Epidemiologic and Clinical Features of Adult Patients with Measles During 2000 Epidemic

Song, Joon Young; Park, Cheong Won; Lee, Jong Seop; Eom, Joong Shik; Sohn, Jang Wook; Cheong, Hee Jin; Kim, Woo Joo; Kim, Min Ja; Park, Seung Chull

Abstract

BACKGROUND: Measles is an acute highly contagious infection caused by measles virus. Since the introduction of measles vaccines in 1963, measles has been dramatically decreased in Korea. However, measles outbreaks have occurred periodically every 4 to 6 years during the 1990s. During 2000, measles outbreak of large scale occurred throughout the country and the total of 32,088 cases were reported. The majority of affected population was infants and school-aged children, but measles was reported also among adolescent and adult population. There was no report about the epidemiology of adult measles cases during the last decade. In this study, we retrospectively analyzed the epidemiologic and clinical features of adult measles patients in Korea.
METHODS
From July of 2000 to January of 2001, 50 adult cases of measles had been admitted to Korea University Hospital. Medical records of these 50 patients, who were clinically diagnosed as measles, were reviewed. Demographic data, clinical features, history of measles vaccination and laboratory findings were evaluated.
RESULTS
The median age of patients was 23 years : 28 (56%) were male. Most cases (49/50, 98%) occurred between November of 2000 to January of 2001 and 8 (16%) patients were associated with outbreaks. The occupation of patients was diverse but, students (28%) and office workers (20%) were the most common. 44 (88%) of 50 patients had no underlying diseases. Adult measles patients demonstrated similar clinical symptoms, which were shown in children with measles. In laboratory findings, mean WBC count was 4,933/micro L and 18 (36%) patients had thrombocytopenia. 21 (42 %) patients had complication of measles, and hepatitis was the most common episodes among them. Measles vaccination history revealed that 5 (10%) had two-dose and 7 (14%) had one-dose measled vaccine. In 35 patients, measles IgM antibody test was done. It appears that IgM positive rate among one-dose measle vaccination group, two-dose measle vaccination group, and group with unknown vaccination history were 86% (6/ 7), 40% (2/5), and 78% (18/23), respectively. Most (94%) of patients were hospitalized and more than two-third of patients were isolated. All the patients were recovered without sequelae.
CONCLUSION
In 2000 measles outbreak, adult measles had the typical clinical features similar to those in the children and the severe complication was rare. Adult measles patients demonstrated low measles vaccination rate and occurred mainly among the students and office workers.