Drug related measles deaths
Measles  Drug reaction citations  [back] Infections from drugs/poisons

"About half the deaths from measles in the past were in children with illnesses like leukemia who could not be immunised because of the suppression of their immune system by disease or therapies such as anti-cancer drugs and steroids."--Paul Ince, Prof of neuropathology, Sheffield University

[Measles death June 2006]  The 13 year-old who died was particularly susceptible as he was being treated for a lung condition.   In 2006 there was one measles death in a 13 years old male who had an underlying lung condition and was taking immunosuppressive drugs. ref

C L MILLER. Deaths from measles in England and Wales, 1970-83. British Medical Journal, Vol 290, 9 February 1985  Fifty-three per cent of the 270 deaths occurred in individuals with no pre-existing condition......The pre-existing conditions in the 126 previously abnormal individuals included cerebral palsy (24), mental retardation (20), Down's syndrome (19) and various congenital abnormalities (22). There were nine children with immune deficiency or immunosuppression, and 19 aged 2-8 with lymphatic leukaemia, a number of them in remission.

"In his case, it wasn't down to his parents not giving him the vaccine because it was a contra-indication to other health problems he had. "He was admitted to hospital because of those problems and picked up the virus while on the paediatric ward."[Media Jun 21 2006]

Deltason/Orasone--generic name Prednisone, a steroid:  "Diseases such as chickenpox or measles can be very serious or even fatal in both children and adults who take this drug "--PDR

Breitfeld V, Hashida Y, Sherman FE, Odagiri K, Yunis EJ.   Fatal measles infection in children with leukemia. Lab Invest. 1973 Mar;28(3):279-91. No abstract available. PMID: 4348408 [PubMed - indexed for MEDLINE]

Chapnick EK, Gradon JD, Kim YD, Narvios A, Gerard P, Till M, Sepkowitz DV.   Fatal measles pneumonia in an immunocompetent patient--case report.Clin Infect Dis. 1992 Aug;15(2):377-9. No abstract available.PMID: 1520778 [PubMed - indexed for MEDLINE]

Drysdale HC, Jones LF, Oppenheimer DR, Tomlinson AH.  Measles inclusion-body encephalitis in a child with treated acute lymphoblastic leukaemia.J Clin Pathol. 1976 Oct;29(10):865-72. : 789401 [PubMed - indexed for MEDLINE]
A child with acute lymphoblastic leukaemia, being treated in the UKALL II Trial, had while in remission an attack of measles and made a normal recovery. Four months later she developed an acute encephalopathy and died within two weeks. The brain showed mild inflammatory features and widespread inclusion bodies in neurones and glial cells. Immunofluorescence proved an infection with measles virus. Similar cases have been called SSPE; reasons are given for preferring the term "measles inclusion-body encephalitis".

Gray MM, Hann IM, Glass S, Eden OB, Jones PM, Stevens RF.  Mortality and morbidity caused by measles in children with malignant disease attending four major treatment centres: a retrospective review. Br Med J (Clin Res Ed). 1987 Jul 4;295(6589):19-22. PMID: 3113597
Measles is a major cause of mortality and morbidity in children receiving treatment for leukaemia. A review was made of all the documented cases of measles in children in first remission from acute lymphoblastic leukaemia at four major treatment centres in 1974-84. Over the 11 years reviewed 1043 children with acute lymphoblastic leukaemia were referred to these centres. Fifty one (4.9%) died while in first remission and 15 (29.4%) of these deaths were due to measles or its complications: 12 cases of pneumonia, 10 of them fatal; and six cases of encephalitis, five of them fatal and the sixth child left severely handicapped. These children would have had at least a 50% chance of long term survival. The severity of measles in the immunocompromised patient reinforces the need to improve the poor uptake of measles immunisation in Britain.

Machado CM, Goncalves FB, Pannuti CS, Dulley FL, de Souza VA.  Measles in bone marrow transplant recipients during an outbreak in Sao Paulo, Brazil. Blood. 2002 Jan 1;99(1):83-7. PMID: 11756156 [PubMed - indexed for MEDLINE]

Martin LT, Counahan R, Tait R, Cosgrove JF.  Fatal measles giant cell pneumonia.Ir Med J. 1982 Jul;75(7):252-3. No abstract available.PMID: 7129845 [PubMed - indexed for MEDLINE]

Pullan CR, Noble TC, Scott DJ, Wisniewsk K, Gardner PS.   Atypical measles infections in leukaemic children on immunosuppressive treatment.Br Med J. 1976 Jun 26;1(6025):1562-5.PMID: 1064463 [PubMed - indexed for MEDLINE]
One case of giant-cell pneumonia and two of encephalopathy, all due to measles infection in children in leukaemic remission on immunosuppressive treatment, were seen recently. The clinical syndromes were variable and atypical and the antibody responses unpredictable. Conventional doses of pooled immunoglobulin failed to protect the two children to whom it was given. Degeneration rather than inflammation seems to characterise the encephalopathy in immunosuppressed children infected with measles virus.

Smyth D, Tripp JH, Brett EM, Marshall WC, Almeida J, Dayan AD, Coleman JC, Dayton R.  Letter: Atypical measles encephalitis in leukaemic children in remission.Lancet. 1976 Sep 11;2(7985):574. No abstract available.PMID: 60648 [PubMed - indexed for MEDLINE]
Fatal measles pneumonia developed in a 7-year-old boy who was in complete remission from acute lymphoblastic leukemia. There was no detectable antibody titer in two specimens taken eight days apart. Measles virus was grown from a lung biopsy taken shortely after hospital admission. Classical measles had been diagnosed in the patient and his siblings nine months previously. Immunosuppressed children who do not develop an antibody rise after a measles infection are at risk of later development of measles giant cell pneumonia. Suggestions are offered for the prevention of this often fatal complication.

Siegel MM, Walter TK, Ablin AR.  Measles pneumonia in childhood leukemia.Pediatrics. 1977 Jul;60(1):38-40.PMID: 267267

Sobonya RE, Hiller FC, Pingleton W, Watanabe I.  Fatal measles (rubeola) pneumonia in adults.Arch Pathol Lab Med. 1978 Jul;102(7):366-71. PMID: 580870 [PubMed - indexed for MEDLINE]
Fatal measles (rubeola) pneumonia, confirmed by viral culture and electron microscopy, occurred in a previously healthy 19-year-old man. Autopsy disclosed measles pneumonia but no recognizable disease that would predispose to such an infection. However, the prolonged course of the measles infection and very low levels of serum antibodies to measles indicate that an immune deficient state existed. Nearly all other adults dying of measles pneumonia have had impairment of the immune system, typically due to a lymphatic or hematologic malignant neoplasm treated with chemotherapy. An immunodeficient state may be a precondition for death from measles pneumonia in adults. Enlargement of air spaces with fibrosis in the anterior portions of both lungs is suspected to be due to tissue necrosis and high mechanical ventilatory pressures.

Vannier JP, Janvresse C, Tron P.  [Regressive acute neurologic complication and measles in lymphoblastic leukemia]Presse Med. 1983 Sep 10;12(31):1936. French. No abstract available.PMID: 6226006 [PubMed - indexed for MEDLINE]
Measles encephalopathy during immunosuppression (MEI) occurs in patients with immunologic defects and is fatal. The course of the disease in 2 children, 4 and 5 years old, in the remission phase of acute lymphatic leukemia is presented. Diagnosis was possible, post-mortem, by recognition of measles virus antigen in brain tissue and in one patient by demonstration of intrathecal production of measles antibodies. Treatment with interferon did not improve the condition. Preventive measures primarily by early immunization of the childhood population against measles is stressed.

Szajner-Milart I, Pakula J.  [Giant-cell pneumonia during measles in a leukemic child]  Pol Tyg Lek. 1973 May 23;28(17):613-5. Polish. No abstract available. PMID: 4514530 [PubMed - indexed for MEDLINE]

[No authors listed]  Editorial: Measles encephalitis during immunosuppressive treatment.Br Med J. 1976 Jun 26;1(6025):1552. No abstract available.PMID: 1064462 [PubMed - indexed for MEDLINE]

Olding-Stenkvist E, Forsgren M, Henley D, Kreuger A, Lundmark KM, Nilsson A, Wadell G.   Measles encephalopathy during immunosuppression: failure of interferon treatment. Scand J Infect Dis. 1982;14(1):1-4. PMID: 6176019 [PubMed - indexed for MEDLINE]

Loirat C, Danon F, Broyer M.  [Subacute sclerosing panencephalitis appearing during nephrotic syndrome treated with immunosuppressive agents] Arch Fr Pediatr. 1971 Dec;28(10):1083-91. French. No abstract available. PMID: 5150494 [PubMed - indexed for MEDLINE]

Paine TF Jr.  Letter: Possible adverse effect of prednisone in SSPE.N Engl J Med. 1974 Jun 6;290(23):1326. No abstract available.PMID: 4827637