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Immunoparesis and outcome in measles

H M Coovadia, A Wesley, P Brain

    Lancet (London, England)
    |March 19, 1977
    PubMed

    Insights

    Measles infection can cause significant immunosuppression, particularly a lower lymphocyte count, in children who die from the disease compared to those who recover. This immune deficiency is evident during the acute rash phase.

    Area of Science:

    • Immunology
    • Pediatrics
    • Virology

    Background:

    • Measles is a highly contagious viral illness.
    • Immunosuppression is a known complication of measles.
    • The extent and specific markers of immunosuppression in fatal measles cases require further elucidation.

    Purpose of the Study:

    • To investigate and compare the degree of immunosuppression in children with measles who died versus those who recovered.
    • To identify specific immunological parameters associated with measles mortality.

    Main Methods:

    • Comparative analysis of immunological markers in two groups of children with measles: those who died (Group A) and those who recovered (Group B).
    • Measurement of absolute total lymphocyte counts (T and B cells), serum complement factor C3, and phytohemagglutinin stimulation index (S.I.).
    • Retrospective analysis of lymphocyte counts in a larger cohort of deceased and recovered measles patients.

    Main Results:

    • Group A (deceased) exhibited more pronounced immunosuppression during the acute rash phase compared to Group B (recovered).
    • Significantly lower absolute total lymphocyte counts were observed in Group A.
    • Mean serum C3 levels were lower in Group A, but other complement factors and immunoglobulins showed no significant differences.
    • Phytohemagglutinin stimulation index was low in both groups, but lowest in patients who died.

    Conclusions:

    • Measles-associated immunosuppression, particularly lymphopenia, is more severe in children who succumb to the illness.
    • Lower lymphocyte counts and C3 levels may serve as indicators of severe measles infection and poor prognosis.
    • Further research into the mechanisms of measles-induced immunosuppression is warranted.

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