Current course of measles in adults (a literature review)

Abstract

Measles is a highly contagious acute infectious disease of viral etiology. Thanks to the widespread use of measles vaccine in the European Region in the early 2000s, WHO set a goal to achieve measles elimination. An essential feature of measles during the period of elimination was the predominance of cases among adults. The purpose of the work is to analyze the literature data on the peculiarities of the current course of measles in adults. According to the WHO, in 2017–2018 inEurope, including Ukraine, there was a significant increase in the number of people with measles. The rise in the incidence of measles in modern conditions is characterized by a change in the genotypes of circulating viruses. The data of modern medical literature show that a significant feature of measles outbreaks in recent years is the predominance of cases among adults, the incidence of measles among medical workers who were vaccinated against measles. The clinical picture of measles in adults remains typical; however, unlike measles in children, it is characterized by a greater incidence of complications. The development of pneumonia and encephalitis is the most severe and life-threatening. Pneumonia is a frequent complication of measles in adults over 20 years of age, the incidence of which in adults, according to different studies, ranges from 14 % to 66 %, but the most patients need oxygen therapy. The risk of measles encephalitis occurs during the rash onset and mortality rate depends on the age of patients in this complication: 25 % in adults versus 5 % in children. In adult patients with measles, liver damage is recorded much more often than in children, with the prevalence of cytolytic syndrome, sometimes with the development of jaundice, but is characterized by a benign clinical course. In the literature, there are reports of enteritis and pancreatitis development in patients with measles. Data on the course of measles in pregnant women warrant special attention due to such adverse effects as abortions, premature births, and stillbirths. Measles is a controlled infection, therefore vaccination, including adults, is the main focus in the fight against this disease. Conclusions. In modern conditions, there is a high incidence of measles in adults, primarily due to the low level of community immunity. The prevalence of adults among measles patients is an important feature of this infection outbreak in recent years. The clinical picture of measles in adults retains typical symptoms, but the course is characterized by a high risk of a wide range of complications, the most severe of which are pneumonia and measles encephalitis. It is possible to achieve success in the fight against measles through the effective vaccination coverage.

Keywords

• measles
• diagnosis
• complications