Study Finds One in Eight Children with Measles Develop Serious Breathing Complication

A new study led by pediatricians at Hadassah Medical Center reveals that approximately 12% of children diagnosed with measles develop stridor, a significant respiratory complication indicating upper airway obstruction. The research, published in the journal Pediatrics, found that 90% of these children required hospitalization, with nearly 18% admitted to pediatric intensive care units. The study analyzed 317 children with PCR-confirmed measles during the 2025 outbreak in Israel, focusing on cases treated at Hadassah Ein Kerem, Hadassah Mount Scopus, and Shaare Zedek Medical Centers.

Stridor, characterized by a harsh, barking sound during inhalation, was observed in 39 children, with a median age of 15 months. Most (85%) of the affected children were unvaccinated. Severity was assessed using the Westley Croup Score, with cases ranging from mild to near respiratory failure. The primary reasons for hospitalization were respiratory distress and dehydration, and about 70% required some form of respiratory support, including two children who needed mechanical ventilation. No deaths were reported among the study participants.

The study highlights that measles-related stridor is more severe and prolonged than typical viral croup, with a median hospital stay of three days compared to one day for standard viral croup cases. Professor Saar Hashavya, co-author and head of the pediatric emergency department at Hadassah Ein Kerem, emphasized the need for heightened awareness and preparedness among healthcare providers, especially given the ongoing measles outbreaks in Israel and worldwide.

Dr. Oren Gordon, an infectious disease specialist and co-author, noted that stridor as a complication of measles is under-recognized by some physicians and parents. He stressed the importance of vaccination, which protects against both measles and its severe complications. The study was retrospective and observational, with some limitations including the inability to fully exclude co-infections and a relatively small sample size.

Israel has been experiencing a significant measles outbreak since 2025, with around 3,800 cases reported by June 2026, though actual numbers may be closer to 17,000 according to the Ministry of Health. Seventeen deaths have been recorded since the outbreak began, the most recent in March 2026. The findings underscore the serious risks measles poses to children, reinforcing the critical role of vaccination and early detection of complications like stridor.