What is the risk of mortality from measles (rubeola)?

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Last updated: March 11, 2025View editorial policy

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From the Guidelines

The risk of mortality from measles is approximately 1-2 deaths per 1,000 reported cases in the United States, with the most common causes of death being pneumonia and acute encephalitis. This risk is higher in certain populations, including infants, young children, and adults, compared to older children and adolescents 1. The severity of measles and its complications can vary significantly depending on factors such as age, nutrition, and access to healthcare. In developing countries, the case-fatality rate can be as high as 25% due to poorer healthcare conditions and higher rates of malnutrition 1.

Key factors that contribute to the risk of mortality from measles include:

  • Age: Infants, young children, and adults are at a higher risk of death from measles compared to older children and adolescents
  • Nutrition: Malnutrition can increase the severity of measles and its complications
  • Healthcare access: Limited access to healthcare can lead to delayed or inadequate treatment, increasing the risk of mortality
  • Complications: Pneumonia and acute encephalitis are the most common causes of death from measles

It is essential to note that vaccination is the most effective method of preventing measles and its complications, with the MMR vaccine providing approximately 97% protection after two doses 1. The standard vaccination schedule includes the first dose at 12-15 months and the second at 4-6 years of age. For unvaccinated individuals who are exposed to measles, receiving the vaccine within 72 hours or immune globulin within 6 days of exposure can provide some protection.

From the Research

Risk of Mortality from Measles (Rubeola)

  • The risk of mortality from measles is high, especially in nonimmunized populations, with conditions such as unfavorable nutrition, high risk of concurrent infection, and inadequate case management favoring the development of complications and adverse outcomes 2.
  • Measles can lead to serious complications, disability, and death, with the clinical spectrum ranging from a mild, self-limiting illness to a fatal disease 2, 3, 4.
  • The effectiveness of measles vaccine in preventing disease is high, with one dose being at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts 3, 4.
  • The risk of mortality from measles can be reduced through vaccination, with the measles vaccine being effective in preventing disease in the individual and controlling it in the community if given at the critical age and with high immunization rates 2, 5.
  • Certain populations, such as those with human immunodeficiency virus (HIV) infection, are at higher risk for complications and mortality from measles, and special considerations are needed for vaccination in these populations 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Measles: summary of worldwide impact.

Reviews of infectious diseases, 1983

Research

Vaccines for measles, mumps, rubella, and varicella in children.

The Cochrane database of systematic reviews, 2020

Research

Vaccines for measles, mumps and rubella in children.

The Cochrane database of systematic reviews, 2012

Research

Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP).

MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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