Measles transmission-related epidemiological parameter estimates: a systematic review and meta-analysis

With the recent resurgence of global measles outbreaks, it is crucial to understand measles transmission dynamics to guide timely and effective public health responses and parameterize infectious disease models for accurate outbreak projections. This systematic review aims to provide a comprehensive resource of measles transmission-related epidemiological parameters. A search was conducted from inception to 14 May 2024. English and French primary studies of transmission-related epidemiological parameters were included, and standard systematic review methodology was followed. Evidence was synthesized using random-effects meta-analyses and descriptive plots. Subgroup analyses by World Health Organization (WHO) region, population, decade, and quality of reporting were conducted to explore heterogeneity. Between 1910 and 2024, 1 209 estimates across 32 transmission-related epidemiological parameters from 612 studies were reported. Measles was characterized by a pooled incubation period (13.5 days, 95%CI 12.6-14.4; I² = 95.9%), serial interval (12.4 days, 95%CI 11.5-13.4; I² = 97.6%), symptom onset to hospitalization (4.8 days, 95%CI 3.7-5.8, I² = 99.7%), and basic reproduction number median 11.5 (range of 0-57). This work is part of a global epidemic preparedness and response project to establish an accessible living Global Repository of Epidemiological Parameters aimed at reducing duplicative efforts in identifying and summarizing epidemiological parameters.