Severe measles: a reappraisal of the role of nutrition, overcrowding and virus dose.

摘要: The factors predisposing to severe measles, which accounts for a considerable fraction of the high infant and child mortality in third world, are re-examined. conviction that protein-energy-malnutrition (PEM) aggravates measles is challenged by findings prospective community-based studies. It was found not associated with PEM but frequently accompanied overcrowding Guinea-Bissau. Secondary cases fared worse than index patients. Among adequately nourished hospitalised African children, immunological radiological parameters, together effects age HLA antigens, were closely related sickness death measles. This variation case fatality rate does appear be simply explained age-dependent host reactions or differences medical care. hypothesis fits most observed facts postulates transmission large inoculum virus particles susceptible children an important cause disease. implication this interpretation specific control, only improvements nutrition, risk areas reduction mortality. further suggested health policy should promote those social changes limit intense exposure virus.