Clinical and Epidemiologic Study of Adult Measles

Jeong, Mun Cheol; Park, Hyun Ho; Kim, Nack In

Abstract

BACKGROUND
Clinical manifestations and complications of measles are more severe in adults than children. But, there has been few clinical and epidemiologic data about adult measles in Korea. OBJECTIVE: We investigated clinical features, laboratory findings, disease courses and complications and discussed the reason why measles incidence has been increasing recently in young adults to find out the solutions to prevent measles. METHOD: From April 1999 to February 2001, we examined prodromal symptoms, skin rash, complications, routine CBC, and blood chemistry of 42 adults who were admitted in KangBuk SamSung Hospital for measles and performed qualitative serum measles specific IgM and IgG antibody test using ELISA method. RESULTS: Age distribution of most adult measle patients was between 15 and 25 years old(78.6%). Fever was found in all patients and cough, coryza, headache, myalgia, conjunctivitis, sore throat, nausea, diarrhea, and vomit were found in decreasing order of frequency. Skin rashes were started from the face and spread to trunk, arms and then legs in 37 patients out of 42. Five patients had skin rash in the face and trunk at the same time, and one had hemorrhagic rash. Koplik's spots were found in 26 patients (62%). Among them, 2 had Koplik's spots before the rash and 24 had Koplik's spots with the rash simultaneously or thereafter. Koplik's spots were disappeared as skin rash disappeared. Exfoliative dermatitis was found following the skin rash in one patient. Among 26 patients who performed qualitiative serum measles specific IgM and IgG antibody test using ELISA, the seropositivity of measles specific IgM was 70%, of measles specific IgG was 27%, and of both measles specific IgM and IgG was 12%. Complications were like this; hepatitis in 23, cervical lympadenitis in 20, laryngitis and bronchitis in 7, otitis media in 4, pneumonia on chest X-ray in 3, hepatosplenomegaly on upper abdomen ultrasonography in 5. Two patients were in pregnancy of 12 and 16 weeks, and the former had spontaneous abortion. Pnemonia and otitis media were recovered within average 5 days after administrating antibiotics and antipyretics.