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. 2015 Dec;143(16):3434-41.
doi: 10.1017/S0950268815000631. Epub 2015 Apr 13.

Age-specific measles mortality during the late 19th-early 20th centuries

G D Shanks  1 , M Waller  2 , H Briem  3 , M Gottfredsson  3
Affiliations

Age-specific measles mortality during the late 19th-early 20th centuries

G D Shanks et al. Epidemiol Infect. 2015 Dec.

Abstract

Measles mortality fell prior to the introduction of vaccines or antibiotics. By examining historical mortality reports we sought to determine how much measles mortality was due to epidemiological factors such as isolation from major population centres or increased age at time of infection. Age-specific records were available from Aberdeen; Scotland; New Zealand and the states of Australia at the end of the 19th and beginning of the 20th centuries. Despite the relative isolation of Australia, measles mortality was concentrated in very young children similar to Aberdeen. In the more isolated states of Tasmania, Western Australia and Queensland adults made up 14-15% of measles deaths as opposed to 8-9% in Victoria, South Australia and New South Wales. Mortality in Iceland and Faroe Islands during the 1846 measles epidemic was used as an example of islands isolated from respiratory pathogens. The transition from crisis mortality across all ages to deaths concentrated in young children occurred prior to the earliest age-specific mortality data collected. Factors in addition to adult age of infection and epidemiological isolation such as nutritional status and viral virulence may have contributed to measles mortality outcomes a century ago.

Keywords: Epidemics; measles (rubeola).

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Figures

Fig. 1.
Fig. 1.
Measles mortality rate/100 000 population in the six states of Australia for the period 1889–1914.
Fig. 2.
Fig. 2.
Measles mortality by age in Australia 1889–1914 expressed as a percentage of all measles deaths in a particular state. (a) Victoria, New South Wales and Queensland; (b) Tasmania, Western Australia and South Australia. The apparent mortality increase at age 5 years is an artifact caused by a change from annual to 5-year intervals.
Fig. 3.
Fig. 3.
Measles morbidity (measles cases/100 000 population) and mortality (number of measles deaths) in Aberdeen, Scotland, 1883–1902.
Fig. 4.
Fig. 4.
Age-specific measles case-fatality rate by gender for Aberdeen, Scotland, from 1883 to 1902.
Fig. 5.
Fig. 5.
Mortality in Iceland (all-cause mortality) and the Faroe Islands (measles-specific mortality) during the 1846 measles epidemic.
See this image and copyright information in PMC

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