title: South African measles outbreak 2009 - 2010 as experienced by a paediatric hospital.
abstract: BACKGROUND
  Between 2009 and 2010, South Africa experienced a major measles outbreak, with more than 18 000 confirmed cases reported to the National Institute of Communicable Diseases.
  
  
  METHODS
  We studied measles admissions during the outbreak to Red Cross War Memorial Children's Hospital, Cape Town, between 1 November 2009 and 31 July 2010. Factors associated with mortality were retrospectively identified from notification records and hospital admissions data. Multivariate logistic regression was used to investigate potential risk factors for death.
  
  
  RESULTS
  In total, 1 861 children were diagnosed with measles; 552 (30%) were admitted to hospital. The most common reason for admission was pneumonia (379 (68%)) and/or diarrhoea (262 (48%)). The median age at admission was 7.36 months (interquartile range (IQR) 5.0 - 10.7). The median duration of admission was 4 days (IQR 2 - 6); total hospital admission time was 3 746 days (10.3 child-years). HIV status was known in 404 (73%) children: 39/400 (14%) were HIV-infected. Eighteen children died (3% of all admissions); 15 (83%) of them were less than 1 year old. In the regression model, HIV-infection (adjusted odds ratio (aOR) 7.55, 95% confidence interval (CI) 2.27 - 25.12) and female sex (aOR 3.86, 95% CI 1.26 - 11.84) were associated with higher odds of death.
  
  
  CONCLUSIONS
  There was a large paediatric admission burden during the 2009 - 2010 measles outbreak in Cape Town; young children were predominantly affected. HIV-infected children had a significantly higher case fatality.
authors.affiliation: Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. DrDaveleRoux@gmail.com
authors.forename: David M
authors.initials: DM
authors.lastname: le Roux
authors.forename: Stanzi M
authors.initials: SM
authors.lastname: le Roux
authors.forename: James J
authors.initials: JJ
authors.lastname: Nuttall
authors.forename: Brian S
authors.initials: BS
authors.lastname: Eley
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000458:organization & administration; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology*; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology