Which of the following is the most common complication of measles?

NORCET 8 Prelims-2025

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 8 Prelims-2025

Explanation

Otitis media (middle ear infection) is cited as the most common complication of measles, occurring in approximately 7-9% of cases.
It is typically caused by a secondary bacterial infection that takes advantage of the immune suppression caused by the measles virus.
While diarrhoea has a very similar incidence rate, major pediatric textbooks explicitly state that otitis media is the most common complication, making it the best answer in an exam context.
The risk is highest in children under five years of age, and it can potentially lead to permanent hearing loss if not managed properly.

Option A: Encephalitis (inflammation of the brain) is a very serious but rare complication of measles, occurring in only about 1 in 1,000 cases (0.1%). It is not the most common.
Option B: Pneumonia is the most common cause of death related to measles, but it is not the most frequent complication overall. Its incidence is about 1-6%, which is lower than that of otitis media or diarrhoea.
Option D: Diarrhoea is a very common complication, with an incidence rate of around 8%, nearly identical to otitis media. However, otitis media is more frequently and explicitly stated in textbooks as the single most common complication.

Visual 1: Infographic: A bar chart comparing the incidence rates (%) of measles complications: Otitis Media, Diarrhoea, Pneumonia, and Encephalitis. This visually reinforces the relative frequencies.
Visual 2: Image: A picture of Koplik's spots on the buccal mucosa, captioned 'Pathognomonic sign of measles, appearing 1-2 days before the rash.'
Visual 3: Image: A diagram showing a cross-section of the middle ear, illustrating the site of infection in otitis media.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Measles (Rubeola) as background academic context rather than a clinical decision trigger.
The high incidence of preventable complications underscores the critical importance of the MMR (Measles, Mumps, Rubella) vaccine in public health.
Nurses must be vigilant in monitoring a child with measles for signs of complications, such as ear pain (otitis media), rapid breathing (pneumonia), severe diarrhoea, or changes in consciousness (encephalitis).
What if? If a child with measles develops a high fever and starts pulling at their ear, the nurse should suspect otitis media and report it for prompt assessment and treatment to prevent hearing damage.

How to Approach the Question

First, identify the keywords in the question: 'measles' and 'most common complication'.
This is a factual recall question that requires knowledge of the epidemiology of measles.
Recall or look up the common complications: otitis media, pneumonia, diarrhoea, and encephalitis.
Compare the relative frequencies of these complications. Remember to distinguish between the most common complication (highest incidence) and the most common cause of death (highest mortality).
Pneumonia is the deadliest, but not the most frequent. Encephalitis is the most severe neurologically, but is rare.
The choice is between otitis media and diarrhoea, which have very similar incidence rates. Recall that textbooks often single out otitis media as the 'most common' complication, making it the strongest answer.

Concept Tested & Keywords

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