A new study published in Pediatrics, one of the world's leading pediatric journals, found that about 121% of children who contracted measles developed stridor, a condition that indicates upper airway obstruction. Most of them required hospitalization, and almost a fifth were admitted to the pediatric intensive care unit.
The study was led by specialists in pediatric emergency medicine and pediatric infectious diseases at Hadassah, and was co-led by researchers from the Hebrew University of Jerusalem and Shaare Zedek Medical Center.
The study, which was recently presented in the journal, shows that stridor is a significant and common complication among children with measles.
The emergency departments and pediatric departments at Hadassah Medical Center treated the highest number of children and infants who contracted measles in Israel, and therefore the researchers from Hadassah Ein Kerem and Hadassah Mount Scopus had the lion's share of the data regarding those hospitalized, the symptoms for which they came to the emergency room, and the complications that developed later.
The study was conducted in three pediatric emergency departments in Israel during the 2025 measles outbreak and included 317 children with PCR-confirmed measles.
Of all the children, 39 – approximately 121% – arrived with stridor as one of the symptoms of the disease.
The researchers found that this was an extremely young population, with a median age of only 15 months, and that 851% of the children had not been vaccinated against measles.
It was also found that approximately 901% of the children with stridor required hospitalization, approximately 181% were hospitalized in the pediatric intensive care unit, and two children required ventilation.
No deaths have been recorded among measles patients who presented with stridor (but 17 children died of measles in recent outbreaks as a result of other complications).
High rates of dehydration, respiratory distress, and other complications, including pneumonia, ear infections, and bacterial tracheitis, were also observed among the children.
The researchers note that stridor is commonly caused by other respiratory viruses (most commonly parainfluenza), but compared to these, measles-associated stridor is characterized by more severe disease, significantly higher hospitalization rates, and a longer course of illness.
Dr. Oren Gordon, a pediatric infectious disease specialist at Hadassah Medical Center and one of the senior authors of the study, explains:
“Measles is sometimes seen as a passing childhood illness, but our findings emphasize that it can cause significant complications, including damage to the upper airways that sometimes requires hospitalization and even intensive care intervention. At a time when we are witnessing measles outbreaks in Israel and around the world, it is important that doctors are aware of this symptom and recognize it early, and there is no doubt that the information is also essential for parents in outbreak areas, in order to identify the symptoms of stridor that require seeking medical treatment.”
Prof. Saar Hashabiya, Director of the Pediatric Department at Hadassah Ein Kerem and Deputy Director of the hospital, who was also one of the senior authors of the study, adds: “The importance of the study lies in the unequivocal understanding that stridor is not a rare complication of measles and is of great interest worldwide. In fact, one in eight children diagnosed with measles also suffered from stridor, and the data require high vigilance on the part of the treating teams and appropriate preparation in the health systems. Ultimately, after the significant outbreak we experienced this year at the national level, there is no knowing what awaits us next winter in Israel and around the world.”
The researchers conclude that in an era when measles outbreaks are becoming more common in many countries, it is important to be aware of the unique characteristics of measles-related stridor, as it is a significant complication that may lead to prolonged hospitalization and even the need for increased intensive care unit care in order to avoid life-threatening respiratory distress.
