What are the long-term complications of measles (Rubeola)?

From the Guidelines

Measles can lead to severe long-term complications, including subacute sclerosing panencephalitis (SSPE), intellectual disabilities, permanent hearing loss, blindness, and immune system amnesia, emphasizing the importance of prevention through vaccination. The risk of these complications is higher in certain populations, such as children under 5, adults over 20, pregnant women, and immunocompromised individuals 1. According to the most recent evidence, vaccination with the MMR (measles, mumps, rubella) vaccine is the best prevention method, providing 97% protection with two doses 1.

Key Complications

• Subacute sclerosing panencephalitis (SSPE): a rare but fatal neurological disease that can develop 7-10 years after infection
• Intellectual disabilities from encephalitis
• Permanent hearing loss affecting one or both ears
• Blindness from corneal scarring
• Immune system amnesia, which suppresses previously acquired immunity for months to years, increasing vulnerability to other infections

Prevention and Vaccination

• The MMR vaccine is the primary means of preventing measles, mumps, and rubella virus infections and their related complications 1
• Two doses of the MMR vaccine are necessary to develop adequate population immunity to prevent measles outbreaks among school-aged and older persons 1
• The Advisory Committee on Immunization Practices (ACIP) recommends the use of PRIORIX, a newly approved MMR vaccine, as an option to prevent measles, mumps, and rubella according to the existing recommended schedules and for off-label uses 1

High-Risk Populations

• Children under 5
• Adults over 20
• Pregnant women
• Immunocompromised individuals

Importance of Vaccination

• Vaccination is crucial in preventing the long-term complications of measles and reducing the risk of outbreaks 1
• The MMR vaccine has been shown to be safe, immunogenic, and effective in preventing measles, mumps, and rubella 1

From the Research

Long-term Complications of Measles (Rubeola)

The long-term complications of measles (Rubeola) can be severe and potentially life-threatening. Some of the complications include:

• Otitis media (middle ear infection) 2, 3, 4, 5
• Pneumonia (infection of the lungs) 2, 3, 4, 5
• Diarrhea 2, 3, 4, 5
• Encephalitis (inflammation of the brain) 3, 4, 5, 6
• Subacute sclerosing panencephalitis (a rare but serious complication of measles) 4, 5
• Malnutrition and related complications, such as noma (or cancrum oris), a rapidly progressive gangrenous infection of the mouth and face 5
• Blindness, especially in those who are vitamin A deficient 5
• Neurodevelopmental sequelae, such as permanent brain damage or intellectual disability 4

Risk Factors for Complications

Certain individuals are at higher risk for developing complications from measles, including:

• Young children, especially those under the age of 2 2, 4
• Malnourished children 2, 5
• Immunocompromised individuals, such as those with weakened immune systems 3, 5
• Pregnant women 5
• Unvaccinated individuals 2, 3, 4, 5

Prevention and Management

Prevention and management of measles complications are crucial to reducing the risk of long-term effects. This includes:

• Vaccination against measles, with two doses recommended for sufficient immunity 3, 4, 5, 6
• Supportive care, such as administering acetaminophen for fever, oral rehydrating salt (ORS) for diarrhea and vomiting, and antibiotics for otitis media and pneumonia 6
• Vitamin A supplementation to prevent severe effects in children 6