Vitamin A levels and severity of measles. New York City
T. R. Frieden, A. L. Sowell, K. J. Henning, D. L. Huff and R. A. Gunn
Division of Field Epidemiology, Centers for Disease Control.
Recent studies show that vitamin A levels decrease during measles and that
vitamin A therapy can improve measles outcome in children in the developing
world. Vitamin A levels of children with measles have not been studied in
developed countries. We therefore measured vitamin A levels in 89 children
with measles younger than 2 years and in a reference group in New York
City, NY. Vitamin A levels in children with measles ranged from 0.42 to 3.0
mumol/L; 20 (22%) were low. Children with low levels were more likely to
have fever at a temperature of 40 degrees C or higher (68% vs 44%), to have
fever for 7 days or more (54% vs 23%), and to be hospitalized (55% vs 30%).
Children with low vitamin A levels had lower measles-specific antibody
levels. No child in the reference group had a low vitamin A level. Our data
show that many children younger than 2 years in New York City have low
vitamin A levels when ill with measles, and that such children seem to have
lower measles-specific antibody levels and increased morbidity. Clinicians
may wish to consider vitamin A therapy for children younger than 2 years
with severe measles. Additional studies of vitamin A in measles and other
infectious diseases, and in vaccine efficacy trials, should be done.
