What are the causes of mortality associated with measles (rubeola)?

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From the Guidelines

Measles can cause death primarily through complications such as pneumonia and acute encephalitis, with pneumonia being the most common cause of death. The disease can be severe and is most frequently complicated by diarrhea, middle ear infection, or bronchopneumonia, as noted in a study by the Advisory Committee on Immunization Practices (ACIP) 1. According to this study, encephalitis occurs in approximately one of every 1,000 reported cases, and survivors of this complication often have permanent brain damage and mental retardation. Some key points to consider about measles complications include:

  • The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents 1.
  • In developing countries, measles is often more severe and the case-fatality rate can be as high as 25% 1.
  • Death occurs in 1-2 of every 1,000 reported measles cases in the United States, with the most common causes of death being pneumonia and acute encephalitis 1. The importance of vaccination cannot be overstated, as it is highly effective at preventing these potentially fatal complications, and is a crucial public health intervention worldwide, especially in areas with high case-fatality rates 1.

From the Research

Causes of Death for Measles

  • Respiratory complications, such as pneumonia, are a major cause of death from measles, particularly in younger children 2, 3, 4
  • Neurologic complications, including encephalitis and subacute sclerosing panencephalitis, are also significant causes of death, especially in older children and adults 2, 5, 4
  • Underlying diseases, such as physical or mental retardation, can increase the risk of death from measles 2
  • Secondary bacterial infections, such as otitis media and laryngotracheobronchitis, can also contribute to mortality 5, 3
  • Measles pneumonitis is a potentially fatal complication of measles, particularly in adults with respiratory failure 6
  • Other causes of death from measles include gastroenteritis, blindness, and measles inclusion body encephalitis 5, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Measles mortality. Analysis of the primary cause of death.

American journal of diseases of children (1960), 1975

Research

Measles pneumonitis.

Advances in respiratory medicine, 2019

Research

Measles.

Nature reviews. Disease primers, 2016

Research

Measles.

Lancet (London, England), 2022

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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