Brote de sarampión en Barcelona. Características clínicas y epidemiológicas

Introduction: Measles is an acute, highly contagious illness that affects humans, the only natural host. Although effective attenuated virus vaccines exist for this disease, outbreaks continue to occur in susceptible subgroups. From August 2006 to July 2007, an outbreak of measles occurred in the Barcelona (Spain) area, resulting from an imported case. The aim of this study was to describe the clinical and epidemiological characteristics of children with microbiologically confirmed measles diagnosed at our hospital. Methods: Retrospective, descriptive study. The clinical histories and emergency records of children diagnosed with measles and evaluated at our hospital during the outbreak were analyzed. Results: Of the 130 children with suspected measles evaluated, 99 cases were confirmed by laboratory tests. Median age at diagnosis was 12.4 months (25th-75th percentile: 9.6-14.4 months; 74.6% 6-15 months of age) and 51.4% were boys. Among the total, 23.6% of patients had been vaccinated against measles and 55.3% reported previous contact with a confirmed measles case. The most frequent symptoms/signs were fever (100%; mean evolution 4.3 days (standard deviation [SD]: 2.2 days), rash (82.7%), Koplik's spots (60.2%), and red eyes (59.2%). Complementary tests were performed in 35.7% of children. Most common complications were acute otitis media (20.4%) and pneumonia (15.3%). Among the total, 23.5% of patients were hospitalized for a mean duration of 6.6 days (SD: 3.6 days). Conclusion: Geographical mobility facilitates the reappearance of diseases having a low incidence. Infants 6-15 months of age were the patient group most highly affected by the measles outbreak. Most cases were diagnosed with typical signs and symptoms of the infection, but as the outbreak advanced, patients were diagnosed based on less specific symptoms because of the epidemiological context.