Measles: Not just another viral exanthem
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Date
2003
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
The Lancet 361
Abstract
Abstract
Measles is the most frequent cause of vaccine-preventable childhood deaths. Infants younger
than the recommended age for vaccination are susceptible to the disease, and in developing
countries they have a high risk of complications and mortality. Vaccine coverage in excess of
95% interrupts endemic transmission of measles in many countries, but achievement of such
coverage almost always requires coordinated supplementary mass vaccination campaigns. There
are substantial health gains if countries improve measles vaccine coverage, irrespective of
whether or not high coverage is achieved; these gains include much lower measles complication
and case fatality rates, long-term interepidemic duration, and possibly non-specific
improvements in survival of children. Investigation into the cost-effectiveness of different
strategies for measles control, including mass campaigns, two-dose schedules, and young-infant
doses, would help countries to formulate control policies appropriate to their setting. Pneumonia
is the most common fatal complication associated with measles, and at least 50% of measlesrelated
pneumonias are due to bacterial superinfection. WHO has developed standard case
management programmes for measles, but there are several unresolved clinical issues, including
optimum indications for antibiotic treatment, the importance of intravenous immunoglobulin, the
role of viral coinfection, and the risk of tuberculosis after measles. The priority in worldwide
efforts to control measles is to lend support to poor countries, helping them to increase vaccine
coverage and sustain improvements to vaccination infrastructure, and to address technical issues
with respect to optimum vaccination schedules. Measles represents a specific challenge, whereby
partnerships between high-income and developing nations would reduce child mortality in
developing countries; such partnerships are not without incentive for high-income countries,
since without them imported measles cannot be prevented.
Description
Keywords
Measles vaccine
Citation
Duke, Trevor, and Charles S. Mgone. "Measles: not just another viral exanthem." The Lancet 361, no. 9359 (2003): 763-773.