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H.C. Whittle

and P. Aaby



Epidemiology—an estimated 164 000 people still die of measles each year.

Measles in Europe—misleading medical articles, anti-vaccine sentiments, and religious or superstitious beliefs are hampering control.

Prevention of measles in HIV-infected and severely malnourished children—WHO recommends measles vaccination in the acute phase, followed by a second dose on recovery.

Survival benefit of two doses of measles vaccine in infancy—two doses of Edmonston–Zagreb measles vaccine in infancy reduces case fatality to 30% lower than in controls receiving a single dose of measles vaccine at 9 months of age.

Eradication—prospects of fulfilling WHO’s aim of eradication by 2020.

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date: 19 September 2021

Measles is a single-stranded RNA virus that is spread by aerosolized droplets and is highly transmissible. It causes a spectrum of disease ranging from mild in the well nourished to severe in the malnourished or immunosuppressed: mortality is 3 to 10% in Africa.

Clinical features—10 to 14 days after infection the viral prodrome typically consists of runny nose and fever, sometimes also diarrhoea or convulsions; signs include mild conjunctivitis, red mucosae, and (on the buccal mucosa) Koplik’s spots. After 14 to 18 days a morbilliform rash first appears on the forehead and neck, then spreads to involve the trunk and finally the limbs. Other manifestations include severe conjunctivitis (especially in those who are vitamin-A deficient), pneumonitis and enteritis (which may cause profuse diarrhoea). Early complications include (1) pneumonia—caused by ...

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