Severe Measles, Vitamin A Deficiency, and the Roma Community in Europe, Emergent Infectious Diseases, September 2012.

Measles epidemiology has changed; the disease now mainly affects children <1 year old and young adults, the latter of whom are mostly unvaccinated or have unknown vaccination status (2,4). Roma people in Europe experience some of the worst health conditions in the industrialized world: they live in overcrowded conditions and have limited access to prevention programs and to healthcare services (2,5). In such populations, deficiencies of vitamins, such as A, C, and E, have been reported (6). Vitamin A deficiency has been associated with severe cases of measles in children in developing countries (7,8). To date, we did not find published data associating vitamin A deficiency with severe measles among adults. We describe 6 adults from the Roma community in Marseille, France, who had measles and low levels of vitamin A; 2 of these persons had severe measles.

laying recovery and promoting xerophthalmia, corneal ulcer, and blindness (7,8,10). Acute measles precipitates vitamin A deficiency by depleting vitamin A stores and increasing its utilization, leading to more severe ocular injury (7,8). Vitamin A supplementation given to children with measles has been associated with better outcomes (7,8). Although it is too early to associate vitamin A deficiency with severe measles in adult patients, such an association is possible. Adults with low levels of vitamin A but not infected with measles could be at higher risk for more severe disease if they become infected with the virus.