Measles-related hospitalizations and associated complications in jerusalem, 2018-2019.

The 2018 measles outbreak in Israel has affected > 2000 patients in Jerusalem. The aim of the study was to describe clinical features and complications of hospitalized measles patients in Jerusalem, as related to age group and risk factors.All patients hospitalized with measles in the three main hospitals in Jerusalem during March 2018-February 2019 were included. Demographic, clinical and laboratory data were analyzed.Of 161 hospitalized patients, 86 (53.4%) were < 5y old, 16 (10%) were ≥ 5y-< 20y old, and 59 (36.6%) were ≥ 20y old. The majority, 114/135 (85%) were non-vaccinated. Immunocomromised state was identified in 12/161 (7.5%) patients, 20/161 (12.4%) had other underlying comorbidities, and four were pregnant. Hypoxemia on admission was a common finding in all age groups. Hepatitis was more common among adults ≥ 20y old (33/59, 59%). Measles-related complications were noted in 95/161 (59%) patients, and included pneumonia/pneumonitis (67/161, 41.6%), which was more common in young (<5y) children, diarrhea (18/161, 11.2%), otitis (18/161, 11.2%), and neurological complications (6/161, 3.7%) - the latter occurring more frequently in the 5-20y age group. Two of the 12 immunocompromised patients died of measles-related complications. A high re-admission rate (19/161, 11.8%) within 3 months was documented among hospitalized measles patients.The burden of hospitalization, as well as the high rate of short and long-term complications observed in hospitalized patients, underscore the importance of maintaining a high measles vaccine coverage, with enhanced targeting of un-vaccinated population-pockets.