients with measles were hospitalized; the majority of the cases corresponded to the period between 1985 and 1989. Fifty five percent of the cases corresponded to children under one year of age. Of those older than 12 months, 81% lacked an immunization history. Eighty percent were from Mexico city or from the neighboring state of Mexico. The mayor complications included: respiratory tract infections such as pneumonia (50.8%), diarrhea (18.2%), and less frequent: laringotracheitis, otitis media, myocarditis and pyodermitis. More than 70% were significantly (grade II or III) malnourished. Twenty three patients died, for a mortality of 13%. The factors more likely related to measles mortality were; age less than two years, undernutrition, and more than two medical complications associated. This report emphasizes that medical complications and mortality are more likely to occur in very young unimmunized, malnourished children.
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Objective To understand the epidemiology,clinical and laboratory features of measles cases in our hospital in 2004-2006.Methods Clinical data was collected and retrospectively analyzed in 55 cases with measles admitted to hospital in 2004-2006.Results A totle of 55 children with measles were reported from our department in 2004-2006.Most inpatients presented typical clinical manifestations of measles.40% patients were complicated with pneumopia.Conclusion The group with highest prevalence rate is those who younger than 9 months and older than 6-year-old.The rate of measles inoculations is connected with the mobidity of measles.The most common complication of measles is pneumonia.
Clinical epidemiology
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Measles is a highly contagious disease that often leads to substantial morbidity among pediatric patients especially when not addressed properly. While vaccination has already been implemented in the country, there is still a resurgence of measles outbreak. The study aims to describe the demographic and clinical profile of pediatric patients diagnosed with measles during the recent measles outbreak in a tertiary hospital in Central Luzon, Philippines; and to investigate the relationship of nutrition and measles immunization status with the outcomes of measles infection A ross sectional analytic study, conducted in Tertiary training government hospital situated in Pampanga. Patients included in the study were less than 19 years old, admitted between January to April 2019, and manifested the following criteria for suspected measles: fever, generalized maculopapular rash, cough, coryza, conjunctivitis. A total of 373 patients were included in this study, 60% (224) were males and 40% (149) were females. Majority were under 0-6 months, 40% (149). Most cases came from Pampanga, 333 (89.2%). Three Hundred fifty five (95%) were classified as clinically compatible measles, seven (2%) were laboratory confirmed and all seven had Measles IgM antibodies, while four (1%) were epidemiologically linked cases. Most of the cases manifested the classic symptoms of measles: fever 100%, rashes 99%, cough 96%, colds 84%, conjunctivitis 55% while Koplik’s spots was seen in only 13% of cases. As to exposure, those with exposure (49%) and without exposure (51%) are almost the same. Majority of the patients (285, 76%) had no measles vaccine and the top reason for non-immunization is the issue on the patients being too young for vaccination (9 months and below). Majority had normal nutritional status (72.4%). 312 reported the occurrence of clinical complications in patients with measles. Pneumonia was seen in 75% of cases and 9.3% had diarrhea. The occurrence of diarrhea is not directly correlated (p value 0.823) with the outcome of measles while Pneumonia shows significant correlation (p-value<0.001) with outcomes of measles. Death among patients was seen on cases of with pneumonia. The occurrence of pneumonia is not significantly correlated with nutritional status (p value 0.083) while diarrhea is significantly correlated with nutritional status (p value 0.027). Two hundred forty eight patients with normal nutritional status did not develop diarrhea. Vaccination status shows significant correlation with occurrence of pneumonia (p-value 0.001). Out of the 285 non-vaccinated cases, 223 developed pneumonia. Vaccination status did not show significant correlation with occurrence of diarrhea (p-value 0.946). Nutritional status and vaccination status was not significantly correlated with measles outcome with the following p value of 0.605 and 0.120.In terms of outcome, 90% of the patients were discharged and 10% of the patients died.
Maculopapular rash
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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 %) less than 6 months whilst 5(7.35%) were aged between 5-12 years. Partially and unvaccinated patients were 19.11% and 88.88% respectively. Thirty (44.11%) cases were well nourished and 38 (55.88%) malnourished. Pneumonia (41.66%) was the commonest complication followed by diarrhea (37.5%), oral lesions (29.16%), otitis media (10.41%), eye changes, encephalitis, myocarditis and hepatitis (each 4.16%). Mortality was 1.47 %. Complications were more common in malnourished than well nourished patients (p-value <0.05) and in unvaccinated than vaccinated children (p-value <0.05).Conclusion: Majority of patients was less than 9 months age. Pneumonia was the commonest complication and only cause of death. Complications were more common among unvaccinated and malnourished children.
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[Objective] To investigate the epidemiological and clinical characteristics of patients with measles in Tianjin area in recent years. [Methods] Retrospectively analyze the clinical-epidemiological data of 1 876 hospitalized measles cases in Tianjin Infectious Diseases Hospital from December 2006 to May 2008. [Results] In a tota1 of 1 876 hospitalized patients with measles, 1 302 cases (69.4%) were infants younger than 8 months and 374 cases (19.9%) were adults older than 30 years. In these hospitalized cases, 264 patients got infection in foreign provinces while 1 612 cases got infection in Tianjin area. Among these 1 612 cases, 1 076 patients (66.7%) were floating population.There were 1 313 cases (70%) falling ill from March to May. 71 patients (3.8%) certainly had their vaccination against measles.1 200 patients (64%) were complicated with pneumonia.1 107 cases (59%) were found that they had dysfunction of liver. Myocardial enzyme of 1 744 cases (93%) in-creased. 1 331 cases ( 71% ) were positively detected out measles specific IgM antibody. [ Conclusion] The incidence of measles in Tianjin area is extensively higher than before in recent years, it’s a trend to break out. The prevalent seasons are from March to May. Most of patients don’t have their vaccination against measles. The group with highest prevalence rate is cases younger than 8 months.The vaccination against measles should be regulated. The most common complications of measles are pneumonia, liver and myocardial damage. The positive rate of measles specific IgM antibody isn’t higher.
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Objective:To investigate the factor of morbidit,clinical feature and prophylactic measures of measles in recent years.Methods:The clinical data of138adult cases of measles admitted to the First Affiliated Hospital of Chongqing Medical University from1997～2001were analysed retrospectively.Results:The results showed that some cases who were immunized with measles vaccination or had been infected with measles when they were young children were infected again.The patients were older than before and could be infected every season in one year.The intoxication symptoms were serious and the skin eruption were typical examples.In many cases,the hepatic function were damage severˉly.Conclusion:The incidence of the measles cases has been increasing in recent years and the clinical symptoms were serious.We suggest that the measles immunity should be carried out again in teenagers.
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To investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles.A retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR (RT-PCR) was adopted to detect sputum specimens from suspected patients with measles,who were selected randomly,the sequence of the part of the PCR products was analyzed.(1) Clinical and epidemiological data: Totally were 182 children with measles (125 males, 57 females) were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months (69. 8%). The prevalence season was from April to August, while the peak month was April and May (22. 5%, 23. 1%). Among 182 hospitalized children, only 11 cases underwent measles vaccination (6. 0%), and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases (91. 8%) had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population (8. 45%, 6/71) and the settled children (29.4%, 5/17, χ =8. 11 P =0. 004). In total, 24 cases (13. 2%) had definite measles exposure history, with 153 cases (84. 1%) of unknown origin,5 cases (2.7%) without any history of contact. (2) Clinical manifestations: All the 182 patients had fever (100%) and obvious rashes (100%), among them 145 cases had body temperature higher than 39 °C (79. 7%). The fever period ranged from 2 to 38 days. Among 182 hospitalized children,165 cases (90. 7%) had typical measles,17 cases had atypical measles. Among the 17 cases, two had severe measles, one had heterotypic measles. (3) The common complica tions: 96 cases had pneumonia (52. 8%), 80 had laryngitis (44. 0%), 38 had bronchitis (20. 9%),15 had hepatic dysfunction (8. 2%), 11 had myocardial damage (6. 0%), 3 had febrile seizures (1. 6%), and no patient had encephalitis. Of the 96 cases with pneumonia, 92 received sputum test; 38 were sputum culture positive (41%). The dominant pathogens were Streptococcus pneumoniae(11/38,29%), Haemophilus influenzae (6/ 38,16%), Moraxella catarrhalis (4/38, 11%), Escherichia coli (4/38, 11%), Candida albicans (4/38, 11%), Mycoplasma pneumoniae (4/38, 11%) and Staphylococcus aureus (3/38, 8%). (4) The H1a genotype was the only one genotype in the detected sequence of 54 measles virus strains.Measles was more often seen in the children under the age of 9 months from the floating population. The morbidity peak month was from April to May in Shanghai. The H1a genotype was the only one genotype. We should try to improve vaccination coverage rate in the children who are at the age for vaccination, so as to prevent measles outbreak.
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Background: Measles is still a major cause of childhood morbidity and mortality in Nigeria despite the availability of safe and effective vaccines. The burden of measles using length of hospital stay as a result of complications in hospitalised children with measles isreported. Methods: We carried out a two year retrospective study of children admitted with measles into the department of Paediatrics, University of Maiduguri Teaching Hospital. Results: Three hundred and nine children (11.2% of Paediatric admission) aged 6-90 months (median 13 months) with a male: female ratio of 1.6: 1 were admitted with measles. Forty three (14%) patients were aged less than 9-months. Seventy two per cent (223) of the subjects were not immunised against measles. Length of stay ranged between 4 and 32 days (mean; 8.7 days, median; 16 days) and total bed days were 3561 days. Forty per cent (124) of the measles admissions were for more than 14 days (prolonged hospitalisation). Infants and unvaccinated from low socio-economic class were more likely to have prolongedhospitalization. The most frequent complication associated with prolonged length of stay was bronchopneumonia (70.2%). Two of the children suffered acute measles encephalopathy. Conclusions: Therapy for measles and its complications may be a major drain on medical care resources in this part of Nigeria, especially among young children who are unvaccinated and from low socio-economic class.
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To determine the association of clinical outcome of measles in children with demographic profile and complications.A cross-sectional analytical study.Isolation ward, The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), from January 2003 to August 2004.Detailed history and physical examination of all the hospitalized patients with complications of measles was filled in case report form. Immunization cards were assessed for measles vaccination status. Data was analyzed by using SPSS version 10 software. The clinical outcome of measles was compared with demographic profile and complications by using Chi-square test and p-values were obtained.Two hundred and five hospitalized patients with complications of measles were studied. There were 61.5% males. Mean age was 46.1 months and 57% patients were vaccinated against measles. Malnourished patients were 71.2% and had a longer hospital stay (p=0.010). Pneumonia (40.0%) and diarrhoea (38.5%) were the commonest complications. Seven children died. Mortality was significantly associated with younger age (p=0.04), unvaccinated status (p=0.04) and presence of encephalitis (p=0.00001).The most common complications of measles are pneumonia and diarrhoea with dehydration requiring hospitalization. Malnourished children experience more complications and have longer hospital stay. Mortality is significantly associated with infancy, unvaccinated status and encephalitis. A second dose of measles should be introduced at 15 months of age.
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