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No persistent T lymphocyte immunosuppression or increased mortality after measles infection: a community study from
1Epidemiology Research Unit, Danish Epidemiology Science Centre, Copenhagen, Denmark.
Background:
Because measles immunization is reducing overall childhood mortality in addition to mortality from acute measles infection, it has been suggested that postmeasles cases have excess mortality, possibly related to persistent immunosuppression after measles infection. After an epidemic in 1988 in Guinea-Bissau, we therefore examined T lymphocyte subsets and long term survival among measles cases and controls.
Methods:
We examined 69 children < 3 years of age with a median delay of 2 months after measles infection and 71 controls who did not contract measles. The immunoalkaline method was used to determine T lymphocyte subsets. The children were followed for 5 years.
Results:
Compared with controls, there were no significant differences in white blood cell count, absolute lymphocyte count, CD4 percentage, CD8 percentage, total CD4 count and total CD8 count, although measles cases examined > 2 months after infection had slightly higher CD4 counts than controls (P = 0.06). Adjusted for age, sex and immunization status, postmeasles cases had a mortality rate ratio of 0.50 (95% confidence interval, 0.22 to 1.16) (P = 0.11) compared with controls.
Conclusions:
There is no indication of persistent suppression of T cell subsets after measles infection, and postmeasles cases did not have higher mortality than uninfected community controls.
Insights
Measles infection does not appear to cause long-term immunosuppression or increase mortality in children. Post-measles cases showed no increased risk compared to uninfected children, challenging previous theories.
Area of Science:
- Immunology
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Measles immunization reduces childhood mortality, prompting investigation into potential long-term immunosuppression after measles infection.
- Previous studies suggested excess mortality in post-measles cases, possibly due to persistent immune suppression.
Purpose of the Study:
- To investigate T lymphocyte subsets and long-term survival in children following measles infection.
- To determine if measles infection leads to persistent immunosuppression and increased mortality.
Main Methods:
- Examined 69 children under 3 years old with a median 2-month delay after measles infection and 71 controls.
- Assessed T lymphocyte subsets using the immunoalkaline method.
- Followed children for 5 years to determine mortality rates.
Main Results:
- No significant differences were observed in white blood cell counts or T lymphocyte subsets (CD4, CD8) between measles cases and controls.
- Measles cases examined more than 2 months post-infection showed slightly higher CD4 counts.
- Adjusted mortality rate ratio for post-measles cases was 0.50 (95% CI, 0.22-1.16), indicating no increased mortality.
Conclusions:
- No evidence of persistent T cell subset suppression was found after measles infection.
- Post-measles cases did not exhibit higher mortality rates compared to uninfected community controls.