Clinical Aspects And Immune Status Of Adult Patients With Measles After The Covid-19 Pandemic

Abstract

Background: In recent years, Uzbekistan has faced a renewed challenge in controlling measles, with a noticeable rise in adult cases after the COVID-19 pandemic. While measles is typically regarded as a childhood disease, the infection in adults often follows a more severe course and is accompanied by frequent complications. The reduction in population immunity, combined with incomplete vaccination histories, has contributed to the re-emergence of measles among adults. Evaluating both the clinical presentation and serological immune response, particularly measles-specific IgG antibodies, is crucial for understanding current patterns of susceptibility. Objective: To describe the clinical and immunological characteristics of measles in adults in Uzbekistan during 2023–2025, with particular attention to disease severity, complications, and IgG antibody profiles. Methods: A prospective observational study was carried out at the 3rd clinic of Tashkent Me and several regional clinics. The study consisted of 187 adults aged 18–59 years with laboratory-confirmed measles. Diagnosis was based on characteristic clinical features and the detection of measles-specific IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Each patient underwent a detailed clinical assessment and standard laboratory testing. IgG titers were measured at admission and again on days 10–14 to evaluate immune response and seroconversion. Results: Most patients were young adults (mean age 28.4 ± 9.7 years); 72 % reported no prior vaccination. Fever above 39 °C, cough, conjunctivitis, and generalized rash were the predominant symptoms. Complications developed in 37.9 % of patients, most often pneumonia, hepatitis, or gastrointestinal involvement. Laboratory findings commonly showed leukopenia and moderate elevation of liver enzymes. At admission, 26 % of patients had no significant measles-specific IgG, indicating susceptibility despite presumed prior exposure. Among those with paired sera, 84 % demonstrated a fourfold increase in IgG titers during convalescence, confirming an active immune response. Conclusion: Adult measles in Uzbekistan during the post-pandemic period was characterized by a moderate to severe clinical course and a high rate of complications. The detection of low IgG levels in a considerable proportion of patients highlights existing immunity gaps among adults. Incorporating IgG screening into routine epidemiological surveillance and extending vaccination programs to adults could help identify at-risk groups and strengthen measles control in the upcoming years.