Complications

Most common:

• otitis media (7-9%)
• bronchopneumonia, often with Staphylococcus aureus or gram-negative organisms in undernourished children (1-6 %)
• diarrhoea (8%)
• febrile convulsions (1 in 200) (1)

Less common:

• meningitis
• immunosuppression, with giant cell pneumonitis in the immune suppressed
• gastric symptoms

Rare:

• encephalitis - which develops 7-10 days after the onset of symptoms
• late complication of bronchiectasis

Very rare:

• subacute sclerosing panencephalitis
  • affects 1 in 25 000 cases, but the risk of getting SSPE is 16 times higher in children who develop measles under 1 year of age when compared to those infected over 5 years (1)
  • SSPE occurs around seven years after the onset of symptoms but may occur after two or three decades (1).

Measles during pregnancy may lead to potentially fatal pneumonitis in mother, an increased risk of spontaneous abortion, premature delivery, and low birth weight babies. No congenital abnormalities have been found in babies born to mothers who contracted measles during pregnancy (2).

Note that tuberculosis is more common in children following measles. This is related to a depression in cell-mediated immunity and lymphopaenia.

Complications are more common and more severe in poorly nourished and/or chronically ill children, including those who are immunosuppressed (upto 80%)

• in patients with cancer - case fatality rate is around 70%
• in HIV infected patients - case fatality rate is between 5-40% (2)

Reference

• (1) Immunisation Against Infectious Disease - "The Green Book".Chapter 21 Measles (August 2006)
• (2) Asaria P, MacMahon E. Measles in the United Kingdom: can we eradicate it by 2010? BMJ. 2006;333(7574):890–895