Measles

Measles is an acute infectious disease occurring mostly in children. It is very easily passed from one person to another. It causes high fever, cough and a rash, and it lasts for 1 - 2 weeks. Except in isolated populations, measles is nearly universal, most persons being infected before reaching the age of 15. Babies and adults who catch measles are often much sicker and are more likely to suffer longer or die than elementary school children and teenagers with measles.  Generally, measles is considered as a relatively mild and inevitable childhood ailment that is best encountered any time from 3 to 7 years of age.  However, it can cause serious complications; among these are diarrhoea, encephalitis, otitis media, pneumonia and exacerbation of protein-energy malnutrition.  

During the 1800s, measles were a notable cause of death. Epidemics occurred every few years causing a large influx of children into local hospital wards. In Glasgow, Scotland, from 1807-1812 measles accounted for 11% of all deaths. In the years from 1867-1872, 49% of children in a Paris orphanage who developed measles died.  Starting in the mid to late-1800s deaths from all infectious diseases, including measles, began to decline. By the 1930s in England and the United States, the chance of dying from measles had dropped to 1-2 percent.  

For over 100 years, there has been a strong association with vitamin A deficiency and adverse measles outcomes, especially in young children. 

One of every 10 children who catch measles will also have an ear infection or pneumonia. Measles can also cause an infection of the brain that could lead to convulsions (seizures, fits, spasms, twitching, jerking or staring spells), hearing loss and mental retardation. This happens to about 1 out of every 1,000 children reported to have measles. In the United States, 1 child out of every 500 - 10,000 who gets measles dies from it; worldwide, as of 1997, 1 million children a year die from measles.

Developing countries

Measles remains one of the leading causes of childhood mortality in countries where malnutrition, poor sanitation, and inadequate medical care are prevalent; it is often a fatal disease among socio-economically deprived children in tropical countries. Therapy for measles and its complications is a major drain on medical care resources in most parts of Africa, Asia, and Latin America. In 1989, not only did it kill an estimated 1.5 million children annually, but it also contributed to malnutrition and aggravated other diseases, thus indirectly contributing to an even higher number of deaths and morbidity. 

The Inter-American Investigation of Mortality in Childhood reported that measles was either the main cause of death or the second most frequent cause in children aged 1-4 years in several cities in Latin America. Measles outbreaks in Africa and Asia have case-fatality rates of 5-20% among children, especially malnourished ones. Measles complications may also result in developmental retardation, lifelong handicaps, and both direct and indirect economic loss. Furthermore, in children in the developing world, measles interacts with diarrhoeal disease and malnutrition to increase the morbidity and mortality from these conditions. Statistics from the WHO and UNICEF programme in the 1980s suggest that the number of Third World children immunized against measles has risen from three in 10 to more than seven in 10, and that the annual death rate has dropped from a high of 3 million to 1 million in 1993.

Industrialized countries

The Centers for Disease Control and Prevention in the USA reported only 175 cases of measles in 1993. There was a measles epidemic in the USA between 1989 and 1991, when more than 56,000 people contracted the disease and at least 132 died. Most of the cases were among unvaccinated pre-school children.  Between 1980 and 1991 the number of measles cases in the UK fell from 147,000 to 12,000.  In England the measles vaccine was introduced in 1968; in the United States in 1963. By this point measles deaths were extremely rare.