Clinical characteristics of measles in unvaccinated and vaccinated children

doi:10.3877/cma.j.issn.1674-1358.2023.02.006

Abstract

Abstract:

Objective

To investigate the effect of measles vaccination on the clinical characteristics of measles in children.

Methods

Clinical data of 726 children with measles admitted to the Department of Pediatrics, BeijingDitan Hospital, Capital Medical University from March 2009 to July 2019 were analyzed, retrospectively, including onset time, gender, age, measles vaccination, clinical manifestations, complications, auxiliary examinations and prognosis. All children were grouped according to whether or not vaccinated against measles: the unvaccinated group (622 cases) and vaccinated group (104 cases), Chi-square test or continuously corrected Chi-square and rank sum (Mann-Whitney U) test were used to compare the clinical characteristics of measles between the two groups.

Results

Total of 726 children with measles were collected, including 486 boys (66.9%) and 240 girls (33.1%), the median age was [8.6 (6.6, 11.9)] months, among whom, children younger than one year old accounted for 73.1%. Total of 622 children (85.7%) were not vaccinated against measles, with 251 (40.4%) children aged 0-8 months, and 104 children (14.3%) were vaccinated, without < 8 months. The incidence peak was in spring (March to May) in both groups. For the cases in the vaccinated group, the incidence of typical rash (67.0% vs.50.0%: χ² = 11.316, P = 0.001), measles mucosal plaque (Koplik plaque) (61.7% vs. 38.5%: χ² = 19.868, P < 0.001), eyelid edema (22.5% vs. 11.5%: χ² = 6.477, P = 0.011), conjunctival congestion (45.0% vs. 24.0%: χ² = 16.095, P < 0.001), eye secretions (50.0% vs. 30.8%: χ² = 13.221, P < 0.001), watery eyes (12.1% vs. 3.8%: χ² = 6.196, P = 0.013), diarrhea (29.3% vs. 18.3%: χ² = 5.376, P = 0.020), cough (77.2% vs. 63.5%: χ² = 8.980, P = 0.003) and respiratory complications laryngitis (44.7% vs. 26.9%: χ² = 11.541, P = 0.001) and pneumonia (80.4% vs. 59.6%: χ² = 21.982, P < 0.001) in the unvaccinated group were significantly higher; while the incidence of liver damage (12.1% vs. 34.6%: χ² = 35.006, P < 0.001) was significantly lower.

Conclusions

Measles vaccination has an effect on the clinical characteristics of children with measles. Children who are not vaccinated against measles have typical clinical manifestations and more respiratory complications. The clinical manifestations of children vaccinated against measles are atypical. Children who are not vaccinated against measles are the main cases infected with measles. Attention should be paid to measles vaccination and supplementary immunization for infants and young children.

Key words: Children, Measles, Measles vaccine, Retrospective research

Min Miao, Honglin Yang, Yang Liu, Lin Pang. Clinical characteristics of measles in unvaccinated and vaccinated children[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2023, 17(02): 110-116.

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References 40

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临床特征	未接种疫苗组（622例）	接种疫苗组（104例）	χ²值	P值
高热	416（66.9）	78（75.0）	2.701^a	0.100
典型皮疹	528（67.0）	70（50.0）	11.316^a	0.001
Koplik斑	384（61.7）	40（38.5）	19.868^a	< 0.001
眼睑浮肿	140（22.5）	12（11.5）	6.477^a	0.011
结膜充血	280（45.0）	25（24.0）	16.095^a	< 0.001
眼分泌物	311（50.0）	32（30.8）	13.221^a	< 0.001
畏光	32（5.1）	5（4.8）	0.021^a	0.885
流泪	75（12.1）	4（3.8）	6.196^a	0.013
流涕	174（28.0）	23（22.1）	1.547^a	0.214
咳嗽	480（77.2）	66（63.5）	8.980^a	0.003
腹泻	182（29.3）	19（18.3）	5.376^a	0.020
喉炎	278（44.7）	28（26.9）	11.541^a	0.001
支气管炎	95（15.3）	13（12.5）	0.541^a	0.462
肺炎	500（80.4）	62（59.6）	21.982^a	< 0.001
呼吸衰竭	51（8.2）	5（4.8）	1.440^a	0.230
ARDS	8（1.3）	1（1.0）	0.000^b	1.000
肺气漏	15（2.4）	1（1.0）	0.327^b	0.568
鹅口疮	84（13.5）	17（16.3）	0.601^a	0.438
肝功能损害	75（12.1）	36（34.6）	35.006^a	< 0.001
心力衰竭	52（8.4）	7（6.7）	0.317^a	0.574
脑炎	6（0.3）	1（1.9）	0.000^b	1.000
重型麻疹	111（17.8）	16（15.4）	0.374^a	0.541
临床治愈	606（97.4）	102（98.1）	0.003^b	0.957

临床特征	未接种疫苗组（622例）	接种疫苗组（104例）	χ²值	P值
高热	416（66.9）	78（75.0）	2.701^a	0.100
典型皮疹	528（67.0）	70（50.0）	11.316^a	0.001
Koplik斑	384（61.7）	40（38.5）	19.868^a	< 0.001
眼睑浮肿	140（22.5）	12（11.5）	6.477^a	0.011
结膜充血	280（45.0）	25（24.0）	16.095^a	< 0.001
眼分泌物	311（50.0）	32（30.8）	13.221^a	< 0.001
畏光	32（5.1）	5（4.8）	0.021^a	0.885
流泪	75（12.1）	4（3.8）	6.196^a	0.013
流涕	174（28.0）	23（22.1）	1.547^a	0.214
咳嗽	480（77.2）	66（63.5）	8.980^a	0.003
腹泻	182（29.3）	19（18.3）	5.376^a	0.020
喉炎	278（44.7）	28（26.9）	11.541^a	0.001
支气管炎	95（15.3）	13（12.5）	0.541^a	0.462
肺炎	500（80.4）	62（59.6）	21.982^a	< 0.001
呼吸衰竭	51（8.2）	5（4.8）	1.440^a	0.230
ARDS	8（1.3）	1（1.0）	0.000^b	1.000
肺气漏	15（2.4）	1（1.0）	0.327^b	0.568
鹅口疮	84（13.5）	17（16.3）	0.601^a	0.438
肝功能损害	75（12.1）	36（34.6）	35.006^a	< 0.001
心力衰竭	52（8.4）	7（6.7）	0.317^a	0.574
脑炎	6（0.3）	1（1.9）	0.000^b	1.000
重型麻疹	111（17.8）	16（15.4）	0.374^a	0.541
临床治愈	606（97.4）	102（98.1）	0.003^b	0.957

实验室指标	未接种疫苗组（622例）	接种疫苗组（104例）	Z值	P值
WBC（× 10⁹/L）	7.1（5.2，10.54）	8.77（6.08，12.18）	－3.006	0.003
NE（%）	45.27（33.14，58.34）	44.55（25.77，63.13）	－0.759	0.448
LYH（%）	45.44（33.40，57.40）	44.70（27.23，67.87）	－0.634	0.526
CRP（mg/L）	3.0（0，14）	9.4（2.09，40.72）	－4.225	< 0.001
ALT（U/L）	25.75（19.1，36.5）	26.7（17.47，80.17）	－1.791	0.073
AST（U/L）	53.6（42.9，68.57）	49.65（38.35，92.65）	－0.030	0.976
LDH（U/L）	540.35（442.82，650.47）	477.4（404.62，603.20）	－3.191	0.001
CK-MB（U/L）	35（26，45）	30（23.00，42.25）	－2.541	0.011

实验室指标	未接种疫苗组（622例）	接种疫苗组（104例）	Z值	P值
WBC（× 10⁹/L）	7.1（5.2，10.54）	8.77（6.08，12.18）	－3.006	0.003
NE（%）	45.27（33.14，58.34）	44.55（25.77，63.13）	－0.759	0.448
LYH（%）	45.44（33.40，57.40）	44.70（27.23，67.87）	－0.634	0.526
CRP（mg/L）	3.0（0，14）	9.4（2.09，40.72）	－4.225	< 0.001
ALT（U/L）	25.75（19.1，36.5）	26.7（17.47，80.17）	－1.791	0.073
AST（U/L）	53.6（42.9，68.57）	49.65（38.35，92.65）	－0.030	0.976
LDH（U/L）	540.35（442.82，650.47）	477.4（404.62，603.20）	－3.191	0.001
CK-MB（U/L）	35（26，45）	30（23.00，42.25）	－2.541	0.011

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