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High measles mortality in infancy related to intensity of exposure

  • Peter Aaby
    Correspondence
    Reprint requests: Mr. Peter Aaby, Institute of Ethnology and Anthropology, University of Copenhagen, Frederiksholms Kanal 4, DK-1220 Copenhagen K, Denmark.
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Jette Bukh
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Gerdi Hoff
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Jørgen Leerhøy
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Ida Maria Lisse
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Carl H. Mordhorst
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
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  • Ib Rode Pedersen
    Affiliations
    Institute of Ethnology and Anthropology, University of Copenhagen Denmark

    Institute of Medical Microbiology, University of Copenhagen, Denmark

    Department of Infectious Diseases, University Hospital, Rigshospitalet, Denmark

    Rubella Department, Statens Seruminstitut, Denmark

    Ornithosis Department, Statens Seruminstitut, Denmark

    Department of Pathology, Hvidovre Hospital, Copenhagen Denmark
    Search for articles by this author
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      In a West African urban community, measles infection in infants was examined over 5 years (1979–1983). In the age group 0 to 11 months, measles mortality was higher among secondary cases (infected in the house) than among index cases (infected outside the house), and the proportion of secondary cases was significantly higher for this age group than for older children. Intensive exposure related to the social pattern of disease transmission may be important in explaining the high infant mortality observed with measles in developing countries. Mortality during the first 12 months of life increased with age, presumably because of the decrease of maternally derived measles antibodies. In children younger than 6 months of age, who are usually considered to be protected by maternal antibody, intensive exposure may lead to infection, as demonstrated by a high level of measles-specific antibodies in some children exposed to an older sibling with measles. The aim of public health policies should be to change conditions of exposure.
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      References

        • Wakeham PF
        Severe measles in Afghanistan.
        J Trop Pediatr. 1978; 24: 87-88
        • Aaby P
        • Bukh J
        • Lisse IM
        • Smits AJ
        Overcrowding and intensive exposure as determinants of measles mortality.
        Am J Epidemiol. 1984; 120: 49-63
        • The Kasongo Project Team
        Influence of measles vaccination on survival pattern of 7- to 35-month-old children in Kasongo, Zaire.
        Lancet. 1981; 1: 764-767
        • Salunke SR
        • Natu M
        Epidemiological investigations of measles outbreak in Ajiwali.
        Indian Pediatr. 1977; 14: 519-521
        • John TJ
        • Joseph A
        • George TI
        • et al.
        Epidemiology and prevention of measles in rural south India.
        Indian J Med Res. 1980; 72: 153-158
        • Pereira SM
        • Benjamin V
        Measles in a South Indian community.
        Trop Geogr Med. 1972; 24: 124-129
        • Aaby P
        • Bukh J
        • Lisse IM
        • et al.
        Determinants of measles mortality in a rural area of Guinea-Bissau: crowding, age, and malnutrition.
        J Trop Pediatr. 1984; 30: 164-168
        • Williams PJ
        • Hull HF
        Status of measles in The Gambia, 1981.
        Rev Infect Dis. 1983; 5: 391-394
        • Gordon JE
        • Jansen AAJ
        • Ascoli W
        Measles in rural Guatemala.
        J Pediatr. 1965; 66: 779-786
        • Mata LJ
        The children of Santa Maria Cauque: a prospective study of health and growth.
        MIT Press, Cambridge, Mass.1978
        • Muller AS
        • Voorhoeve AM
        • 't Mannetje W
        • Schulpen TWJ
        The impact of measles in a rural area of Kenya.
        East Afr Med J. 1977; 54: 364-372
        • Koster FT
        • Curlin GC
        • Aziz KMA
        • Haque A
        Synergistic impact of measles and diarrhoea on nutrition and mortality in Bangladesh.
        Bull WHO. 1981; 59: 901-908
      1. Epidemiology of measles in a rural community.
        WHO Wkly Epidem Rec. 1980; 55: 85-92
      2. Measles mortality and malnutrition [editorial].
        Lancet. 1983; 2: 661
        • Sinha NP
        Measles in children under six months of age: an epidemiological study.
        J Trop Pediatr. 1981; 27: 120-122
        • Omololu A
        Child health in Western Nigeria.
        West Afr J Med. 1965; : 255-268
        • Aaby P
        • Bukh J
        • Lisse IM
        • Smits AJ
        Measles mortality, state of nutrition, and family structure: a community study from Guinea-Bissau.
        J Infect Dis. 1983; 147: 693-701
        • Leeuwenburg J
        • Muller AS
        • Voorhoeve AM
        • et al.
        The epidemiology of measles.
        in: van Ginneken JK Muller AS Maternal and child health in rural Kenya. Croom Helm, London1984: 77-94
        • Coovadia HM
        • Kiepiela P
        • Wesley AG
        Immunity to and infant mortality from measles.
        S Afr J Med. 1984; 65: 918-921
        • Aaby P
        • Bukh J
        • Lisse IM
        • Smits AJ
        Introduction of measles into a highly immunized West African community: the role of health care institutions.
        J Epidemiol Comm Health. 1985; 39: 113-116
        • Vejtrop M
        • Leerhøy J
        Rubella IgG antibody detection by ELISA using capillary blood samples collected on filter paper and in Microtainer tubes.
        Acta Pathol Microbiol Scand [B]. 1981; 89: 369-370
        • Pedersen IR
        • Antonsdottir A
        • Evald T
        • Mordhorst CH
        Detection of measles IgM antibodies by enzyme-linked immunosorbent assay (ELISA).
        Acta Pathol Microbiol Immunol Scand [B]. 1982; 90: 153-160
        • Foldspang A
        • Juul S
        • Olsen J
        • Sabroe S
        Epidemiologi.
        in: Munksgaard, Copenhagen1981: 111
        • Drinkwater H
        Remarks upon the epidemic of measles prevalent in Sunderland, with notes upon 311 cases from middle of January to end of March 1885.
        James Thin, Edinburgh1885
        • Picken RMF
        The epidemiology of measles in a rural and residental area.
        Lancet. 1921; 1: 1349-1353
        • Scrimshaw NS
        • Salomon JB
        • Bruch HA
        • Gordon JE
        Measles, diarrhea, and nutritional deficiency in rural Guatemala.
        Am J Trop Med Hyg. 1966; 15: 625-631
        • Sabin A
        Immunization against measles by aerosol.
        Rev Infect Dis. 1983; 5: 514-523
        • Herrman C
        Observations on measles.
        Arch Pediatr. 1917; 34: 38-42
        • Wear DJ
        • Rabin ER
        • Richardson LS
        • Rapp F
        Virus replication and ultrastructural changes after induction of encephalitis in mice by measles virus.
        Exp Molec Pathol. 1968; 9: 405-417
        • Morley D
        Measles.
        in: Jelliffe DB Stanfield JP Diseases of children in the subtropics and tropics. Edward Arnold, London1978: 257
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