Pediatric Deaths during Measles Outbreak, Jerusalem, Israel, 2025–2026
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The two-dose measles vaccine shows ~97% effectiveness. This study describes measles mortality in Jerusalem between April 2025 and March 2026 and identifies contributing factors to the unexpectedly elevated mortality. Methods: All clinically and laboratory measles cases underwent epidemiological investigation. The clinical presentation at admission was retrieved from hospital records. Mortality during the acute phase of measles was presented by case fatality rate (CFR) and measles-specific mortality rate (MSMR). Findings: First-dose measles-containing vaccine coverage among children aged 1-6 years in Jerusalem in 2024 was 78.3%, and in six central neighborhoods (6-neighborhoods) in central Jerusalem, populated by Ultraorthodox Jews was ~55%. During the study period, 1,289 measles cases in Jerusalem (129.2 cases:100,000 population) were reported, comprising 36.1% of all cases in Israel. Of those, 912 (70.7%) were under-5-years with a median of 6 household members, and 870 (95.4%) were unvaccinated. Most (68.6%) lived in 6-neighborhoods who totaled 6.8% of the entire under-5-years in Jerusalem.Eleven children died at a median age of 1.4 years (range:0.9-7.1), resulting in a CFR of 0.85% and MSMR of 1.1 deaths:100,000 population. The under-5-year MSMR in Jerusalem and 6-neighborhoods were 7.7 and 80.1 deaths:100,000 children, respectively, with a measles-attributed mortality fraction of 47%. Ten otherwise healthy fatalities were unvaccinated, and 1 with heart disease received a single-dose. Six died on arrival, and 3 were treated with ECMO. Interpretation: Unexpectedly high measles-specific morbidity and mortality rates in Jerusalem, especially among unvaccinated under-5-year-olds living in 6-neighborhoods. Sustained efforts should be maintained to strengthen relationships with affected communities, enhance vaccine reliability, and foster confidence with healthcare providers.
Source: Emerging infectious diseases
Language: English
Topic: Virology and Viral Diseases
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214886556