Frequency of Complications of Measles, 1963

Recent advances in the development of measles vaccines give reason to expect that an acceptable, safe, and effective means of immunization will soon become available. But "the need or desire" for large-scale vaccination in this country is subject to debate (British Medical 7ournal, 1963b). One of the major sources of doubt about the need for immunization stems from the belief among many parents and doctors that measles is a mild disease in which serious complications are rare and almost never fatal in normal children. Deaths have indeed declined rapidly in recent years to about 2 per 10,000 notifications, and a recent study has shown that about half the deaths occur in persons with serious chronic disease or disability (Report, 1963). Little information is available, however, about the frequency of serious complications and consequent permanent disabilities which maay result, especially from neurological complications, in patients who survive. Estimates based only on clinical impression are likely to be misleading and a numerically important minority may easily be overlooked. An investigation by a study group of the College of General Practitioners (1956, 1957), devoted primarily to a study of the place of chemotherapy and antibiotics in the management of measles, added much to knowledge of the disease, but it included fewer than 5,000 cases -too few to assess with confidence the public health importance of the complications of measles in relation to the need for immunization.