Drug related measles deaths
Measles Drug reaction citations
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"About half the deaths from measles in the past were in children with illnesses like leukemia who could not be immunised because of the suppression of their immune system by disease or therapies such as anti-cancer drugs and steroids."--Paul Ince, Prof of neuropathology, Sheffield University
[Measles death June 2006]
The 13 year-old who died was particularly susceptible as he was
being treated for a lung condition.
In 2006 there was one measles death in a 13 years old male who had an underlying
lung condition and was taking immunosuppressive drugs.
ref
C L MILLER. Deaths from measles in England and Wales, 1970-83. British Medical Journal, Vol 290, 9 February 1985 Fifty-three per cent of the 270 deaths occurred in individuals with no pre-existing condition......The pre-existing conditions in the 126 previously abnormal individuals included cerebral palsy (24), mental retardation (20), Down's syndrome (19) and various congenital abnormalities (22). There were nine children with immune deficiency or immunosuppression, and 19 aged 2-8 with lymphatic leukaemia, a number of them in remission.
"In his case, it wasn't down to his parents not giving him the vaccine because it was a contra-indication to other health problems he had. "He was admitted to hospital because of those problems and picked up the virus while on the paediatric ward."[Media Jun 21 2006]
"About half the deaths from measles in the past were in children with illnesses like leukemia who could not be immunised because of the suppression of their immune system by disease or therapies such as anti-cancer drugs and steroids."--Paul Ince, Prof of neuropathology, Sheffield University
Citations
Deltason/Orasone--generic name Prednisone, a steroid: "Diseases such
as chickenpox or measles can be very serious or even fatal in both children and adults who
take this drug "--PDR
Breitfeld V, Hashida Y, Sherman FE, Odagiri K, Yunis EJ. Fatal measles infection in children with leukemia. Lab Invest. 1973 Mar;28(3):279-91. No abstract available. PMID: 4348408 [PubMed - indexed for MEDLINE]
Chapnick EK, Gradon JD, Kim YD, Narvios A, Gerard P, Till M, Sepkowitz DV. Fatal measles pneumonia in an immunocompetent patient--case report.Clin Infect Dis. 1992 Aug;15(2):377-9. No abstract available.PMID: 1520778 [PubMed - indexed for MEDLINE]
Drysdale
HC, Jones LF, Oppenheimer DR, Tomlinson AH. Measles inclusion-body
encephalitis in a child with treated acute lymphoblastic leukaemia.J
Clin Pathol. 1976 Oct;29(10):865-72. : 789401 [PubMed - indexed for MEDLINE]
A child with acute lymphoblastic leukaemia, being treated in the UKALL II Trial,
had while in remission an attack of measles and made a normal recovery. Four months later
she developed an acute encephalopathy and died within two weeks. The brain showed mild
inflammatory features and widespread inclusion bodies in neurones and glial cells.
Immunofluorescence proved an infection with measles virus. Similar cases have been called
SSPE; reasons are given for preferring the term "measles inclusion-body
encephalitis".
Gray
MM, Hann IM, Glass S, Eden OB, Jones PM, Stevens RF. Mortality and
morbidity caused by measles in children with malignant disease attending four major
treatment centres: a retrospective review. Br Med J (Clin Res Ed).
1987 Jul 4;295(6589):19-22. PMID: 3113597
Measles is a major cause of mortality and morbidity in children receiving treatment
for leukaemia. A review was made of all the documented cases of measles in children in
first remission from acute lymphoblastic leukaemia at four major treatment centres in
1974-84. Over the 11 years reviewed 1043 children with acute lymphoblastic leukaemia were
referred to these centres. Fifty one (4.9%) died while in first remission and 15 (29.4%)
of these deaths were due to measles or its complications: 12 cases of pneumonia, 10 of
them fatal; and six cases of encephalitis, five of them fatal and the sixth child left
severely handicapped. These children would have had at least a 50% chance of long term
survival. The severity of measles in the immunocompromised patient reinforces the need to
improve the poor uptake of measles immunisation in Britain.
Machado CM, Goncalves FB, Pannuti CS, Dulley FL, de Souza VA. Measles in bone marrow transplant recipients during an outbreak in Sao Paulo, Brazil. Blood. 2002 Jan 1;99(1):83-7. PMID: 11756156 [PubMed - indexed for MEDLINE]
Martin LT, Counahan R, Tait R, Cosgrove JF. Fatal measles giant cell pneumonia.Ir Med J. 1982 Jul;75(7):252-3. No abstract available.PMID: 7129845 [PubMed - indexed for MEDLINE]
Pullan CR, Noble TC, Scott DJ, Wisniewsk K, Gardner PS.
Atypical measles infections in leukaemic children on immunosuppressive treatment.Br Med J. 1976 Jun 26;1(6025):1562-5.PMID: 1064463 [PubMed - indexed for MEDLINE]
One case of giant-cell pneumonia and two of encephalopathy, all due to measles infection
in children in leukaemic remission on immunosuppressive treatment, were seen recently. The
clinical syndromes were variable and atypical and the antibody responses unpredictable.
Conventional doses of pooled immunoglobulin failed to protect the two children to whom it
was given. Degeneration rather than inflammation seems to characterise the encephalopathy
in immunosuppressed children infected with measles virus.
Smyth D, Tripp JH, Brett EM, Marshall WC, Almeida J, Dayan AD, Coleman JC, Dayton
R. Letter: Atypical measles encephalitis in leukaemic children in
remission.Lancet. 1976 Sep 11;2(7985):574. No abstract
available.PMID: 60648 [PubMed - indexed for MEDLINE]
Fatal measles pneumonia developed in a 7-year-old boy who was in complete remission
from acute lymphoblastic leukemia. There was no detectable antibody titer in two specimens
taken eight days apart. Measles virus was grown from a lung biopsy taken shortely after
hospital admission. Classical measles had been diagnosed in the patient and his siblings
nine months previously. Immunosuppressed children who do not develop an antibody rise
after a measles infection are at risk of later development of measles giant cell
pneumonia. Suggestions are offered for the prevention of this often fatal complication.
Siegel MM, Walter TK, Ablin AR. Measles pneumonia in childhood leukemia.Pediatrics. 1977 Jul;60(1):38-40.PMID: 267267
Sobonya
RE, Hiller FC, Pingleton W, Watanabe I. Fatal measles (rubeola)
pneumonia in adults.Arch Pathol Lab Med. 1978 Jul;102(7):366-71.
PMID: 580870 [PubMed - indexed for MEDLINE]
Fatal measles (rubeola) pneumonia, confirmed by viral culture and electron
microscopy, occurred in a previously healthy 19-year-old man. Autopsy disclosed measles
pneumonia but no recognizable disease that would predispose to such an infection. However,
the prolonged course of the measles infection and very low levels of serum antibodies to
measles indicate that an immune deficient state existed. Nearly all other adults dying of
measles pneumonia have had impairment of the immune system, typically due to a lymphatic
or hematologic malignant neoplasm treated with chemotherapy. An immunodeficient state may
be a precondition for death from measles pneumonia in adults. Enlargement of air spaces
with fibrosis in the anterior portions of both lungs is suspected to be due to tissue
necrosis and high mechanical ventilatory pressures.
Vannier
JP, Janvresse C, Tron P. [Regressive acute neurologic complication
and measles in lymphoblastic leukemia]Presse Med. 1983 Sep
10;12(31):1936. French. No abstract available.PMID: 6226006 [PubMed - indexed for MEDLINE]
Measles encephalopathy during immunosuppression (MEI) occurs in patients with
immunologic defects and is fatal. The course of the disease in 2 children, 4 and 5 years
old, in the remission phase of acute lymphatic leukemia is presented. Diagnosis was
possible, post-mortem, by recognition of measles virus antigen in brain tissue and in one
patient by demonstration of intrathecal production of measles antibodies. Treatment with
interferon did not improve the condition. Preventive measures primarily by early
immunization of the childhood population against measles is stressed.
Szajner-Milart I, Pakula J. [Giant-cell pneumonia during measles in a leukemic child] Pol Tyg Lek. 1973 May 23;28(17):613-5. Polish. No abstract available. PMID: 4514530 [PubMed - indexed for MEDLINE]
[No authors listed] Editorial: Measles encephalitis during immunosuppressive treatment.Br Med J. 1976 Jun 26;1(6025):1552. No abstract available.PMID: 1064462 [PubMed - indexed for MEDLINE]
Olding-Stenkvist E, Forsgren M, Henley D, Kreuger A, Lundmark KM, Nilsson A, Wadell G. Measles encephalopathy during immunosuppression: failure of interferon treatment. Scand J Infect Dis. 1982;14(1):1-4. PMID: 6176019 [PubMed - indexed for MEDLINE]
SSPE
Loirat
C, Danon F, Broyer M. [Subacute sclerosing panencephalitis
appearing during nephrotic syndrome treated with immunosuppressive agents] Arch Fr Pediatr. 1971 Dec;28(10):1083-91. French. No abstract available. PMID:
5150494 [PubMed - indexed for MEDLINE]
Paine TF Jr. Letter: Possible adverse effect of prednisone in SSPE.N Engl J Med. 1974 Jun 6;290(23):1326. No abstract available.PMID: 4827637
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