Science
8 May 2015 vol 348, issue 6235, pages 605-728
http://www.sciencemag.org/current.dtl

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Report
Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality
Michael J. Mina1,2,*, C. Jessica E. Metcalf1,3, Rik L. de Swart4, A. D. M. E. Osterhaus4, Bryan T. Grenfell1,3
Author Affiliations
1Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
2Medical Scientist Training Program, School of Medicine, Emory University, Atlanta, GA, USA.
3Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
4Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands.
Abstract
Immunosuppression after measles is known to predispose people to opportunistic infections for a period of several weeks to months. Using population-level data, we show that measles has a more prolonged effect on host resistance, extending over 2 to 3 years. We find that nonmeasles infectious disease mortality in high-income countries is tightly coupled to measles incidence at this lag, in both the pre- and post-vaccine eras. We conclude that long-term immunologic sequelae of measles drive interannual fluctuations in nonmeasles deaths. This is consistent with recent experimental work that attributes the immunosuppressive effects of measles to depletion of B and T lymphocytes. Our data provide an explanation for the long-term benefits of measles vaccination in preventing all-cause infectious disease. By preventing measles-associated immune memory loss, vaccination protects polymicrobial herd immunity.