Increase in Infant Measles Deaths During a Nationwide Measles Outbreak—Mongolia, 2015–2016

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Lee, Christopher T. ; Hagan, Jose E. ; Jantsansengee, Baigalmaa ; Tumurbaatar, Oyun-Erdene ; Altanchimeg, Samdan ; Yadamsuren, Buyanjargal ; Demberelsuren, Sodbayar ; Tserendorj, Chinbayar ; Munkhtogoo, Oyungerel ; Badarch, Darmaa ; Gunregjav, Nyamaa ; Baatarkhuu, Bolortuya ; Ochir, Chimedsuren ; Berman, LaShondra ; Anderson, Raydel ; Patel, Minal K. ; Gregory, Christopher J. ; Goodson, James L.
• Description:
  Background.
  
  Surveillance data from a large measles outbreak in Mongolia suggested increased case fatality ratio (CFR) in the second of 2 waves. To confirm the increase in CFR and identify risk factors for measles death, we enhanced mortality ascertainment and conducted a case-control study among infants hospitalized for measles.
  
  Methods.
  
  We linked national vital records with surveillance data of clinically or laboratory-confirmed infant (aged <12 months) measles cases with rash onset during March–September 2015 (wave 1) and October 2015–June 2016 (wave 2). We abstracted medical charts of 95 fatal cases and 273 nonfatal cases hospitalized for measles, matched by age and sex. We calculated adjusted matched odds ratios (amORs) and 95% confidence intervals (CIs) for risk factors.
  
  Results.
  
  Infant measles deaths increased from 3 among 2224 cases (CFR: 0.13%) in wave 1 to 113 among 4884 cases (CFR: 2.31%) in wave 2 (P < .001). Inpatient admission, 7–21 days before measles rash onset, for pneumonia or influenza (amOR: 4.5; CI, 2.6–8.0), but not other diagnoses, was significantly associated with death.
  
  Discussion.
  
  Measles infection among children hospitalized with respiratory infections likely increased deaths due to measles during wave 2. Preventing measles virus nosocomial transmission likely decreases measles mortality.
  
  
• Subjects:
  Case-Control Studies Disease Outbreaks Female Hospitals Humans Infant Infant, Newborn Male Measles Mongolia Risk Factors Survival Analysis

  More +
• Keywords:
  Case Fatality Health Care-associated Infection Measles Mortality
• Source:
  J Infect Dis. 220(11):1771-1779
• Pubmed ID:
  30923799
• Pubmed Central ID:
  PMC7034305
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  220
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:4539755876d58b3cdc53c92117963478158faa411096a0bb2ed1f3e3b9432c224818ea878829850eb105f005b000252f33bd74070c6618aa715edee764229e3b
• Download URL:
  https://stacks.cdc.gov/view/cdc/85261/cdc_85261_DS1.pdf
• File Type:
  [PDF - 888.98 KB ]