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Dor E, Fluss R, Israel A, Huppert A. Quantifying the long-term effects of measles infection-a retrospective cohort study. Clin Microbiol Infect 2024:S1198-743X(24)00393-8. [PMID: 39142629 DOI: 10.1016/j.cmi.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To assess whether measles infection has an impact on the rate of non-measles infectious diseases over an extended period. METHODS This retrospective matched cohort study included 532 measles-diagnosed patients who were exactly matched with 2128 individuals without a previous measles diagnosis. Adjusted OR for any all-cause infectious diagnosis and any viral infection diagnosis ≤2 years after measles diagnosis between the measles and control groups was obtained from a conditional logistic regression model. The Cox proportional hazards model was used to estimate the hazard ratio. RESULTS Previous measles virus (MeV) exposure was associated with an increased risk for all-cause non-measles infectious disease diagnosis (OR: 1.83, 95% CI: 1.26-2.64, p 0.001), with 492 diagnoses in the MeV-exposed group and 1868 diagnoses in the control group. Additionally, previous MeV exposure was linked to a higher risk of viral infection diagnosis (OR: 1.23, 95% CI: 1.01-1.59, p < 0.05), with 302 viral infection diagnoses in the MeV-exposed group and 1107 diagnoses in the control group. The hazard ratio for viral diagnosis in the MeV-exposed group compared with the control group was 1.54 (95% CI: 1.18-2.02, p < 0.001). DISCUSSION Individuals diagnosed with measles had a moderately increased risk of being diagnosed with all-cause non-measles infectious disease or viral infection. This observational individual-level study supports previous ecological and individual population-level studies.
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Affiliation(s)
- Ella Dor
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ronen Fluss
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel
| | - Ariel Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Leumit Research Institue, Leumit Health Services, Tel Aviv, Israel
| | - Amit Huppert
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Gabrick EC, Brugnago EL, de Souza SLT, Iarosz KC, Szezech JD, Viana RL, Caldas IL, Batista AM, Kurths J. Impact of periodic vaccination in SEIRS seasonal model. CHAOS (WOODBURY, N.Y.) 2024; 34:013137. [PMID: 38271628 DOI: 10.1063/5.0169834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024]
Abstract
We study three different strategies of vaccination in an SEIRS (Susceptible-Exposed-Infected-Recovered-Susceptible) seasonal forced model, which are (i) continuous vaccination; (ii) periodic short-time localized vaccination, and (iii) periodic pulsed width campaign. Considering the first strategy, we obtain an expression for the basic reproduction number and infer a minimum vaccination rate necessary to ensure the stability of the disease-free equilibrium (DFE) solution. In the second strategy, short duration pulses are added to a constant baseline vaccination rate. The pulse is applied according to the seasonal forcing phases. The best outcome is obtained by locating intensive immunization at inflection of the transmissivity curve. Therefore, a vaccination rate of 44.4% of susceptible individuals is enough to ensure DFE. For the third vaccination proposal, additionally to the amplitude, the pulses have a prolonged time width. We obtain a non-linear relationship between vaccination rates and the duration of the campaign. Our simulations show that the baseline rates, as well as the pulse duration, can substantially improve the vaccination campaign effectiveness. These findings are in agreement with our analytical expression. We show a relationship between the vaccination parameters and the accumulated number of infected individuals, over the years, and show the relevance of the immunization campaign annual reaching for controlling the infection spreading. Regarding the dynamical behavior of the model, our simulations show that chaotic and periodic solutions as well as bi-stable regions depend on the vaccination parameters range.
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Affiliation(s)
- Enrique C Gabrick
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
- Department of Physics, Humboldt University Berlin, Newtonstraße 15, 12489 Berlin, Germany
- Graduate Program in Science, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
| | - Eduardo L Brugnago
- Institute of Physics, University of São Paulo, 05508-090 São Paulo, SP, Brazil
| | - Silvio L T de Souza
- Federal University of São João del-Rei, Campus Centro-Oeste, 35501-296 Divinópolis, MG, Brazil
| | - Kelly C Iarosz
- Graduate Program in Science, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
- University Center UNIFATEB, 84266-010 Telêmaco Borba, PR, Brazil
| | - José D Szezech
- Graduate Program in Science, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
- Department of Mathematics and Statistics, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
| | - Ricardo L Viana
- Institute of Physics, University of São Paulo, 05508-090 São Paulo, SP, Brazil
- Department of Physics, Federal University of Paraná, 81531-980 Curitiba, PR, Brazil
| | - Iberê L Caldas
- Institute of Physics, University of São Paulo, 05508-090 São Paulo, SP, Brazil
| | - Antonio M Batista
- Graduate Program in Science, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
- Institute of Physics, University of São Paulo, 05508-090 São Paulo, SP, Brazil
- Department of Mathematics and Statistics, State University of Ponta Grossa, 84030-900 Ponta Grossa, PR, Brazil
| | - Jürgen Kurths
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
- Department of Physics, Humboldt University Berlin, Newtonstraße 15, 12489 Berlin, Germany
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Borges LP, Barreto MDS, Santos RS, Souza JBDE, Silva BSDA, Jesus PCDE, Silva DMRR, Moura PHM, Santos LMMD, Silva EED, Santana LADAM. Why are measles and rubella returning in Brazil? AN ACAD BRAS CIENC 2023; 95:e20230832. [PMID: 38055566 DOI: 10.1590/0001-3765202320230832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/28/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Lysandro P Borges
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Marina Dos S Barreto
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Ronaldy S Santos
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Jessiane B DE Souza
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Beatriz S DA Silva
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Pamela C DE Jesus
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Deise M R R Silva
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Pedro H M Moura
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Leticia M M Dos Santos
- Federal University of Sergipe, Department of Pharmacy, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Eloia E D Silva
- Federal University of Sergipe, Department of Biological Sciences, Av. Marechal Rondon Jardim, s/n, Rosa Elze, 49100-000 São Cristóvão, SE, Brazil
| | - Lucas A DA M Santana
- Federal University of Sergipe, Graduate Program in Dentistry, Health and Biological Sciences Institute, St. Cláudio Batista, s/n, Cidade Nova, 49060-102 Aracaju, SE, Brazil
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Benn CS, Aaby P. Measles vaccination and reduced child mortality: Prevention of immune amnesia or beneficial non-specific effects of measles vaccine? J Infect 2023; 87:295-304. [PMID: 37482223 DOI: 10.1016/j.jinf.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
Measles vaccine (MV) has been observed to reduce all-cause mortality more than explained by prevention of measles infection. Recently, prevention of "measles-induced immune amnesia" (MIA) has been proposed as an explanation for this larger-than-anticipated beneficial effect of measles vaccine (MV). According to the "MIA hypothesis", immune amnesia leads to excess non-measles morbidity and mortality, that may last up to five years after measles infection, but may be prevented by MV. However, the benefits of MV-vaccinated children could also be due to beneficial non-specific effects (NSEs) of MV, reducing the risk of non-measles infections (The "NSE hypothesis"). The epidemiological studies do provide some support for MIA, as exposure to measles infection before 6 months of age causes long-term MIA, and over 6 months of age for 2-3 months. However, in children over 6 months of age, the MIA hypothesis is contradicted by several epidemiological patterns: First, in community studies that adjusted for MV status, children surviving acute measles infection had lower mortality than uninfected controls (44%(95%CI: 0-69%)). Second, in six randomised trials and six observational studies comparing MV-vaccinated and MV-unvaccinated children, the benefit of MV changed minimally from 54%(43-63%) to 49%(37-59%) when measles cases were censored in the survival analysis, making it unlikely that prevention of measles and its long-term consequences explained much of the reduced mortality. Third, several studies conducted in measles-free contexts still showed significantly lower mortality after MV (55%(40-67%)). Fourth, administration of MV in the presence of maternal measles antibody (MatAb) is associated with much stronger beneficial effect for child survival than administration of MV in the absence of MatAb (55%(35-68%) lower mortality). The MIA hypothesis alone cannot explain the strongly beneficial effects of MV on child survival. Conversely, the hypothesis that MV has beneficial non-specific immune training effects is compatible with all available data. Consideration should be given to continuing MV even when measles has been eradicated.
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Affiliation(s)
- Christine S Benn
- Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau; Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark/Odense University Hospital, Denmark; Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Denmark
| | - Peter Aaby
- Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau; Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark/Odense University Hospital, Denmark.
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