Van Den Hof Susan, Smit Colette, Van Steenbergen Jim E, De Melker Hester E
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Pediatr Infect Dis J. 2002 Dec;21(12):1146-50. doi: 10.1097/00006454-200212000-00012.
A measles epidemic occurred in the Netherlands in 1999 to 2000. We collected data on hospitalized and deceased cases to inform the public about the risks associated with measles infection.
From the National Medical Registration we extracted hospital discharge diagnoses for measles-related hospitalizations (International Classification of Diseases, 9th revision, Clinical Modification Code 055) during the measles epidemic (April 1999 to May 2000). We also reviewed hospital records to assess reasons for hospitalization and severity of disease as a result of measles infection during this epidemic. In addition we estimated the total number of hospitalized cases by a capture-recapture approach using two surveillance sources.
Measles without mention of complication (39%) and postmeasles pneumonia (33%) were most often registered as main discharge diagnoses for the 130 cases in the National Medical Registration. Forty-seven (96%) of the 49 patients whose hospital charts were reviewed were not vaccinated. Median admission period was 5 (range, 1 to 26) days, 19 (38%) required mechanical ventilation and 14 (29%) had sequelae at the time of discharge but none was permanent. Three patients died as a result of complications. No association was observed between preexisting illness and either reason for admission (P = 0.5) or residual symptoms at discharge (P = 0.5). The estimated total number of hospitalized measles patients was 157 (95% confidence interval, 145 to 179), leading to an estimated 825 admission days during an epidemic in which 3,292 cases were reported.
Measles infection can still run a severe course even in a prosperous country.
1999年至2000年荷兰发生了麻疹疫情。我们收集了住院和死亡病例的数据，以便向公众通报与麻疹感染相关的风险。
我们从国家医疗登记处提取了麻疹疫情期间（1999年4月至2000年5月）与麻疹相关住院治疗的医院出院诊断信息（国际疾病分类，第9版，临床修订版代码055）。我们还查阅了医院记录，以评估此次疫情期间因麻疹感染而住院的原因和疾病严重程度。此外，我们使用两种监测来源，通过捕获-再捕获方法估计了住院病例的总数。
在国家医疗登记处登记的130例病例中，未提及并发症的麻疹（39%）和麻疹后肺炎（33%）最常被登记为主要出院诊断。在查阅的49份病历中，有47例（96%）患者未接种疫苗。中位入院时间为5天（范围1至26天），19例（38%）需要机械通气，14例（29%）出院时有后遗症，但均非永久性后遗症。3例患者因并发症死亡。未观察到既往疾病与入院原因（P = 0.5）或出院时残留症状（P = 0.5）之间存在关联。估计麻疹住院患者总数为157例（95%置信区间，145至179），在报告了3292例病例的疫情期间，估计住院天数为825天。
即使在一个繁荣的国家，麻疹感染仍可能导致严重病程。
