Modern clinical and laboratory features of measles in adults depending on the severity of the disease

Abstract

The purpose of the work is to determine the clinical and laboratory features of measles in adults, depending on the severity of the course in modern conditions.Material and methods. Under supervision there were 210 measles patients, aged from 18 to 58 years, who underwent treatment at the Сommunal Institution "Regional Infectious Clinical Hospital" of Zaporizhzhia Regional Council during 2017-2019 years. The diagnosis of measles was confirmed according to WHO criteria (2013). Patients underwent traditional clinical laboratory and instrumental studies. Measles patients, depending on the severity of the disease, were divided into groups: 178 patients with moderate courses, 32 patients with severe course. Statistical data processing was performed in «STATISTICA for Windows 6.0» (StatSoft Inc., №AXXR712D833214FAN5).Results. According to the results of the research, it was found that the clinical presentation of adult measles, in modern conditions, shows typical manifestations, however, in a severe course, more often than moderate, are recorded scleroconjunctivitis with pain in the eyes (100 % versus 66,3 %, p<0,004), hoarseness (78,1 % versus 29,2 %, p<0,0001), hemorrhagic signs (12,5 % versus 1,1 %, p<0,001), nausea (35,7 % versus 7,9 %, p<0,001), vomiting (31,3 % versus 5,1 %, p<0,001),the fever period was longer (p<0,01). In 70,5 % of patients, measles proceeds with the development of complications. The most frequently reported complications are from the side of respiratory system (61,4 %) and gastrointestinal tract (43,8 %), frequency and spectrum of which depend on the severity of the disease. Complications of the nervous system and organs of vision develop in individual patients in severe course of measles. Laboratory changes in adult measles patients are characterized by leukopenia (56,2 %), whereas stab shift (93,8 % versus 54,5 %, p<0,05), thrombocytopenia (71,9 % versus 15,2 %, p<0,05), mononuclear reaction (21,9 % versus 8,4 %, p<0,05) are characteristic of severe course. In patients with the development of hepatitis, cytolytic syndrome is characterized by moderate increase in ALT activity (62,9 %), with higher activities of this enzyme (p<0,05) and GGT (p<0,05) in patients with severe course of measles.Conclusions. Adult measles in modern conditions retains typical symptoms with severe course more often than moderate, scleroconjunctivitis, hoarseness, hemorrhagic manifestations, nausea, vomiting are registered, the feverish period is longer. In 70,5 % of adult patients with measles complications mainly develop from respiratory system (61,4 %) and gastrointestinal tract (43,8 %), frequency and spectrum of which depends on the severity of the disease. Laboratory changes in adult measles patients are characterized by leukopenia, stab shift, thrombocytopenia and mononuclear reaction are characteristic of the severe course. With the development of hepatitis, the activity of ALT and GGT is higher in patients with severe course of the disease.