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==relation with malnutrition==
*still controversial, malnutrition first or measles first ==risk for death from measles==*vit. A deficiency*malnutrition - causation controversial*in larger outbreak*in larger household contact*younger children*HIV positive children ===etiology of child death===*acute overwhelming infection in the first week*secondary bacterial pneumonia in the second week**''S. pneumoniae''**''S. aureus''**air trapping is a feature - possible pneumothorax*secondary viral infection**HSV**RSV**adenovirus*post-measles syndrome**malnutrition**immune paralysis, immunomodulation ==strategies to control==*isolation, theoretically good but useless in reality*effective treatment with vit. A and antimicrobials**vit. A and antimicrobials for secondary bacterial infection can reduce mortality*vaccination**maternal passive immunity wane in 6-9 months after birth***rational for the first vaccination after 9 months of age**10% of primary vaccine failure in the first vaccination***rational for the second vaccination
