Measles: Summary of Worldwide Impact F. Assaad From the Division oj Communicable Diseases, World

Nearly every measles infection results in well-recognized clinical disease. In nonim-munized populations almost every child will get measles early in life. The universality of the disease in nonimmunized communities, particularly those in the developing world, has led to a more or less passive acceptance of measles as an unavoidable risk of early life. The clinical spectrum of measles ranges from a mild, self-limiting illness to a fatal disease. Conditions encountered mainly in the developing world, e.g., un-favorable nutrition, high risk of concurrent infection, and inadequate case manage-ment-particularly at home-favor the development of complications and adverse out-come. Conversely, good clinical management of an otherwise healthy child, a situation seen mostly in the developed world, greatly influences the course of the disease. Hence many in the medical profession believe that measles is a mild disease except among pop-ulations living under particularly unfavorable conditions. Measles vaccine is effective in preventing disease in the individual and in controlling it in the community if it is given at the critical age when maternal antibodies wane and the risk of natural infection increases sharply and if a high immunization rate is maintained in the target popUla