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Published on: August 7, 2017
Perinatal measles infection and subsequent Crohn's disease
A Ekbom1, A J Wakefield, M Zack
1Cancer Epidemiology Unit, University Hospital, Uppsala, Sweden.
Abstract:
Although the aetiology of Crohn's disease is unknown, morphological and epidemiological studies have implicated measles virus as a potential component cause, particularly when exposure occurs in utero or early in life. An increased incidence of Crohn's disease among people born during measles epidemics would support this hypothesis. We identified all individuals born in four counties in central Sweden in 1945-54 who had had Crohn's disease diagnosed before the age of 30 years. Yearly reports compiled in these counties revealed that five measles epidemics had affected all four counties during the trial period. After adjusting for monthly differences in the number of livebirths in the four counties, we calculated the expected number of patients with Crohn's disease and ulcerative colitis born during the 3-month period after the peaks of the epidemics. The number of people with Crohn's disease significantly exceeded that expected: 57 versus 39.0 (standardised incidence ratio 1.46, 95% CI 1.11-1.89). For patients with ulcerative colitis, the observed number (42) was close to that expected (46.8). Our results strengthen the hypothesis that measles is related to Crohn's disease and that the perinatal period is a time of vulnerability.
Insights
Measles virus exposure during infancy may increase Crohn's disease risk. This study found more Crohn's disease cases in individuals born during measles epidemics, suggesting a link.
Area of Science:
- Epidemiology
- Virology
- Gastroenterology
Background:
- The etiology of Crohn's disease remains unknown.
- Measles virus has been implicated as a potential contributing factor, especially with early-life exposure.
- Previous studies suggest a correlation between measles epidemics and increased Crohn's disease incidence.
Purpose of the Study:
- To investigate the association between measles epidemics and the incidence of Crohn's disease.
- To determine if birth during a measles epidemic increases the risk of developing Crohn's disease.
- To assess the vulnerability of the perinatal period to measles exposure in relation to Crohn's disease.
Main Methods:
- Identified individuals diagnosed with Crohn's disease before age 30 in four Swedish counties (1945-1954).
- Analyzed measles epidemic data and birth records for the study period.
- Calculated expected vs. observed Crohn's disease and ulcerative colitis cases born in the 3 months following measles epidemic peaks, adjusting for livebirths.
Main Results:
- A significant excess of Crohn's disease cases (57 observed vs. 39.0 expected) was found in individuals born after measles epidemic peaks (SIR 1.46).
- The observed number of ulcerative colitis cases (42) was similar to the expected number (46.8).
- Results indicate a statistically significant association between measles epidemics and subsequent Crohn's disease diagnosis.
Conclusions:
- The findings strengthen the hypothesis linking measles virus to Crohn's disease.
- The perinatal period appears to be a critical window of vulnerability for measles exposure concerning Crohn's disease development.
- Further research is warranted to elucidate the specific mechanisms involved in this association.
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