Measles Complications in Pediatric Patients in Poland

To the Editors: We read with great interest the article of Hester et al.1 on the complications of measles in children in the United States. In that study, the authors noted that the most common complication of measles among hospitalized children, besides poor feeding, was otitis media (42%).1 Ben-Chetrit et al.2 also reported that otitis media was the second most common complication after pneumonia among children under 5 years of age (15.1% of all complications). In children under the age of 10, according to Ilyas et al.3 otitis media occurs in 3.8% of measles cases, with an additional 8.3% seeing otitis media together with pneumonia. In a study by Lo Vecchio et. al.4 (249 children hospitalized due to measles), complications occurred in 207 (83.1%) of them, and the most common was pneumonia (23.3%). Atti et al.5 showed that of 454 children hospitalized with measles, only 46.7% had no complications. The results presented are a reminder that health care professionals should be aware that measles is an ever-present disease and its complications can be very dangerous to the health and lives of unvaccinated patients. In a retrospective observational study at our own institution, we included 84 patients who were hospitalized due to measles at the Department of Children’s Infectious Diseases (Warsaw, Poland), from January 2017 to December 2019. The median age was 1 year and 11.5 months. There was no history of measles vaccination in 79.76% of patients. With no vaccination data available for 14.29% of patients. In our cohort, noncomplicated measles occurred only in 32.14% of patients with pneumonia being the most common complication in 46.43%. Otitis media was seen in 22.62% of children, of which 8.33% occurred concurrently with pneumonia. The median age of children with otitis media was significantly lower than that of children without this complication (12 months vs. 33 months, P = 0.0039). Other common complications were diarrhea (11.90%) and hepatitis (9.52%). Measles remains a significant health threat in unvaccinated children.