Specific clinical manifestations of measles depending on vaccination status of a patient: the case of the Republic of Dagestan

Aim: to assess a difference between clinical manifestations of measles and risks of complications in vaccinated and unvaccinated patients in the Republic of Dagestan pursuant to a full assessment of clinical and laboratory data, considering a fact that both unvaccinated and measles- vaccinated persons can be involved in the epidemic process in years of growing morbidity. Patients and Methods: from May 2023 to June 2024, 245 men and women (age: 1–65 years) with a confirmed diagnosis of measles of varying severity were hospitalized in the S.M. Magomedov Republican Center for Infections, Prevention and Control of AIDS in Makhachkala. In all patients, measles virus RNA was detected by polymerase chain reaction (PCR) in a nasopharyngeal smear. Routine and biochemical blood tests were performed, and the Clinical Symptom Severity and Treatment Satisfaction Questionnaire was used. Results: in our studies, in 98.4% of cases, patients had an epidemiological connection with measles cases. Among them, 73.5% were unvaccinated children and adults, and 26.5% of cases had information about vaccination. Mostly, the unvaccinated group consisted of children, while the vaccinated one predominantly included adults. Clinical manifestations were the most pronounced in the unvaccinated group. Namely, fever, dyspnoe, and diarrhea were more common in them. The incidence of diarrhea and dyspnoe demonstrated that they are less common in adult patients than in the pediatric population. Moreover, the highest incidence is reported in young children. A proportion of leukopenia persons was 41.9% in unvaccinated patients, while it was only 1.6% in vaccinated ones. In addition, there was an increase in erythrocyte sedimentation rate, as well as in levels of C-reactive protein, aspartate aminotransferase and alanine aminotransferase (ALT) in both groups. During clinical recovery, these values become normal, except for ALT level that remained significantly higher in unvaccinated patients (p <0.001). The vaccination prevented occurrence of complications. Thus, 121 (67.2%) and 13 (20%) patients with the complicated disease were reported in the unvaccinated and vaccinated groups, respectively. Conclusion: in recent times, moderate measles associated with respiratory complications mainly occurs. The vaccination prevents occurrence of complications. Patients with the complicated disease were much higher in the unvaccinated group. Along with this, percentage of unvaccinated patients vs vaccinated ones was quite substantial, and almost all cases resulted from contact with measles patients. Measles vaccination coverage remains low (especially, among children). Increased incidence of moderate complicated measles indicates a need for routine vaccination/revaccination. Keywords: measles, clinical presentation, severity, complications, vaccination. For citation: Ninalalov M.A., Ulukhanova L.U., Gazieva M.M., Tagirova Z.G., Ponezheva Zh.B., Muzyka A.D., Shabalina S.V., Tsvirkun O.V., Turaeva N.T., Ramazanov M.K. Specific clinical manifestations of measles depending on vaccination status of a patient: the case of the Republic of Dagestan. RMJ. 2025;3:4–9. DOI: 10.32364/2225-2282-2025-3-1