Authors: Doctor Wahida Latif , Doctor Zareen Qasmi , Doctor Tayyaba Ali

Abstract

Introduction: Measles is a contagious airborne disease which is vaccine preventable, although included in the extended programme of immunization with administration of two doses at 9 and 15 months of age. It remains a menace for children or causing short- and long-term complications and even death in infected patients. According to WHO an 11-fold rise in 2025 was reported as compared to the same period in 2024.

Objective: The objective of this study is to analyse the cases of measles presenting in the paediatric emergency department of Dr Ruth K M Pfau Civil Hospital Karachi.

Method: It is a retrospective analysis of three years data from May 22- Apr 25 of measles patient who visited the ED and a clinical diagnosis of measles is made. The study includes all patients from 1 month to 13 years of age triaged as P1, P2 and P3 according to the WHO ETAT system. The demographic and clinical data was retrieved from the EMR of the patients maintained by the Childlife Foundation.

Result: A total of 195,861 patients visited the PED during the study duration from May 22 – Apr 25. The results show that 2133 measles patients were seen over a period of 3 years and 22.4%(n=478) of these patients were categorized as P1. The gender distribution was balanced with 53.23% (n=1135) females and 46.77% (n=998) males. The most affected age group was between the age of 1-5 years 59.79% (n=1276). Analysis of the vaccination status revealed that 58.58% (n=1250) were completely vaccinated just till the age of 9 months, missing the important second dose of measles immunization. 19.40% had incomplete vaccination status and 5.95% (n=127) were not vaccinated at all. Most patients had a prolonged length of stay between 4–10 hours (36.55%). 77.55% (n=1655) experienced measles complications, 16.07% had pneumonia, and 6.37% developed encephalitis. Discharge data shows that 34.68% were discharged home, while a significant 22.59% left against medical advice. 16 patients expired in the study group and 6 were brought with out of hospital cardiac arrest. A rise in measles cases was observed from May 23-Apr 25 from 26% (n=557) in May 22- Apr 23, to 37.35% and 36.5% in the subsequent years.

Conclusion: This review highlights a concerning rise in paediatric measles cases post pandemic over 3 years. A significant number of affected children were partially vaccinated or not vaccinated at all, underscoring gaps in vaccine coverage. timeliness and possible waning immunity. High rates of complications, prolonged emergency stays and mortality emphasize the urgent need for strengthened immunization strategies, public awareness and early intervention to curb measles related mortality and morbidity in tertiary care settings.

References: Asia Nawaz, Sidra Rahman, Nighat Haider, Adnan Zeb, Muhammad Ali, (2025), Investigation of Measles Outbreak in Pakistan (2022 to 2023): Exploring Comorbidities, Complications, and Molecular Dynamics, International Journal of Clinical Infectious Diseases, 4(3); DOI:10.31579/2834-5177/046 

Keywords: Measles, Pediatric Emergency