Clinical and Demographic Characteristics of Hospitalized Pediatric Measles Cases; The 2023 Outbreak in Northern Jordan.

Background: Measles remains a leading vaccine-preventable cause of childhood morbidity and mortality globally. Despite immunization efforts, outbreaks persist, including a 2023 outbreak in Irbid, Jordan. Objective: To describe the clinical, demographic, and vaccination characteristics of pediatric measles patients hospitalized during the 2023 Irbid outbreak and assess complications and outcomes. Methods: A retrospective observational study included all children (0-14 years) hospitalized with laboratory-confirmed measles at Princess Rahma Pediatric Hospital, Irbid, from April to December 2023. Data on demographics, vaccination status, symptoms, complications, management, and outcomes were analyzed using descriptive statistics and comparisons between vaccinated/unvaccinated groups. Results: Of 63 hospitalized children, 61.9% were under one year old, and 49.2% were male. Most (63.5%) were unvaccinated; 47.6% of these were ineligible due to age (<9 months). Among eligible children (≥9 months), 27.2% were fully vaccinated, 42.5% under-vaccinated, and 30.3% unvaccinated. Fever (95.2%) and rash (96.8%) were the most common symptoms. Pulmonary complications affected 68.3% (bronchopneumonia: 55.5%; pneumonia: 12.7%). Dehydration (34.9%) and gastrointestinal symptoms (vomiting: 30.1%; diarrhea: 28.5%) were frequent. One unvaccinated 7-month-old infant died from measles-associated pneumonia. Vitamin A was administered to all patients, and 82.5% received empirical antibiotics. The average hospital stay was 4.4 days. Conclusion: The measles outbreak in Northern Jordan predominantly affected unvaccinated children, particularly those under nine months of age. While vaccination reduced the risk of severe complications (eg, pneumonia occurred in 75% of unvaccinated vs 25% of vaccinated cases), breakthrough infections in vaccinated children underscore the need for optimized immunization strategies. Respiratory complications, including pneumonia, were the leading cause of hospitalization and mortality, highlighting the vaccine's critical role in mitigating disease severity. Strengthening vaccination coverage and revisiting age-specific policies in high-risk regions remain essential to reduce measles-related morbidity and mortality.