Post-measles pneumonia: Risks, symptoms and prevention
Vaccination remains the most effective preventive measure, says child health specialist Md Kamruzzaman Kamrul.
A recent surge in Measles infections among children in Bangladesh has heightened concerns over post-measles pneumonia, a potentially life-threatening complication, according to child health specialist Md Kamruzzaman Kamrul.
Dr Kamruzzaman, assistant professor at the Bangladesh Shishu Hospital and Institute, tells The Business Standard that measles remains a highly contagious viral disease that typically presents with fever, cough, runny nose, red eyes and skin rashes, spreading through respiratory droplets and close contact.
"There is no specific antiviral treatment for measles. Symptoms are managed with rest, fluids and medications such as paracetamol or ibuprofen under medical supervision," he says.
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Measles-like illness
He explains that measles-like illnesses, often referred to as "para measles," show similar symptoms – fever, cough, runny nose, red eyes and rash – but may be caused by other viruses such as rubella, adenovirus, enterovirus, parvovirus B19 and human herpesvirus 6.
These infections spread through coughing, sneezing, close contact and crowded environments like schools and daycare centres, he says, adding that children under five, those who are malnourished and unvaccinated, are most at risk.
Post-measles pneumonia
Dr Kamruzzaman describes post-measles pneumonia as the most severe complication of measles.
It occurs when a lung infection develops after measles, he states, adding that it can be caused directly by the virus or by secondary bacterial infection due to weakened immunity.
Common bacterial causes include Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae, he says.
Global and local context
Citing the World Health Organization, he says measles is among the most contagious diseases, with one infected person capable of transmitting the virus to up to 90% of susceptible individuals.
Globally, around 9 million people are infected each year and more than 100,000 die, mostly due to complications like pneumonia, the physician adds.
In Bangladesh, despite vaccination efforts under the Expanded Programme on Immunization, outbreaks still occur due to gaps in immunisation, malnutrition, high population density and cross-border transmission.
About 5–6% of children with measles in Bangladesh develop pneumonia, which is a leading cause of death in severe cases, Kamruzzaman states.
Why children are vulnerable
The measles virus suppresses the immune system by reducing T-cells, weakening macrophage function and diminishing antibody responses, Dr Kamruzzaman says.
This makes children more vulnerable to pneumonia and other infections, the doctor adds.
Symptoms to watch
He advises parents to monitor key symptoms.
During measles:
- Fever, cough, runny nose
- Red eyes and rash
- Koplik spots
If pneumonia develops:
- Rapid breathing
- Chest indrawing
- Low oxygen levels
- Worsening cough
Prevention and treatment
Dr Kamruzzaman stresses that vaccination remains the most effective preventive measure.
In Bangladesh, children receive the MR vaccine at nine months and a booster at 15 months, he mentions.
He also emphasises the importance of vitamin A supplementation, proper nutrition and infection control.
For post-measles pneumonia, treatment may include oxygen therapy, broad-spectrum antibiotics, vitamin A and supportive care, he adds.
He warns that measles remains a serious infectious disease and that timely vaccination, nutrition and early treatment are crucial to reducing child mortality.
