Assessing the Effects of Measles Virus Infections on Childhood Infectious Disease Mortality in Brazil.
Assessing the Effects of Measles Virus Infections on Childhood Infectious Disease Mortality in Brazil.
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评估麻疹病毒感染对巴西儿童传染病死亡率的影响。
DOI：
10.1093/infdis/jiac233
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Mina,MichaelJ
中科院分区：
文献类型：
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作者：
Xia,Siyang;Gullickson,CricketC;Metcalf,CJessicaE;Grenfell,BryanT;Mina,MichaelJ
背景麻疹病毒感染会在感染后数周内引起急性免疫抑制，还会损害先前存在的免疫记忆，导致可持续数年的“免疫失忆症”。这两种机制都使宿主容易遭受后续感染的严重后果。因此，麻疹动态可能会影响其他传染病的流行病学。方法为了验证这一假设，我们分析了1980年至1995年巴西1-9岁儿童的年死亡率。我们使用线性和负二项式模型计算了非麻疹传染病死亡率和麻疹死亡率之间的相关性，并使用3种方法来控制时间的混杂影响。我们还估计了麻疹引起的免疫调节的持续时间。结果非麻疹传染病和麻疹病毒感染的死亡率高度相关。在去除时间趋势后，这种正相关性仍然显着。我们没有发现超过一年的长期麻疹免疫调节的证据。结论这些结果支持麻疹病毒感染可能增加其他传染病的死亡率。麻疹影响的短暂滞后（<1 年）意味着巴西的这种影响可能是急性免疫抑制造成的。总体而言，我们的研究表明麻疹对儿童传染病死亡率的贡献不成比例，凸显了麻疹疫苗接种的重要性。
BackgroundMeasles virus infection induces acute immunosuppression for weeks following infection, and also impairs preexisting immunological memory, resulting in “immune amnesia” that can last for years. Both mechanisms predispose the host to severe outcomes of subsequent infections. Therefore, measles dynamics could potentially affect the epidemiology of other infectious diseases.MethodsTo examine this hypothesis, we analyzed the annual mortality rates of children aged 1–9 years in Brazil from 1980 to 1995. We calculated the correlation between nonmeasles infectious disease mortality rates and measles mortality rates using linear and negative-binomial models, with 3 methods to control the confounding effects of time. We also estimated the duration of measles-induced immunomodulation.ResultsThe mortality rates of nonmeasles infectious diseases and measles virus infection were highly correlated. This positive correlation remained significant after removing the time trends. We found no evidence of long-term measles immunomodulation beyond 1 year.ConclusionsThese results support that measles virus infection could increase the mortality of other infectious diseases. The short lag identified for measles effects (<1 year) implies that acute immunosuppression was potentially driving this effect in Brazil. Overall, our study indicates disproportionate contributions of measles to childhood infectious disease mortality, highlighting the importance of measles vaccination.