Особливості Клінічних Проявів Та Перебігу Кору

Abstract

Проведено огляд літератури стосовно особливостей клінічних проявів, перебігу кору за останні роки під час епідемії у країнах Європи, а також подано результати особистих досліджень щодо хворих, які лікувались у лікувальних закладах України.

Current course of measles in adults (a literature review)

“…In another French study [32], the development of pneumonia was noted in 31% of adult patients with measles, 72 % of whom needed oxygen therapy. In Ukraine, in 2017-2018, the analysis of measles complications in the military showed the development of pneumonia in 20 % of cases, while in the cohort study patients with measles had a mild-to-moderate course [14]. All while, the researchers noted that pneumonia was suspected in these patients with measles based on the presence of decreased breath sounds in the lower lung fields in the absence of wheezing, and confirmation of it required not only a chest X-ray examination in a number of cases, but also a computer tomography [14].…”

“…In Ukraine, in 2017-2018, the analysis of measles complications in the military showed the development of pneumonia in 20 % of cases, while in the cohort study patients with measles had a mild-to-moderate course [14]. All while, the researchers noted that pneumonia was suspected in these patients with measles based on the presence of decreased breath sounds in the lower lung fields in the absence of wheezing, and confirmation of it required not only a chest X-ray examination in a number of cases, but also a computer tomography [14]. At the same time, the frequency of pneumonia in children was 4.5 % during the period of measles outbreak in 2017-2018, while the vast majority of these children was over 12 years old [10].…”

“…From 2005-2006, in Europe, there were also sporadic cases of measles due to another imported virus D4 genotype. This genotype is endemic for India, Eastern and Southern Africa, and the Middle East [14]. The effectiveness of post-vaccinal immunity against measles in relation to the level of viruses with different genotypes neutralization by post-vaccine antibody response is still an open question [4,15].…”

“…In the examination of 140 patients with measles, the development of hepatitis manifested by a cytolytic syndrome without clinical symptoms was observed only in 1.4 % of patients aged 15 and 17 years [10]. In modern scientific literature there is little information about the liver damage in adults with measles, but they all indicate a high incidence of hepatitis in adult measles patients [14,[34][35][36]. Analysis of the course of measles in 65 adults in the 1980s allowed the authors to show the dependence of hepatitis frequency on the disease severity [35].…”

“…In the 1990s, Mexican researchers analyzing the course of measles in 201 adults recorded hepatitis in 45 % of patients [36]. In conditions of the current course of measles, the development of hepatitis in adult patients, most authors note much more often the liver damage [14,34]. In the work of French researchers [34], the analysis of measles course in 80 adult patients with a mean age of 30.1 years showed 81 % of hepatitis patients with ALT elevation and in some patients up to a significant level, namely 5 times more than normal in 22.2 % and 10 times more -in 6.2 % of patients.…”