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Severe Measles Cases requiring Pediatric Intensive Care Unit Admission

Year 2023, Volume: 45 Issue: 1, 50 - 57, 23.01.2023
https://doi.org/10.20515/otd.1166772

Abstract

Measles is a vaccine-preventable disease, and the disease burden is reduced with widespread pediatric measles immunization. Sporadic and severe cases might be observed during local outbreak situations, especially among unvaccinated people or vaccine non-eligible age groups, including infancy. In this study, we retrospectively evaluated the clinical and laboratory findings, and outcomes of children with measles requiring pediatric intensive care unit admission. We retrospectively evaluated medical records of 14 children with measles, who were followed up in the pediatric intensive care unit of Sanliurfa Training and Research Hospital between January 1st and June 30th, 2019. The median age was 9.5 months (range between one and 120 months). The most common reasons for admission to the pediatric intensive care unit were bronchopneumonia (n: 10) and/or sepsis. Two were diagnosed with pediatric acute respiratory distress syndrome, four patients had sepsis, and one patient had meningoencephalitis. The mortality rate was 14.2%. Risk factors associated with intensive care unit admission included being unvaccinated, being malnourished, having an underlying condition, and the development of bronchopneumonia as a complication. The mortality rate of measles, which is a preventable disease despite early treatments in the pediatric intensive care unit, is high, especially in unvaccinated children and those who have underlying conditions.

References

  • Referans1. American Academy of Pediatrics. Measles. In: Kimberlin DW, editor. Red Book: 2021 Report of the Committee on Infectious Diseases. 32th ed. Itasca, IL: American Academy of Pediatrics; 2021:503–19.
  • Referans2. World Health Organization. Global progress against measles threatened amidst COVID-19 pandemic. Available from: https://www.who.int/news/item/10-11-2021-global-progress-against-measles-threatened-amidst-covid-19-pandemic. Accessed 08.03.2022.
  • Referans3. Patel MK, Goodson JL, Alexander JP Jr, et al. Progress Toward Regional Measles Elimination - Worldwide, 2000-2019. MMWR Morb Mortal Wkly Rep. 2020;69(45):1700-1705.
  • Referans4. Eskiocak M, Marangoz B. Status of immunization services in Turkey. Ankara: Turkish Medical Association publications; 2019:78.
  • Referans5. Turkish Statistical Institute, Birth Statics, 2020: https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2020-37229. Accessed 08.03.2022.
  • Referans6. Metin Ö, Tanır G, Öz FN, et al. Evaluation of 44 pediatric measles cases detected in Ankara, Turkey during 2012-2013 epidemic and molecular characterization of the viruses obtained from two cases. Microbiol Bul. 2014;48(2):259-70.
  • Referans7. Gastañaduy PA, Redd SB, Fiebelkorn AP, et al. Measles - United States, January 1-May 23, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(22):496-499.
  • Referans8. Gastañaduy PA, Goodson JL, Panagiotakopoulos L, et al. Measles in the 21st Century: Progress Toward Achieving and Sustaining Elimination, The Journal of Infec Dis. 2021; 224: 420–428.
  • Referans9. Strebel PM, Papania MJ, Parker Fiebelkorn A, Halsey NA. Measles Vaccine. In: Plotkin SA, Orenstein WA, Offit P, editors. Vaccines. 6 ed. Elsevier Saunders; 2013: 352–387.
  • Referans10. Moss WJ. Measles. Lancet. 2017;390(10111):2490-2502. doi:10.1016/S0140-6736(17)31463-0.
  • Referans11. Donadel M, Stanescu A, Pistol A, et al. Risk factors for measles deaths among children during a Nationwide measles outbreak - Romania, 2016-2018. BMC Infect Dis. 2021;21(1):279.

ÇÇocuk Yoğun Bakım Ünitesine Yatış Gerektiren Ağır Kızamık Vakaları

Year 2023, Volume: 45 Issue: 1, 50 - 57, 23.01.2023
https://doi.org/10.20515/otd.1166772

Abstract

AMAÇ: Kızamık aşı ile önlenebilir bir hastalıktır. Yerel salgın durumlarında, özellikle aşılanmamış kişilerde sporadik ve ciddi vakalar gözlenebilir. Bu çalışmada, çocuk yoğun bakım ünitesinde yatış gerektiren kızamık tanısı kesin olan çocukların klinik ve laboratuvar bulgularını ve sonuçlarını geriye dönük olarak değerlendirdik.
YÖNTEM ve GEREÇLER: 1 Ocak-30 Haziran 2019 tarihleri ​​arasında Şanlıurfa Eğitim ve Araştırma Hastanesi çocuk yoğun bakım ünitesinde izlenen 14 kızamık tanılı çocuğun tıbbi kayıtları geriye dönük olarak değerlendirildi.
BULGULAR: hastaların median yaşı 9,5 aydı (1 ile 120 ay arasında değişiyordu). Pediatrik yoğun bakım ünitesine en sık yatış nedenleri bronkopnömoni (n: 10) ve/veya sepsis idi. İki hastada pediatrik akut solunum sıkıntısı sendromu, dört hastada sepsis ve bir hastada meningoensefalit tanısı konuldu. Mortalite oranı %14,2 idi. Yoğun bakım ünitesine kabul ile ilişkili risk faktörleri arasında aşılanmamış olma, yetersiz beslenme, altta yatan bir durumun olması ve komplikasyon olarak bronkopnömoni gelişimi yer almaktadır.
SONUÇ: Önlenebilir bir hastalık olan kızamık nedeniyle yoğun bakım yatışı gereksinimi olan çocuklarda ölüm oranı erken müdahalelere rağmen yüksektir.

References

  • Referans1. American Academy of Pediatrics. Measles. In: Kimberlin DW, editor. Red Book: 2021 Report of the Committee on Infectious Diseases. 32th ed. Itasca, IL: American Academy of Pediatrics; 2021:503–19.
  • Referans2. World Health Organization. Global progress against measles threatened amidst COVID-19 pandemic. Available from: https://www.who.int/news/item/10-11-2021-global-progress-against-measles-threatened-amidst-covid-19-pandemic. Accessed 08.03.2022.
  • Referans3. Patel MK, Goodson JL, Alexander JP Jr, et al. Progress Toward Regional Measles Elimination - Worldwide, 2000-2019. MMWR Morb Mortal Wkly Rep. 2020;69(45):1700-1705.
  • Referans4. Eskiocak M, Marangoz B. Status of immunization services in Turkey. Ankara: Turkish Medical Association publications; 2019:78.
  • Referans5. Turkish Statistical Institute, Birth Statics, 2020: https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2020-37229. Accessed 08.03.2022.
  • Referans6. Metin Ö, Tanır G, Öz FN, et al. Evaluation of 44 pediatric measles cases detected in Ankara, Turkey during 2012-2013 epidemic and molecular characterization of the viruses obtained from two cases. Microbiol Bul. 2014;48(2):259-70.
  • Referans7. Gastañaduy PA, Redd SB, Fiebelkorn AP, et al. Measles - United States, January 1-May 23, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(22):496-499.
  • Referans8. Gastañaduy PA, Goodson JL, Panagiotakopoulos L, et al. Measles in the 21st Century: Progress Toward Achieving and Sustaining Elimination, The Journal of Infec Dis. 2021; 224: 420–428.
  • Referans9. Strebel PM, Papania MJ, Parker Fiebelkorn A, Halsey NA. Measles Vaccine. In: Plotkin SA, Orenstein WA, Offit P, editors. Vaccines. 6 ed. Elsevier Saunders; 2013: 352–387.
  • Referans10. Moss WJ. Measles. Lancet. 2017;390(10111):2490-2502. doi:10.1016/S0140-6736(17)31463-0.
  • Referans11. Donadel M, Stanescu A, Pistol A, et al. Risk factors for measles deaths among children during a Nationwide measles outbreak - Romania, 2016-2018. BMC Infect Dis. 2021;21(1):279.
There are 11 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Eylem Kıral 0000-0003-2245-5340

Ayse Filiz Yetimakman 0000-0002-9334-4464

Publication Date January 23, 2023
Published in Issue Year 2023 Volume: 45 Issue: 1

Cite

Vancouver Kıral E, Yetimakman AF. Severe Measles Cases requiring Pediatric Intensive Care Unit Admission. Osmangazi Tıp Dergisi. 2023;45(1):50-7.


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