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. 1988 Apr 30;296(6631):1225–1228. doi: 10.1136/bmj.296.6631.1225

Decline in measles mortality: nutrition, age at infection, or exposure?

Peter Aaby, Jette Bukh, Ida Maria Lisse, Maria Clotilde da Silva
PMCID: PMC2545704  PMID: 3133023

Abstract

The mortality from measles was studied in an urban area of Guinea-Bissau one year before and five years after the introduction of a vaccination programme. The years after the introduction of immunisation saw a decline in mortality among unvaccinated children with measles. This decline occurred despite a lower age at infection and an increasing prevalence of malnourished children. State of nutrition (weight for age) did not affect the outcome of measles infection. The incidence of isolated cases, however, increased in the period after the introduction of measles vaccination. As mortality was lower among these cases, diminished clustering explained some of the reduction in mortality. Comparison between the urban district and a rural area inhabited by the same ethnic group showed a lower age at infection, less clustering of cases, and lower case fatality ratios in the urban area.

Endemic transmission of measles in urban districts leads to less clustering of cases, which may help explain the usually lower case fatality ratios in these areas. As measles vaccination increases herd immunity and diminishes clustering of cases, it may reduce mortality even among unvaccinated children who contract the disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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