Measles is a preventable disease still responsible for a number of outbreaks worldwide. Although most adults with measles recover uneventfully, measles-related complications may occur. However, as to whether every complicated case requires hospital management is still a point of debate. In this study we described the rate, clinical features and severity of measles complications in patients admitted to the ED of a tertiary-care teaching hospital during the outbreak that took place in 2017. Some insights into the impact on the health care system are reported as well. A retrospective cohort study was performed. Medical records of adults discharged from January to December 2017 with diagnosis of "measles" were collected and analyzed. Out of 58,579 of ED admissions, 162 measles cases were enrolled. Acute measles infection was laboratory confirmed in 71.6% and deemed as possible/probable in 24.0% of cases. Three percent of patients were immunocompromised while 1.2% of cases occurred in pregnant women. Of all complications reported (37%), hepatitis was the most frequent (29%) followed by pneumonia (10.4%), keratitis (3.8%), thrombocytopenia (3.8%) and otitis media (0.6%). No significant clinical and laboratory difference emerged between complicated and non-complicated cases besides antibiotic prescription (80.0% vs 66.3%; p=0.039). The course of the disease was mild, and no life-threatening measles-related complications or critical care support were reported. One out of three measles cases may experience at least one measles-related complication. However, the course of the disease seems to be rather benign in young adults, and the widespread use of the ED and hospitalization observed seem an inappropriate approach to the issue.

Lesson learned from the 2017 measles outbreak in Italy: report from an emergency department / Spagnolello, Ornella; Russo, Alessandro; Borrazzo, Cristian; D'Ettorre, Gabriella; Ceccarelli, Giancarlo. - In: LE INFEZIONI IN MEDICINA. - ISSN 1124-9390. - 29:2(2021), pp. 252-258.

Lesson learned from the 2017 measles outbreak in Italy: report from an emergency department

Spagnolello, Ornella
Primo
;
Russo, Alessandro
Secondo
Conceptualization
;
Borrazzo, Cristian;d'Ettorre, Gabriella
Penultimo
;
Ceccarelli, Giancarlo
Ultimo
2021

Abstract

Measles is a preventable disease still responsible for a number of outbreaks worldwide. Although most adults with measles recover uneventfully, measles-related complications may occur. However, as to whether every complicated case requires hospital management is still a point of debate. In this study we described the rate, clinical features and severity of measles complications in patients admitted to the ED of a tertiary-care teaching hospital during the outbreak that took place in 2017. Some insights into the impact on the health care system are reported as well. A retrospective cohort study was performed. Medical records of adults discharged from January to December 2017 with diagnosis of "measles" were collected and analyzed. Out of 58,579 of ED admissions, 162 measles cases were enrolled. Acute measles infection was laboratory confirmed in 71.6% and deemed as possible/probable in 24.0% of cases. Three percent of patients were immunocompromised while 1.2% of cases occurred in pregnant women. Of all complications reported (37%), hepatitis was the most frequent (29%) followed by pneumonia (10.4%), keratitis (3.8%), thrombocytopenia (3.8%) and otitis media (0.6%). No significant clinical and laboratory difference emerged between complicated and non-complicated cases besides antibiotic prescription (80.0% vs 66.3%; p=0.039). The course of the disease was mild, and no life-threatening measles-related complications or critical care support were reported. One out of three measles cases may experience at least one measles-related complication. However, the course of the disease seems to be rather benign in young adults, and the widespread use of the ED and hospitalization observed seem an inappropriate approach to the issue.
2021
measles outbreak; measles-related complications; emergency department; public health
01 Pubblicazione su rivista::01a Articolo in rivista
Lesson learned from the 2017 measles outbreak in Italy: report from an emergency department / Spagnolello, Ornella; Russo, Alessandro; Borrazzo, Cristian; D'Ettorre, Gabriella; Ceccarelli, Giancarlo. - In: LE INFEZIONI IN MEDICINA. - ISSN 1124-9390. - 29:2(2021), pp. 252-258.
File allegati a questo prodotto
File Dimensione Formato  
Spagnolello_Lesson learned from_2021.pdf

accesso aperto

Note: https://www.infezmed.it/index.php/article?Anno=2021&numero=2&ArticoloDaVisualizzare=Vol_29_2_2021_252
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 687.62 kB
Formato Adobe PDF
687.62 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1552047
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? ND
social impact