Response to Comment on “Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality”

Mina, Michael J.; Grenfell, Bryan T.; Metcalf, C. Jessica E.

doi:10.1126/science.aax6498

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…We previously reported evidence that measles epidemics link to population mortality 2 to 3 years later (15,40). We hypothesized that the observed dynamics could potentially be explained by an immunomodulatory effect of measles, similar to what we show here.…”

Section: Experimental MV Infection Confirms a Decrease In Previously ...supporting

confidence: 86%

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens

Mina

Kula

Leng

et al. 2019

Science

Self Cite

361

289

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Measles virus is directly responsible for more than 100,000 deaths yearly. Epidemiological studies have associated measles with increased morbidity and mortality for years after infection, but the reasons why are poorly understood. Measles virus infects immune cells, causing acute immune suppression. To identify and quantify long-term effects of measles on the immune system, we used VirScan, an assay that tracks antibodies to thousands of pathogen epitopes in blood. We studied 77 unvaccinated children before and 2 months after natural measles virus infection. Measles caused elimination of 11 to 73% of the antibody repertoire across individuals. Recovery of antibodies was detected after natural reexposure to pathogens. Notably, these immune system effects were not observed in infants vaccinated against MMR (measles, mumps, and rubella), but were confirmed in measles-infected macaques. The reduction in humoral immune memory after measles infection generates potential vulnerability to future infections, underscoring the need for widespread vaccination.

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Section: Experimental MV Infection Confirms a Decrease In Previously ...supporting

confidence: 86%

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens

Mina

Kula

Leng

et al. 2019

Science

Self Cite

361

289

View full text Add to dashboard Cite

show abstract

“…Using model simulation and the posterior estimates from the model inference system, we are also able to estimate the impact of vaccination campaigns implemented during the outbreak, including numbers of infections and hospitalizations averted, for each age group. These latter findings echo those from previous studies (9)(10)(11) and again highlight the severity of measles disease should there be no effective infection and transmission controls (in particular, vaccination).…”

Section: Discussionsupporting

confidence: 86%

Transmission dynamics of and insights from the 2018–2019 measles outbreak in New York City: A modeling study

Yang

2020

Sci. Adv.

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In 2018–2019, New York City experienced the largest measles outbreak in the United States in nearly three decades. To identify key contributing factors, we modeled the transmission dynamics of this outbreak. Results indicate that delayed vaccination of 1- to 4-year-olds enabled the initial spread and that increased infectious contact, likely via “measles parties,” facilitated later transmission. We found that around half of infants were susceptible by age 1 and thus had many infections. Without the implemented vaccination campaigns, numbers of infections and hospitalizations could have been >10 times higher and would predominantly affect those under 4. These results suggest that a first vaccine dose before age 1 and the second dose before age 4 could allow parents to vaccinate and protect children more effectively should a high level of vaccine hesitancy persist. Enhanced public health education is needed to reduce activities that unnecessarily expose children to measles and other infections.

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“…But in the comment to [ 3 ], Thakkar et al failed to detect “immune amnesia” in data from Iceland (1900–1980) [ 6 ]. Later, in the response to the comment, Mina et al demonstrated that “immune-amnesia” is largely undetectable in small populations with large fluctuations in mortality as Iceland (1900–1980) [ 7 ]. An epidemiological study using individual-level data found that incidence of non-measles infectious diseases was increased for a period of 5 years in the United Kingdom [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale

Grenfell

et al. 2021

BMC Infect Dis

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Background Infection with measles virus (MeV) causes immunosuppression and increased susceptibility to other infectious diseases. Only few studies reported a duration of immunosuppression, with varying results. We investigated the effect of immunosuppression on the incidence of hospital admissions for infectious diseases in Vietnamese children. Methods We used retrospective data (2005 to 2015; N = 4419) from the two pediatric hospitals in Ho Chi Minh City, Vietnam. We compared the age-specific incidence of hospital admission for infectious diseases before and after hospitalization for measles. We fitted a Poisson regression model that included gender, current age, and time since measles to obtain a multiplicative effect measure. Estimates were transformed to the additive scale. Results We observed two phases in the incidence of hospital admission after measles. The first phase started with a fourfold increased rate of admissions during the first month after measles, dropping to a level quite comparable to children of the same age before measles. In the second phase, lasting until at least 6 years after measles, the admission rate decreased further, with values up to 20 times lower than in children of the same age before measles. However, on the additive scale the effect size in the second phase was much smaller than in the first phase. Conclusion The first phase highlights the public health benefits of measles vaccination by preventing measles and immune amnesia. The beneficial second phase is interesting, but its strength strongly depends on the scale. It suggests a complicated interaction between MeV infection and the host immunity.

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Response to Comment on “Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality”

Cited by 7 publications

References 11 publications

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens

Transmission dynamics of and insights from the 2018–2019 measles outbreak in New York City: A modeling study

Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale

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