Potential Complications
About 30% of measles cases develop one or more complications, including
- Pneumonia, which is the complication that is most often the cause of death in young children.
- Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
- Diarrhea is reported in about 8% of cases.
These
complications are more common among children under 5 years of age and adults
over 20 years old.
Even in previously healthy children, measles can be a
serious illness requiring hospitalization. As many as 1 out of every 20
children with measles gets pneumonia, and about 1 child in every 1,000
who get measles will develop encephalitis.
(This is an inflammation of the brain that can lead to convulsions, and
can leave the child deaf or mentally retarded.) For every 1,000 children
who get measles, 1 or 2 will die from it. Measles also can make a
pregnant woman have a miscarriage, give birth prematurely, or have a
low-birth-weight baby.
In developing countries, where malnutrition and vitamin A
deficiency are common, measles has been known to kill as many as one
out of four people. It is the leading cause of blindness among African
children. It is estimated that in 2008 there were 164,000 measles deaths
worldwide.
SSPE (subacute sclerosing panencephalitis)
SSPE is a very rare, but fatal
degenerative disease of the central nervous system that results from a
measles virus infection acquired earlier in life. Analysis of data from
an outbreak of measles in the United States during 1989-1991 suggests a
rate of 4-11 cases of SSPE per 100,000 cases of measles. A risk factor
for developing this disease is measles infection at an early age.
Studies in the United Kingdom indicate that 18 out of every 100,000
people who get measles when they are less than a year old will develop
SSPE. This is compared to 1.1 per 100,000 in those infected after 5
years of age. On average, the symptoms of SSPE begin 7 to 10 years after
measles infection, but they can appear anytime from 1 month to 27 years
after infection.
The first signs of SSPE may be changes in personality, a gradual onset of
mental deterioration and myoclonia (muscle spasms or jerks). The diagnosis
of SSPE is based on signs and symptoms and on test results, such as typical
changes observed in electroencephalographs, an elevated anti-measles antibody
(IgG) in the serum and cerebrospinal fluid, and typical histologic findings
in brain biopsy tissue.
SSPE progresses in stages, which can vary from person to person. In some
cases, the cognitive decline may continue for years before progression to
more severe neuromuscular disorders are observed, and thus the diagnosis
may be delayed or missed. There are reports of remission and some treatments
are available; however, the average survival is one to two years.
All of the genetic analyses of viral material derived from brain tissue of
SSPE patients have revealed sequences of wild-type measles virus, never vaccine
virus. There is no evidence that measles vaccine can cause SSPE. Cases of
SSPE in patients who have a history of measles vaccination but no knowledge
of having had measles either had an undiagnosed rash illness or possibly a
mild measles infection early in life due to the presence of maternal antibody.
Therefore, physicians should consider SSPE in the differential diagnosis of
encephalitis even when the patient does not have a history of measles.
تعليقات
إرسال تعليق