Epidemic management in a measles outbreak in 2023, the return of vaccine–preventable diseases: A single center, retrospective observational study

Abstract

Objective: To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles. Methods: This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023, at Marmara University Pendik Training and Research Hospital. The effects of vaccination status and underlying disease on the clinical course, treatments, and complications were evaluated. Results: In total, 117 patients were enrolled in the study with a median age of 80 months (IQR: 32.5-125.0). Twelve patients with contact history were asymptomatic and had an underlying disorder, and intravenous immunoglobulin was given to them for post-exposure prophylaxis. Fifty-one patients had confirmed measles diagnosis. Ribavirin treatment was given to three patients (a newborn, a girl with rhabdomyosarcoma, and a healthy boy) with respiratory distress. Seventy-eight percent of confirmed measles cases were unvaccinated, and all hospitalized cases were unvaccinated or under-vaccinated. Four full-vaccinated children had confirmed measles infection. Measles PCR from nasopharyngeal swabs was negative in all of them, and their diagnosis was established with anti-measles IgM positivity. Conclusions: The measles vaccine is the most effective way to protect from measles and measles-related complications. Although measles can also occur in fully vaccinated patients, the disease is milder than in unvaccinated patients. Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.