Risk factors for severe measles

[ema-adama]

Most of the subjects (91. 1%) came from lower socio-economic levels, living in unfavorable environmental conditions in crowded housing.

http://cat.inist.fr/?aModele=afficheN&cpsidt=4656313

Does this mean anything about who is at risk for severe complications from measles?

[shuttlt]

Originally Posted by ema-adama

http://cat.inist.fr/?aModele=afficheN&cpsidt=4656313

Does this mean anything about who is at risk for severe complications from measles?

Surely this would be complicated by measles spreading more readily in crowded housing?

[Th1Th2]

Strictly speaking, measles is generally mild, self-limiting and uncomplicated. It has never been a fatal disease or severe in nature. Poor health and medical mismanagement of measles are the reasons for serious complications and other sequelae.

[shuttlt]

Originally Posted by Th1Th2

Strictly speaking, measles is generally mild, self-limiting and uncomplicated. It has never been a fatal disease or severe in nature. Poor health and medical mismanagement of measles are the reasons for serious complications and other sequelae.

I'm not denying the truth of what you say, but I would like to see a primary source for the claim that people only die from measles for these reasons.

[ema-adama]

Originally Posted by shuttlt

Surely this would be complicated by measles spreading more readily in crowded housing?

I am wondering what you mean by this?

[shuttlt]

Originally Posted by ema-adama

I am wondering what you mean by this?

Oh, just that (taking an extreme case) if 6 of you are sharing a room in a building where other people are doing the same I'd have thought illnesses will spread much more easily than if you live in less a crowded, wealthier part of town.

[shuttlt]

Maybe this was obvious from your initial post. The study didn't to me seem to be telling you that the odds of any given person infected with measles having complication was greater if they lived in poverty. It told you that a disproportionate number of people who end up with complications live in poverty. That might be due to more people living in poverty coming down with measles.

Perhaps that was your original point, perhaps I'm wrong.

[ema-adama]

Originally Posted by shuttlt

Maybe this was obvious from your initial post. The study didn't to me seem to be telling you that the odds of any given person infected with measles having complication was greater if they lived in poverty.

:

It told you that a disproportionate number of people who end up with complications live in poverty.

Sorry, I do not get what the difference is between the odds of having a complication if you live in poverty, and the disproportionate numbers of people living in poverty having complications. Can you explain some more? Surely there is a reason why the odds are higher if you live in poverty as a disproportionate number of people living in poverty have complications, as poverty is not conducive to good health.

That might be due to more people living in poverty coming down with measles.

Why would more people living in poverty come down with measles?

Perhaps that was your original point, perhaps I'm wrong.

My point was that it would seem that poverty is a factor when assessing who is at risk for severe complication.

[tmaue]

Originally Posted by ema-adama

hy would more people living in poverty come down with measles?

Assuming that people who live in poverty are not as healthy (due to malnutrition, possible dirty living conditions, possible exposure to unhealthy behaviors of those around them like smoking, etc.), I think this would put them at greater risk of coming down with measles sickness if exposed. But maybe not. There are always going to be people, who when exposed, don't come down with the sickness, but I guess it matters if this has anything to do with their overall health (at least in the measles case) or some other immune system function.

If makes sense that if those in poverty got sick, they would be sicker and have more complications due to health status.

[ema-adama]

Originally Posted by tmaue

If makes sense that if those in poverty got sick, they would be sicker and have more complications due to health status.

That is what I thought.

[shuttlt]

Let me just explain my thinking. Let's say for the sake of argument that rich and poor, people who live in castles and people who live one on top of another in slums have the same odds of getting complications if they come down with measles. Let's also assume that poor slum dwellers are much more likely, due to poor hygiene and close proximity to get infected with measles. In that case poor slum dwellers would show up as a disproportionate number of measles complications even though their odds of a complication once infected are the same.

Have I misread the study? Does anybody understand the distinction I'm trying to make? I don't have a fever any more so i can't use it as an excuse.

[shuttlt]

Originally Posted by ema-adama

Originally Posted by tmaue

If makes sense that if those in poverty got sick, they would be sicker and have more complications due to health status.

That is what I thought.

It makes sense to me too. But is it the case, and if so, how much. Perhaps they are fortunate enough to have vigorous, well stimulated immune systems unlike their rich pampered cousins?

[mamakay]

Originally Posted by shuttlt

Surely this would be complicated by measles spreading more readily in crowded housing?

Prevaccine in the US, pretty much everyone caught measles before age 10, rich and poor alike. Just like chickenpox was when we were kids. It's not like the rich kids just didn't catch it. It was never a "disease of poverty".

[shuttlt]

Originally Posted by mamakay

Prevaccine in the US, pretty much everyone caught measles before age 10, rich and poor alike. Just like chickenpox was when we were kids. It's not like the rich kids just didn't catch it. It was never a "disease of poverty".

Sure, I'm not arguing that they didn't. The question I am asking is are they just as likely? Is there no difference? It seems plausible that there might be. Does this difference account for the finding in the OP? Could it be enough to mask poor slum dwellers having stronger immune systems?

How about vaccination rates, are they the same across these groups?

[mamakay]

Originally Posted by shuttlt

Sure, I'm not arguing that they didn't. The question I am asking is are they just as likely? Is there no difference? It seems plausible that there might be. Does this difference account for the finding in the OP? Could it be enough to mask poor slum dwellers having stronger immune systems?

How about vaccination rates, are they the same across these groups?

Measles incidence by age 10 is about 100% regardless of socioecomonic background, so...yeah. Rich kids aren't less likely to catch measles. Overcrowding might make the poor kids catch it at an earlier age, though.

[mamakay]

http://www.mothering.com/discussions...hlight=measles

[mamakay]

New link, same info:

http://www.immunize.org/reports/report085.asp

Measles, itself, does not kill children. Instead, complications from measles attack the child's already weak immune system. Measles attacks the body, inside and out. It is similar to HIV in the sense that when it knocks down the immune system, the child becomes susceptible to the myriad of diseases that fester in poor living conditions.

[Juvysen]

I thought complications are often related to a vitamin A deficiency? Surely someone in poverty would be more likely to have that sort of a deficiency because access to healthy food would likely be less...

[ema-adama]

Originally Posted by shuttlt

Let me just explain my thinking. Let's say for the sake of argument that rich and poor, people who live in castles and people who live one on top of another in slums have the same odds of getting complications if they come down with measles.

I just do not see how they could have the same odds for complications when we know what puts you at risk regarding nutrition, access to health care and overall health. (all not good when you live in poverty)

Let's also assume that poor slum dwellers are much more likely, due to poor hygiene and close proximity to get infected with measles.

I do not think that would be the case. From what I have understood it is highly contagious and socioeconomics don't have much to do with getting measles, only with developing complications.

In that case poor slum dwellers would show up as a disproportionate number of measles complications even though their odds of a complication once infected are the same.

But that is not the case.

ETA: Juvysen - yes vit A is very much part of the picture.

[carriebft]

The recent measles deaths in Germany, France, and Switzerland were all in previously healthy kids living in developed countries. I don't think we can necesarily say that the deaths only happen to the poor kids.