Increased measles mortality in households with multiple cases in the Gambia, 1981.

Analysis of previously collected data from measles outbreaks in three Gambian villages demonstrated that an age of less than 3 years was the primary risk factor for death in the months following measles infection. No association was found between overall measles mortality and size of household or number of measles cases in a household. When the analysis was confined to patients less than 3 years of age (i.e., those most likely to die), measles mortality was strongly associated with the occurrence of more than five measles cases in a household. Intensive exposure to measles virus may, therefore, be a secondary risk factor for death following measles. Reducing measles mortality by altering social patterns and elevating socioeconomic status to reduce exposure to the virus is beyond the scope of most public health programs. Age-appropriate immunization, therefore, remains the principal strategy for preventing death following measles.