Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008-2013

Marta Ciofi Degli Atti, Antonietta Filia, Antonino Bella, Annamaria Sisto, Maria Antonietta Barbieri, Antonino Reale, Massimiliano Raponi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The Lazio region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the emergency department (ED) of the largest pediatric hospital in Italy, located in Lazio.

METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home to assess possible determinants of hospital admission.

RESULTS: Of 248 patients with measles evaluated in the ED, 113 (45.6%) were admitted as inpatients. The number of measles cases peaked in 2011 (N = 122; 49.2%), when epidemics were reported in Lazio. Median age was 2.7 years (range: 21 days to 17.9 years), and 31 patients (13%) had an underlying chronic illness. The strongest independent predictor of hospitalization was having an underlying chronic illness [adjusted odd ratio (OR): 9.87; 95% confidence interval: 3.13-31.13]. Other factors independently and significantly associated with higher risk of hospitalization were taking medications at the time of ED visit, being younger than 1 year of age and having altered liver enzyme values. Eighty-five percent of children >15 months of age who were hospitalized were not vaccinated. One hundred six hospitalized children (94%) had at least 1 measles complication; 1 child required intensive care for respiratory insufficiency.

CONCLUSIONS: Hospitalizations of children with measles continue to occur in European areas where elimination has not been achieved. Children with chronic diseases represent a vulnerable population that is at higher risk of hospitalization.

Original languageEnglish
Pages (from-to)844-848
Number of pages5
JournalThe Pediatric infectious disease journal
Volume36
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Pediatric Hospitals
Measles
Italy
Hospital Emergency Service
Hospitalization
Chronic Disease
Inpatients
Hospitalized Child
Vulnerable Populations
Critical Care
Respiratory Insufficiency
Odds Ratio
Demography
Confidence Intervals
Liver
Enzymes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008-2013. / Ciofi Degli Atti, Marta; Filia, Antonietta; Bella, Antonino; Sisto, Annamaria; Barbieri, Maria Antonietta; Reale, Antonino; Raponi, Massimiliano.

In: The Pediatric infectious disease journal, Vol. 36, No. 9, 01.09.2017, p. 844-848.

Research output: Contribution to journalArticle

@article{6a376f13ba464406aefb7fd59a8eeba3,
title = "Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008-2013",
abstract = "BACKGROUND: The Lazio region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the emergency department (ED) of the largest pediatric hospital in Italy, located in Lazio.METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home to assess possible determinants of hospital admission.RESULTS: Of 248 patients with measles evaluated in the ED, 113 (45.6{\%}) were admitted as inpatients. The number of measles cases peaked in 2011 (N = 122; 49.2{\%}), when epidemics were reported in Lazio. Median age was 2.7 years (range: 21 days to 17.9 years), and 31 patients (13{\%}) had an underlying chronic illness. The strongest independent predictor of hospitalization was having an underlying chronic illness [adjusted odd ratio (OR): 9.87; 95{\%} confidence interval: 3.13-31.13]. Other factors independently and significantly associated with higher risk of hospitalization were taking medications at the time of ED visit, being younger than 1 year of age and having altered liver enzyme values. Eighty-five percent of children >15 months of age who were hospitalized were not vaccinated. One hundred six hospitalized children (94{\%}) had at least 1 measles complication; 1 child required intensive care for respiratory insufficiency.CONCLUSIONS: Hospitalizations of children with measles continue to occur in European areas where elimination has not been achieved. Children with chronic diseases represent a vulnerable population that is at higher risk of hospitalization.",
author = "{Ciofi Degli Atti}, Marta and Antonietta Filia and Antonino Bella and Annamaria Sisto and Barbieri, {Maria Antonietta} and Antonino Reale and Massimiliano Raponi",
year = "2017",
month = "9",
day = "1",
doi = "10.1097/INF.0000000000001609",
language = "English",
volume = "36",
pages = "844--848",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Measles Cases in Children Requiring Hospital Access in an Academic Pediatric Hospital in Italy, 2008-2013

AU - Ciofi Degli Atti, Marta

AU - Filia, Antonietta

AU - Bella, Antonino

AU - Sisto, Annamaria

AU - Barbieri, Maria Antonietta

AU - Reale, Antonino

AU - Raponi, Massimiliano

PY - 2017/9/1

Y1 - 2017/9/1

N2 - BACKGROUND: The Lazio region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the emergency department (ED) of the largest pediatric hospital in Italy, located in Lazio.METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home to assess possible determinants of hospital admission.RESULTS: Of 248 patients with measles evaluated in the ED, 113 (45.6%) were admitted as inpatients. The number of measles cases peaked in 2011 (N = 122; 49.2%), when epidemics were reported in Lazio. Median age was 2.7 years (range: 21 days to 17.9 years), and 31 patients (13%) had an underlying chronic illness. The strongest independent predictor of hospitalization was having an underlying chronic illness [adjusted odd ratio (OR): 9.87; 95% confidence interval: 3.13-31.13]. Other factors independently and significantly associated with higher risk of hospitalization were taking medications at the time of ED visit, being younger than 1 year of age and having altered liver enzyme values. Eighty-five percent of children >15 months of age who were hospitalized were not vaccinated. One hundred six hospitalized children (94%) had at least 1 measles complication; 1 child required intensive care for respiratory insufficiency.CONCLUSIONS: Hospitalizations of children with measles continue to occur in European areas where elimination has not been achieved. Children with chronic diseases represent a vulnerable population that is at higher risk of hospitalization.

AB - BACKGROUND: The Lazio region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the emergency department (ED) of the largest pediatric hospital in Italy, located in Lazio.METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home to assess possible determinants of hospital admission.RESULTS: Of 248 patients with measles evaluated in the ED, 113 (45.6%) were admitted as inpatients. The number of measles cases peaked in 2011 (N = 122; 49.2%), when epidemics were reported in Lazio. Median age was 2.7 years (range: 21 days to 17.9 years), and 31 patients (13%) had an underlying chronic illness. The strongest independent predictor of hospitalization was having an underlying chronic illness [adjusted odd ratio (OR): 9.87; 95% confidence interval: 3.13-31.13]. Other factors independently and significantly associated with higher risk of hospitalization were taking medications at the time of ED visit, being younger than 1 year of age and having altered liver enzyme values. Eighty-five percent of children >15 months of age who were hospitalized were not vaccinated. One hundred six hospitalized children (94%) had at least 1 measles complication; 1 child required intensive care for respiratory insufficiency.CONCLUSIONS: Hospitalizations of children with measles continue to occur in European areas where elimination has not been achieved. Children with chronic diseases represent a vulnerable population that is at higher risk of hospitalization.

UR - http://www.scopus.com/inward/record.url?scp=85029668234&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029668234&partnerID=8YFLogxK

U2 - 10.1097/INF.0000000000001609

DO - 10.1097/INF.0000000000001609

M3 - Article

C2 - 28426447

VL - 36

SP - 844

EP - 848

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 9

ER -