What is the mortality and morbidity of measles virus pneumonia?

Updated: Mar 24, 2021
  • Author: Zab Mosenifar, MD, FACP, FCCP; Chief Editor: John J Oppenheimer, MD  more...
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In the United States, pneumonia is responsible for 60% of the measles mortality in infants. Although deaths from measles in the United States decreased steadily throughout the 20th century—from approximately 12 per 100,000 population in 1912 to approximately 0.2 per 100,000 population in 1960—mortality rates declined markedly after a measles vaccine was licensed in 1963. [53]

Measles is almost eradicated in the Western Hemisphere. Although only 71 cases were confirmed in the United States in 2009, a sharp increase occurred in 2014. Through August 1, 2014, 593 confirmed measles cases were reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). [54] This is the highest number of cases since measles elimination was documented in the US in 2000. Measles-virus pneumonia is still a notable cause of mortality and morbidity in nonvaccinated children and immunocompromised adults.

In 1990, 6.5% of Americans with measles developed pneumonia. A study of 3220 US military recruits demonstrated that 3.3% had measles-related pneumonia. Most cases of pneumonia were secondary to bacterial superinfection. No deaths were reported among these otherwise healthy adults. However, in another study using different diagnostic criteria, pneumonia was found in 50% of recruits with measles. A follow-up study of Afghani children hospitalized for measles revealed an 85.4% rate of bronchopneumonia.

The CDC reported four cases of measles pneumonia, with two fatalities, among HIV-infected children in 1986-1987. [55] In children, mortality rates due to measles bronchopneumonia are high (28%). The mortality rate due to measles pneumonia is even higher in immunocompromised groups: 70% in those with cancer and 40% in those with AIDS. Investigators reported 10 fatalities secondary to measles pneumonia in 12 children with leukemia.

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