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Measles Hospitalizations at a United States Children’s Hospital 2011–2017

Hester, Gabrielle, MD*; Nickel, Amanda, MPH; LeBlanc, Julie, MPH; Carlson, Rebecca, MAN*; Spaulding, Alicen B., PhD; Kalaskar, Anupama, MD§; Stinchfield, Patricia, MS

The Pediatric Infectious Disease Journal: June 2019 - Volume 38 - Issue 6 - p 547–552
doi: 10.1097/INF.0000000000002221
Original Studies
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Background: There are no recent descriptions of measles hospitalizations and complications in US children despite outbreaks within the past decade—including 2 in Minnesota (2011 and 2017). The objective of our study was to describe complications, hospital management and resource utilization for children hospitalized for measles at a US children’s hospital.

Methods: Retrospective case series of children (0–18 years of age) hospitalized for measles (observation/inpatient diagnosis code for measles) at Children’s Minnesota, January 1, 2011, to September 1, 2017. Descriptive statistics were performed.

Results: Thirty-three patients were included (7 from 2011 and 21 from 2017 outbreaks). Median age was 27 months (range, 6–95 months), 94% were Black or African American (73% Somali ethnicity), 88% had medical assistance and 91% were unvaccinated to measles. Poor feeding was a primary reason for admission (97%); additional complications included otitis media (42%), pneumonia (30%), tracheitis (6%) and keratitis (3%). Additional testing was common [chest radiographs (70%), blood cultures (64%), nonmeasles viral testing (42%)]. Seventy-three percent received antibiotics, 30% required oxygen and 21% received vitamin A. Median length of stay was 3.7 days (range, 1.1–26.2 days); 1 patient was readmitted. Median direct cost in 2017 was $5291 (interquartile range : $3907–$7519), and estimated total cost to the hospital for the 2017 outbreak was $1.3 million.

Conclusions: Clinicians should be aware of measles complications and treatment. Public and private health efforts should continue to focus on immunization, given significant implications of measles infections for patients and healthcare systems. Future studies may assess complications of measles across the United States as individual outbreaks often occur in specific populations, making generalization of results challenging.

From the *Hospital Medicine

Research Institute

Infection Prevention and Control

§Infectious Diseases, Children’s Minnesota Minneapolis, MN.

Accepted for publication September 18, 2018.

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com).

Address for correspondence: Gabrielle Hester, MD, Department of Hospital Medicine, 2525 Chicago Ave S, Minneapolis, MN 55404. E-mail: gabrielle.hester@childrensmn.org.

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