Burden and clinical characteristics of measles in pre-vaccination age infants

Background: Measles remains an important cause of childhood morbidity, particularly among infants who are below the routine age for measles-rubella vaccination. These infants may be vulnerable because of declining maternal antibodies and absence of vaccine-derived protection. This study assessed the burden and clinical characteristics of measles among hospitalized children, with particular attention to the pre-vaccination-age group. Methods: This hospital-based cross-sectional study was conducted in the Department of Pediatrics, Mugda Medical College Hospital, Dhaka, from March 2026 to May 2026. A total of 300 children aged 1 month to 12 years admitted to the measles isolation ward were included. Data on demographic characteristics, age, clinical manifestations, complications, management and outcomes were collected using a structured proforma. Measles was diagnosed according to the WHO clinical case definition. Results: Males constituted 61.7% of participants, while 38.3% were female. Infants younger than 1 year represented 57.1% of cases, including 102 (34.0%) infants below 9 months. Fever and rash were present in all patients. Cough, coryza and conjunctivitis were reported in 82.7%, 78.9% and 73.7%, respectively. Pneumonia was the most frequent complication, affecting 63.9% of patients, followed by diarrhea (45.1%) and vomiting (30.1%). All patients received supportive care, while 18.8% required oxygen therapy. ICU admission was required in 0.72% and mortality was 1.0%. Conclusions: Measles caused substantial morbidity among hospitalized children, with pre-vaccination-age infants comprising a considerable proportion of cases. Early recognition, prompt supportive management and strengthened preventive strategies are essential to reduce severe measles-related outcomes.