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Published on: September 7, 2022
Specifically Increased Rate of Infections in Children Post Measles in a High Resource Setting
Daniel Bühl1, Olga Staudacher1,2, Sabine Santibanez3
1Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Objectives:
Post-measles increased susceptibility to subsequent infections seems particularly relevant in low-resource settings. We tested the hypothesis that measles causes a specifically increased rate of infections in children, also in a high-resource setting.
Methods:
We conducted a retrospective cohort study on a large measles outbreak in Berlin, Germany. All children with measles who presented to hospitals in Berlin were included as cases, children with non-infectious and children with non-measles infectious diseases as controls. Repeat visits within 3 years after the outbreak were recorded.
Results:
We included 250 cases, 502 non-infectious, and 498 infectious disease controls. The relative risk for cases for the diagnosis of an infectious disease upon a repeat visit was 1.6 (95% CI 1.4-2.0, p < 0.001) vs. non-infectious and 1.3 (95% CI 1.1-1.6, p = 0.002) vs. infectious disease controls. 33 cases (27%), 35 non-infectious (12%) and 57 (18%) infectious disease controls presented more than three times due to an infectious disease (p = 0.01, and p = 0.02, respectively). This results in a relative risk of more than three repeat visits due to an infection for measles cases of 1.8 (95% CI 1.3-2.4, p = 0.01), and 1.4 (95% CI 1.0-1.9, p = 0.04), respectively.
Conclusion:
Our study demonstrates for the first time in a high-resource setting, that increased post-measles susceptibility to subsequent infections in children is measles-specific-even compared to controls with previous non-measles infections.
Insights
Measles infection in children increases their susceptibility to subsequent infections, even in high-resource settings. This study confirms measles-specific immune suppression, highlighting the need for continued vaccination efforts.
Area of Science:
- Immunology
- Infectious Diseases
- Pediatrics
Background:
- Post-measles immunosuppression is a recognized concern, particularly in resource-limited areas.
- The specific impact of measles on subsequent infection rates in high-resource settings requires further investigation.
Purpose of the Study:
- To test the hypothesis that measles infection leads to a specifically increased rate of subsequent infections in children.
- To evaluate measles-induced immune susceptibility in a high-resource setting.
Main Methods:
- A retrospective cohort study was conducted during a large measles outbreak in Berlin, Germany.
- Children diagnosed with measles were compared to controls with non-infectious and non-measles infectious diseases.
- Repeat medical visits for infections within three years post-outbreak were analyzed.
Main Results:
- Measles cases showed a significantly higher relative risk of infectious disease diagnosis upon repeat visits (1.6 vs. non-infectious controls, 1.3 vs. infectious disease controls).
- Measles cases had a higher relative risk (1.8) of more than three repeat visits due to infection compared to infectious disease controls.
- 27% of measles cases presented more than three times due to infection, versus 18% of infectious disease controls.
Conclusions:
- This study provides the first evidence in a high-resource setting that measles infection increases susceptibility to subsequent infections.
- The observed increased susceptibility is measles-specific, even when compared to children with prior non-measles infections.
- Findings underscore the importance of measles vaccination to prevent long-term health consequences.
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