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Measles

Risk Factors for Severe Disease

Gary S. Marshall, MD 
Reviewed on October 18, 2024
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Factors for Complications

Several risk factors increase the likelihood of developing complications from measles. Particularly serious comorbidities include undernutrition, vitamin A deficiency and immunocompromised status; patients with these conditions who acquire measles require close monitoring. There is evidence to suggest that intensity of exposure to measles morbillivirus (MeV) (crowding, within-household transmission) correlates with increased mortality. A less well-established risk factor for severe disease is female sex, with greater mortality reported in girls 0-4 years of age (4% increase), 5-14 years of age (11% increase) and in girls and women 15-44 years of age (43% increase). Although still poorly understood and understudied, host genetic factors may also influence disease severity through modulation of the immune response to infection or vaccination. Management of measles in immunodeficient patients and patients with other conditions that heighten the risk of severe…

Factors for Complications

Several risk factors increase the likelihood of developing complications from measles. Particularly serious comorbidities include undernutrition, vitamin A deficiency and immunocompromised status; patients with these conditions who acquire measles require close monitoring. There is evidence to suggest that intensity of exposure to measles morbillivirus (MeV) (crowding, within-household transmission) correlates with increased mortality. A less well-established risk factor for severe disease is female sex, with greater mortality reported in girls 0-4 years of age (4% increase), 5-14 years of age (11% increase) and in girls and women 15-44 years of age (43% increase). Although still poorly understood and understudied, host genetic factors may also influence disease severity through modulation of the immune response to infection or vaccination. Management of measles in immunodeficient patients and patients with other conditions that heighten the risk of severe disease requires a comprehensive approach (see Assessment and Treatment).

References

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