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Measles
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==Prognosis== Most people survive measles, though in some cases, complications may occur. About 1 in 4 individuals will be hospitalized and 1–2 in 1,000 will die. Complications are more likely in children under age 5, adults over age 20, and pregnant people.<ref name=":13">{{Cite web |title=Management of Obstetric–Gynecologic Patients During a Measles Outbreak |url=https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2024/03/management-of-obstetric-gynecologic-patients-during-a-measles-outbreak |access-date=21 March 2025 |website=www.acog.org }}</ref><ref>{{cite web |title=Measles Complications |url=https://www.cdc.gov/measles/symptoms/complications.html |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=14 May 2019 |date=25 February 2019 |archive-date=19 November 2019 |archive-url=https://web.archive.org/web/20191119142611/https://www.cdc.gov/measles/symptoms/complications.html |url-status=live }}</ref> [[Pneumonia]] is the most common fatal complication of measles infection and accounts for 56–86% of measles-related deaths.<ref>{{Cite journal |last1=Di Pietrantonj |first1=Carlo |last2=Rivetti |first2=Alessandro |last3=Marchione |first3=Pasquale |last4=Debalini |first4=Maria Grazia |last5=Demicheli |first5=Vittorio |date=22 November 2021 |title=Vaccines for measles, mumps, rubella, and varicella in children |journal=The Cochrane Database of Systematic Reviews |volume=2021 |issue=11 |pages=CD004407 |doi=10.1002/14651858.CD004407.pub5 |issn=1469-493X |pmc=8607336 |pmid=34806766}}</ref> Possible consequences of measles virus infection include [[laryngotracheobronchitis]], [[sensorineural hearing loss]],<ref name=Cohen2014>{{cite journal | vauthors = Cohen BE, Durstenfeld A, Roehm PC | title = Viral causes of hearing loss: a review for hearing health professionals | journal = Trends in Hearing | volume = 18 | pages = 2331216514541361 | date = July 2014 | pmid = 25080364 | pmc = 4222184 | doi = 10.1177/2331216514541361 }}</ref> and—in about 1 in 10,000 to 1 in 300,000 cases<ref name=Noyce2012>{{cite journal | vauthors = Noyce RS, Richardson CD | title = Nectin 4 is the epithelial cell receptor for measles virus | journal = Trends in Microbiology | volume = 20 | issue = 9 | pages = 429–39 | date = September 2012 | pmid = 22721863 | doi = 10.1016/j.tim.2012.05.006 }}</ref>—[[Subacute sclerosing panencephalitis|panencephalitis]], which is usually fatal.<ref name="ninds.nih.gov">{{NINDS|subacute-sclerosing-panencephalitis|Subacute Sclerosing Panencephalitis}}</ref> Acute measles encephalitis is another serious risk of measles virus infection. It typically occurs two days to one week after the measles [[exanthem|rash]] breaks out and begins with very high fever, severe headache, [[convulsion]]s and altered mentation. A person with measles encephalitis may become [[coma]]tose, and death or brain injury may occur.<ref name="Merck Manual" /> For people having had measles, it is rare to ever have a symptomatic reinfection.<ref>{{cite journal | title = Recommendation of the Immunization Practices Advisory Committee (ACIP). Measles prevention | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 31 | issue = 17 | pages = 217–24, 229–31 | date = May 1982 | pmid = 6804783 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/00001090.htm | author1 = Centers for Disease Control (CDC) | access-date = 10 May 2019 | archive-date = 23 February 2021 | archive-url = https://web.archive.org/web/20210223235542/http://www.cdc.gov/mmwr/preview/mmwrhtml/00001090.htm | url-status = live }}</ref> The measles virus can deplete previously acquired [[Immunological memory|immune memory]] by killing cells that make antibodies, and thus weakens the immune system, which can cause deaths from other diseases.<ref name = Amnesia/><ref name="Mina 2019">{{cite journal | vauthors = Mina MJ, Kula T, Leng Y, Li M, de Vries RD, Knip M, Siljander H, Rewers M, Choy DF, Wilson MS, Larman HB, Nelson AN, Griffin DE, de Swart RL, Elledge SJ | title = Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens | journal = Science | volume = 366 | issue = 6465 | pages = 599–606 | date = 1 November 2019 | pmid = 31672891 | doi = 10.1126/science.aay6485 | pmc = 8590458 | issn = 0036-8075 | bibcode = 2019Sci...366..599M | hdl = 10138/307628 | doi-access = free | title-link = doi | access-date = 1 November 2019 }}</ref><ref name = Nature/> Suppression of the immune system by measles lasts about two years and has been epidemiologically implicated in up to 90% of childhood deaths in [[Third World|third world]] countries, and historically may have caused rather more deaths in the United States, the UK and Denmark than were directly caused by measles.<ref name="pmid25954009" >{{cite journal |title=Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality |journal=Science |date=May 2015 |doi=10.1126/science.aaa3662 |pmid=25954009 |pmc=4823017 |bibcode=2015Sci...348..694M |vauthors=Mina MJ, Metcalf CJ, de Swart RL, Osterhaus AD, Grenfell BT |volume=348 |issue=6235 |pages=694–9 | doi-access = free | title-link = doi }}</ref><ref>{{cite web | last=Bakalar | first=Nicholas | title=Measles May Increase Susceptibility to Other Infections | website=[[The New York Times]] | date=7 May 2015 | url=https://archive.nytimes.com/well.blogs.nytimes.com/2015/05/07/measles-may-increase-susceptibility-to-other-infections/ |access-date=7 June 2015 |archive-date=10 May 2015 |archive-url=https://web.archive.org/web/20150510032648/http://well.blogs.nytimes.com/2015/05/07/measles-may-increase-susceptibility-to-other-infections/ |url-status=live }}</ref> Although the measles vaccine contains an attenuated strain, it does not deplete immune memory.<ref name="Mina 2019"/>
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