Measles epidemics of variable lethality in the early 20th Century

Shanks, G. Dennis, Hu, Zheng, Waller, Michael, Lee, Seung-eun, Terfa, Daniel, Howard, Alan, van Heyningen, Elizabeth and Brundage, John F. (2014) Measles epidemics of variable lethality in the early 20th Century. American Journal of Epidemiology, 179 4: 413-422. doi:10.1093/aje/kwt282

Author Shanks, G. Dennis
Hu, Zheng
Waller, Michael
Lee, Seung-eun
Terfa, Daniel
Howard, Alan
van Heyningen, Elizabeth
Brundage, John F.
Title Measles epidemics of variable lethality in the early 20th Century
Journal name American Journal of Epidemiology   Check publisher's open access policy
ISSN 0002-9262
Publication date 2014-02-15
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1093/aje/kwt282
Open Access Status DOI
Volume 179
Issue 4
Start page 413
End page 422
Total pages 10
Place of publication Cary, NC, United States
Publisher Oxford University Press
Language eng
Abstract Until the mid-20th century, mortality rates were often very high during measles epidemics, particularly among previously isolated populations (e.g., islanders), refugees/internees who were forcibly crowded into camps, and military recruits. Searching for insights regarding measles mortality rates, we reviewed historical records of measles epidemics on the Polynesian island of Rotuma (in 1911), in Boer War concentration camps (in 1900-1902), and in US Army mobilization camps during the First World War (in 1917-1918). Records classified measles deaths by date and clinical causes; by demographic characteristics, family relationships (for Rotuma islanders and Boer camp internees), and prior residences; and by camp (for Boer internees and US Army recruits). During the Rotuman and Boer War epidemics, measles-related mortality rates were high (up to 40%); however, mortality rates differed more than 10-fold across camps/districts, even though conditions were similar. During measles epidemics, most deaths among camp internees/military recruits were due to secondary bacterial pneumonias; in contrast, most deaths among Rotuman islanders were due to gastrointestinal complications. The clinical expressions, courses, and outcomes of measles during first-contact epidemics differ from those during camp epidemics. The degree of isolation from respiratory pathogens other than measles may significantly determine measles-related mortality risk.
Keyword Boer War
US Army
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published online: 26 November 2013.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Public Health Publications
Centre for Military and Veterans' Health Publications
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