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Early measles virus infection is associated with the development of inflammatory bowel disease
D S Pardi1, W J Tremaine, W J Sandborn
1Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Objective:
The measles virus has been implicated as a possible etiological agent in the development of inflammatory bowel disease (IBD). Measles infection at an early age is associated with subacute sclerosing panencephalitis, a degenerative neurological condition caused by persistent measles infection of the central nervous system. We sought to determine whether infection with measles virus at an early age was also associated with an increased risk of developing IBD.
Methods:
Patients with measles infection diagnosed before the age of 5 yr were identified through the diagnostic indices of the Mayo Clinic and the Rochester Epidemiology Project. A questionnaire was used to ascertain a subsequent history of IBD, which was confirmed by records from the subjects' physicians. The risks of developing Crohn's disease and ulcerative colitis were calculated relative to expected rates for these conditions in the Olmsted County, Minnesota population.
Results:
Of 1164 eligible cases, 662 (57%) completed the questionnaire. There were six confirmed cases of Crohn's disease and six of ulcerative colitis. The expected number of cases was 1.9 for Crohn's disease (standardized incidence ratio [SIR] 3.1, 95% confidence interval [CI] 1.1-6.8) and 2.0 for ulcerative colitis (SIR 3.0, CI 1.1-6.5). There was a trend towards a higher risk of developing IBD with an earlier age of infection.
Conclusions:
Early measles infection is associated with an increased risk of developing Crohn's disease and ulcerative colitis. The risk may be higher with earlier infection.
Insights
Early measles infection may increase the risk of developing inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. The risk appears higher with earlier childhood measles exposure.
Area of Science:
- Gastroenterology
- Virology
- Epidemiology
Background:
- Measles virus is a potential factor in inflammatory bowel disease (IBD) development.
- Early measles infection is linked to subacute sclerosing panencephalitis.
- The association between early measles infection and IBD risk requires further investigation.
Purpose of the Study:
- To determine if measles infection before age 5 increases the risk of developing IBD.
- To investigate the specific risks for Crohn's disease and ulcerative colitis.
Main Methods:
- Identified patients with measles diagnosed before age 5 using Mayo Clinic and Rochester Epidemiology Project records.
- Used questionnaires to assess subsequent IBD history, confirmed by physician records.
- Calculated relative risks for Crohn's disease and ulcerative colitis compared to the general population.
Main Results:
- Six cases of Crohn's disease and six of ulcerative colitis were confirmed among eligible participants.
- The standardized incidence ratio for Crohn's disease was 3.1 and for ulcerative colitis was 3.0.
- A trend indicated a higher IBD risk with earlier age of measles infection.
Conclusions:
- Measles infection in early childhood is associated with an elevated risk of developing Crohn's disease and ulcerative colitis.
- The risk of IBD may be dose-dependent on the age of measles infection.