Measles dominate childhood illnesses in tropical Africa with a variety and severity of complications virtually unknown in the West. There is no apparent continental variation in measles virus but environmental factors vary widely. The frequent association of severe measles with malnutrition and recent studies indicating impaired humoral, cellular, and mucocutaneous immunologic function in the malnourished may explain this perplexing disease. Prevention of early malnutrition combined with lasting and economic early immunization with heat-stable vaccine, currently unavailable, are needed to halt this fre quent, costly, and often fatal African scourge.
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