MEASLES AND MALNUTRITION

Measles is an important acute childhood viral infection having severe consequences on the nutritional status. The adverse nutritional effect s of measles are experienced by both the well-nourished and the malnou rished children. However, the severe nutritional deficiencies like kwa shiorkor/marasmus are precipitated only in children who are already ma lnourished. As high as 3-4 per cent of children with measles suffered from these clinical nutritional syndromes in their post-measles period . Though malnutrition is widespread among Asian children also, measles appears to run a milder course with low mortality rates in developing Asian countries, as compared to African children. The associated seco ndary infections which apparently complicate the primary illness in ma lnourished children might be responsible for higher mortality and coul d be due to socio-economic and environmental causes that are associate d with poverty and malnutrition rather than due to malnutrition or mea sles per se. Measles related blindness is of multifactorial aetiology. While acute measles triggers corneal ulceration through viral prolife ration in the cornea, nutritional keratomalacia is often the cause of blindness in the post-measles period. Measles vaccination is the major preventive measure. However, timely use of local antibiotic therapy t o the eyes and administration of vitamin A supplements offer protectio n to the child who already has measles. Response of malnourished child ren to live attenuated measles vaccine has been found to be safe and e ffective. Neither malnutrition nor tuberculosis which are widespread a mong malnourished children of developing countries appear to be contra indications for measles vaccination. Thus, the beneficial effects of t he measles vaccination should be fully exploited by adequate supply of potent vaccine and coverage of all susceptible children.