What are the complications of measles (rubeola)?

From the Guidelines

Measles can lead to severe complications, including diarrhea, middle ear infection, bronchopneumonia, and encephalitis, with a mortality rate of 1-2 per 1,000 reported cases in the United States, as reported by 1. The disease can be severe and is most frequently complicated by:

• Diarrhea
• Middle ear infection
• Bronchopneumonia Encephalitis occurs in approximately one of every 1,000 reported cases, with survivors often having permanent brain damage and mental retardation, according to 1. The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents, with the most common causes of death being pneumonia and acute encephalitis, as stated in 1. In developing countries, measles is often more severe and the case-fatality rate can be as high as 25%, highlighting the importance of prevention and treatment, as noted in 1. Children with measles complications should be administered standard treatment, such as oral rehydration therapy (ORT) for diarrhea and antibiotics for acute lower respiratory infection (ALRI), as recommended by 1. Additionally, children with complicated measles should receive a second dose of vitamin A on day 2, as suggested by 1. Overall, the complications of measles can be severe and life-threatening, emphasizing the need for vaccination and prompt treatment to prevent morbidity and mortality.

From the Research

Complications of Measles

• Measles can affect many organs and often includes complications such as:
  • Otitis media
  • Laryngotracheobronchitis
  • Pneumonia
  • Stomatitis
  • Diarrhea 2
• Neurological complications are uncommon but serious, and can occur during or soon after the acute disease, such as:
  • Acute disseminated encephalomyelitis
  • Measles inclusion body encephalitis
  • Subacute sclerosing panencephalitis 2, 3
• Measles can also lead to other complications, including:
  • Blindness, especially in those who are vitamin A deficient 3
  • Noma (or cancrum oris), a rapidly progressive gangrenous infection of the mouth and face, in malnourished children 3
• Pneumonia is a leading cause of morbidity and mortality due to measles, accounting for most measles-associated deaths 4, 5

Management of Complications

• Management of patients with measles includes:
  • Provision of vitamin A, which can reduce the severity of complications during measles 2, 6
  • Supportive therapy, such as monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhea 2, 4
• Vitamin A supplementation has been shown to reduce the incidence and severity of diarrheal and respiratory complications of measles 6