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Measles exacts high toll among Europe’s youngest citizens
MADRID – Children younger than 2 years who contracted measles were significantly more likely to die of the disease than were older children, according to new data from the European Center for Disease Control and Prevention.
Infants younger than 12 months faced the worst mortality outcomes, with a sevenfold increased risk of death, compared with children aged 2 years or older, Emmanuel Robesyn, MD said at the European Society of Clinical Microbiology and Infectious Diseases annual congress. Infants and children younger than 2 years also were much more likely to develop severe complications of the disease, including pneumonia and encephalitis.
The statistics should drive home the point that measles can be a life-threatening disease, especially for small children, said Dr. Robesyn, an expert in outbreak response at the European Center for Disease Prevention and Control, Stockholm.
“We want the population to understand that measles is much more than a nuisance illness of childhood,” he said. “Already this year we have recorded 13 deaths from measles,” which were not included in the data he presented.
“As you know, measles has been set for elimination” as a communicable disease, he said. “We need high immune coverage to achieve that, meaning 95% of the population covered with two doses. That is a challenge.”
Infants are especially vulnerable, and they fully reliant on the immunity of others to avoid measles.
“Vaccination recommendations begin at age 1, so before that, infants are dependent on their mothers’ antibodies, and on herd immunity. It’s very important that we have high vaccine coverage to protect them.”
Dr. Robesyn described measles outcomes in children 24 months and younger in 30 member states of the European Union and the European Economic Area from 2013 to 2017. Data were extracted from the European Surveillance System, which collects and analyzes infectious disease data across Europe.
During that period, there were 37,365 measles cases in people of all ages. Most were in Italy, Romania, Germany, the Netherlands, and the United Kingdom, with each reporting more than 5% of the cases. These countries also had the most cases that had not been connected with importation of the disease.
Overall, the patients were a mean of 12 years old. Less than 2% had been fully vaccinated against the disease. Complications (diarrhea, otitis media, pneumonia, or encephalitis) occurred in 13.6%, and about 33% of patients had to be hospitalized. Most cases (81%) occurred in people aged 2 years and older, 9% occurred in children who were 12-24 months old, and 10% occurred in children younger than 12 months. These younger children, however, accounted for 61% of the deaths in the cohort, Dr. Robesyn said.
Most of the cases occurred in unvaccinated or incompletely vaccinated patients. Forty-six died from measles, a mortality rate of about 1 per 1,000 who contracted the disease. Of these deaths, 16 were among children younger than 12 months, 12 among children aged 12-24 months, and the remainder among those older than 2 years.
These younger patients were also more susceptible to complications of measles, both mild (diarrhea and otitis media) and severe (pneumonia and encephalitis). Most of the uncomplicated cases (75%) occurred in children older than 24 months, with just 25% of uncomplicated cases occurring in the younger groups.
“When we looked at age as a continuous variable, we saw that the chance of having no complications or just mild complications increased with age, and the chance of having severe complications decreased with age,” Dr. Robesyn said.
“We definitely saw that these two groups are at increased risk. The consequences however, are different. For the children who are 1 year of age or older, the message is that it’s really important to strictly follow national recommendations and get timely and complete vaccination. For those younger than 1 year, we have to rely on the population to be vaccinated. It is very important that we reach this 95% coverage rate to protect these youngest children. We need adolescents and young adults who have missed vaccinations to get them completed,” he said.
Dr. Robesyn had no financial disclosures.
SOURCE: Robesyn E et al. ECCMID 2018, abstract O0060
MADRID – Children younger than 2 years who contracted measles were significantly more likely to die of the disease than were older children, according to new data from the European Center for Disease Control and Prevention.
Infants younger than 12 months faced the worst mortality outcomes, with a sevenfold increased risk of death, compared with children aged 2 years or older, Emmanuel Robesyn, MD said at the European Society of Clinical Microbiology and Infectious Diseases annual congress. Infants and children younger than 2 years also were much more likely to develop severe complications of the disease, including pneumonia and encephalitis.
The statistics should drive home the point that measles can be a life-threatening disease, especially for small children, said Dr. Robesyn, an expert in outbreak response at the European Center for Disease Prevention and Control, Stockholm.
“We want the population to understand that measles is much more than a nuisance illness of childhood,” he said. “Already this year we have recorded 13 deaths from measles,” which were not included in the data he presented.
“As you know, measles has been set for elimination” as a communicable disease, he said. “We need high immune coverage to achieve that, meaning 95% of the population covered with two doses. That is a challenge.”
Infants are especially vulnerable, and they fully reliant on the immunity of others to avoid measles.
“Vaccination recommendations begin at age 1, so before that, infants are dependent on their mothers’ antibodies, and on herd immunity. It’s very important that we have high vaccine coverage to protect them.”
Dr. Robesyn described measles outcomes in children 24 months and younger in 30 member states of the European Union and the European Economic Area from 2013 to 2017. Data were extracted from the European Surveillance System, which collects and analyzes infectious disease data across Europe.
During that period, there were 37,365 measles cases in people of all ages. Most were in Italy, Romania, Germany, the Netherlands, and the United Kingdom, with each reporting more than 5% of the cases. These countries also had the most cases that had not been connected with importation of the disease.
Overall, the patients were a mean of 12 years old. Less than 2% had been fully vaccinated against the disease. Complications (diarrhea, otitis media, pneumonia, or encephalitis) occurred in 13.6%, and about 33% of patients had to be hospitalized. Most cases (81%) occurred in people aged 2 years and older, 9% occurred in children who were 12-24 months old, and 10% occurred in children younger than 12 months. These younger children, however, accounted for 61% of the deaths in the cohort, Dr. Robesyn said.
Most of the cases occurred in unvaccinated or incompletely vaccinated patients. Forty-six died from measles, a mortality rate of about 1 per 1,000 who contracted the disease. Of these deaths, 16 were among children younger than 12 months, 12 among children aged 12-24 months, and the remainder among those older than 2 years.
These younger patients were also more susceptible to complications of measles, both mild (diarrhea and otitis media) and severe (pneumonia and encephalitis). Most of the uncomplicated cases (75%) occurred in children older than 24 months, with just 25% of uncomplicated cases occurring in the younger groups.
“When we looked at age as a continuous variable, we saw that the chance of having no complications or just mild complications increased with age, and the chance of having severe complications decreased with age,” Dr. Robesyn said.
“We definitely saw that these two groups are at increased risk. The consequences however, are different. For the children who are 1 year of age or older, the message is that it’s really important to strictly follow national recommendations and get timely and complete vaccination. For those younger than 1 year, we have to rely on the population to be vaccinated. It is very important that we reach this 95% coverage rate to protect these youngest children. We need adolescents and young adults who have missed vaccinations to get them completed,” he said.
Dr. Robesyn had no financial disclosures.
SOURCE: Robesyn E et al. ECCMID 2018, abstract O0060
MADRID – Children younger than 2 years who contracted measles were significantly more likely to die of the disease than were older children, according to new data from the European Center for Disease Control and Prevention.
Infants younger than 12 months faced the worst mortality outcomes, with a sevenfold increased risk of death, compared with children aged 2 years or older, Emmanuel Robesyn, MD said at the European Society of Clinical Microbiology and Infectious Diseases annual congress. Infants and children younger than 2 years also were much more likely to develop severe complications of the disease, including pneumonia and encephalitis.
The statistics should drive home the point that measles can be a life-threatening disease, especially for small children, said Dr. Robesyn, an expert in outbreak response at the European Center for Disease Prevention and Control, Stockholm.
“We want the population to understand that measles is much more than a nuisance illness of childhood,” he said. “Already this year we have recorded 13 deaths from measles,” which were not included in the data he presented.
“As you know, measles has been set for elimination” as a communicable disease, he said. “We need high immune coverage to achieve that, meaning 95% of the population covered with two doses. That is a challenge.”
Infants are especially vulnerable, and they fully reliant on the immunity of others to avoid measles.
“Vaccination recommendations begin at age 1, so before that, infants are dependent on their mothers’ antibodies, and on herd immunity. It’s very important that we have high vaccine coverage to protect them.”
Dr. Robesyn described measles outcomes in children 24 months and younger in 30 member states of the European Union and the European Economic Area from 2013 to 2017. Data were extracted from the European Surveillance System, which collects and analyzes infectious disease data across Europe.
During that period, there were 37,365 measles cases in people of all ages. Most were in Italy, Romania, Germany, the Netherlands, and the United Kingdom, with each reporting more than 5% of the cases. These countries also had the most cases that had not been connected with importation of the disease.
Overall, the patients were a mean of 12 years old. Less than 2% had been fully vaccinated against the disease. Complications (diarrhea, otitis media, pneumonia, or encephalitis) occurred in 13.6%, and about 33% of patients had to be hospitalized. Most cases (81%) occurred in people aged 2 years and older, 9% occurred in children who were 12-24 months old, and 10% occurred in children younger than 12 months. These younger children, however, accounted for 61% of the deaths in the cohort, Dr. Robesyn said.
Most of the cases occurred in unvaccinated or incompletely vaccinated patients. Forty-six died from measles, a mortality rate of about 1 per 1,000 who contracted the disease. Of these deaths, 16 were among children younger than 12 months, 12 among children aged 12-24 months, and the remainder among those older than 2 years.
These younger patients were also more susceptible to complications of measles, both mild (diarrhea and otitis media) and severe (pneumonia and encephalitis). Most of the uncomplicated cases (75%) occurred in children older than 24 months, with just 25% of uncomplicated cases occurring in the younger groups.
“When we looked at age as a continuous variable, we saw that the chance of having no complications or just mild complications increased with age, and the chance of having severe complications decreased with age,” Dr. Robesyn said.
“We definitely saw that these two groups are at increased risk. The consequences however, are different. For the children who are 1 year of age or older, the message is that it’s really important to strictly follow national recommendations and get timely and complete vaccination. For those younger than 1 year, we have to rely on the population to be vaccinated. It is very important that we reach this 95% coverage rate to protect these youngest children. We need adolescents and young adults who have missed vaccinations to get them completed,” he said.
Dr. Robesyn had no financial disclosures.
SOURCE: Robesyn E et al. ECCMID 2018, abstract O0060
REPORTING FROM ECCMID 2018
Key clinical point: Measles is most dangerous to children younger than 2 years.
Major finding: Children younger than 12 months who contracted measles were seven times more likely to die of the disease than were children 2 years and older.
Study details: The analysis involved 37,365 measles cases that occurred in the European Union from 2013 to 2017.
Disclosures: The analysis was conducted by the European Center for Disease Prevention and Control.
Source: Robesyn E et al. ECCMID 2018, abstract O0060.