The Changing Global Epidemiology of Measles, 2013–2018

Patel, Minal; Antoni, Sébastien; Nedelec, Yoann; Sodha, Samir V.; Menning, Lisa; Ogbuanu, Ikechukwu U.; M, Dobó

doi:10.1093/infdis/jiaa044

Cited by 30 publications

(28 citation statements)

References 18 publications

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“…Measles remains one of the leading causes of vaccine-preventable illnesses, with increasing resurgence seen worldwide [ 22 ]. Seroprevalence data can aid in measles eradication as they identify immunity gaps and allow for public health officials to target these gaps with additional efforts [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Surprisingly Low Levels of Measles Immunity in Persons With HIV: A Seroprevalence Survey in a United States HIV Clinic

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Kubat

Sayles

et al. 2020

Open Forum Infectious Diseases

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Background Measles outbreaks have become increasingly common due to deteriorating vaccination rates, fluctuating herd immunity, and varying antibody decline. Limited knowledge exists regarding prevalence and risk factors associated with measles seronegativity among persons with HIV (PWH). Materials/methods This was a cross-sectional study conducted at an academic HIV clinic in Omaha, Nebraska. Participants were screened for the presence of measles IgG antibody. Demographic and clinical information was obtained through electronic medical record review. Simple and multivariable logistic regressions were performed to identify risk factors for measles seronegativity. Results 351 participants were enrolled with a measles seroprevalence rate of 70.3%. Mean age was 48 years (range 20 to 74), 77% were male and 53% Caucasian. Mean CD4 nadir was 334 cells/mm3 (range 1 to 1675). At the time of testing, 86% and 87% of the seronegative and seropositive participants had an HIV RNA &50 copies/mL, respectively. Younger age was significantly associated with measles seronegativity (p=0.003) as was birth year after 1957 (p=0.021). Prior history of measles infection was associated with seropositivity (p=0.011). All other risk factors evaluated, including written documentation of adequate vaccination, were not associated with seronegativity. Conclusions Our study demonstrates a measles seroprevalence rate that is remarkably lower than previously reported in PWH (92%), and, more importantly, is considerably lower than the rate needed to maintain herd immunity (95%). With higher than expected seronegativity and absence of notable risk factors aside from age, our findings support expanded measles immunity screening for PWH who are at risk of measles exposure.

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Section: Discussionmentioning

confidence: 99%

Surprisingly Low Levels of Measles Immunity in Persons With HIV: A Seroprevalence Survey in a United States HIV Clinic

Rearigh

Kubat

Sayles

et al. 2020

Open Forum Infectious Diseases

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“…Despite it being vaccine preventable, it continues to be a cause of major morbidity and mortality the world over. There is currently a global resurgence of measles in many parts of the world due to reduction in vaccination coverage, the causes of which differ for various continents ( 10 , 36 – 38 ). Reported measles cases increased between 2013 and 2018, with 66% of cases being in low and middle income countries (LMICs) and 23% in persons ≥15 years ( 10 ).…”

Section: Para- and Post-infectious Neurological Disordersmentioning

confidence: 99%

“…Despite the advances in antimicrobial treatments and prevention through vaccines and other interventions, neuroinfections continue to ravage populations the world over ( 10 – 12 ). New developments in molecular biology, immunology, better understanding of neuroinflammatory responses and advances in neuroimaging have resulted in better insights into the pathophysiology and impact of neuroinflammation.…”

Section: Introductionmentioning

confidence: 99%

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

et al. 2022

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The direct impact and sequelae of infections in children and adults result in significant morbidity and mortality especially when they involve the central (CNS) or peripheral nervous system (PNS). The historical understanding of the pathophysiology has been mostly focused on the direct impact of the various pathogens through neural tissue invasion. However, with the better understanding of neuroimmunology, there is a rapidly growing realization of the contribution of the innate and adaptive host immune responses in the pathogenesis of many CNS and PNS diseases.The balance between the protective and pathologic sequelae of immunity is fragile and can easily be tipped towards harm for the host. The matter of immune privilege and surveillance of the CNS/PNS compartments and the role of the blood-brain barrier (BBB) and blood nerve barrier (BNB) makes this even more complex. Our understanding of the pathogenesis of many post-infectious manifestations of various microbial agents remains elusive, especially in the diverse African setting. Our exploration and better understanding of the neuroimmunology of some of the infectious diseases that we encounter in the continent will go a long way into helping us to improve their management and therefore lessen the burden.Africa is diverse and uniquely poised because of the mix of the classic, well described, autoimmune disease entities and the specifically “tropical” conditions. This review explores the current understanding of some of the para- and post-infectious autoimmune manifestations of CNS and PNS diseases in the African context. We highlight the clinical presentations, diagnosis and treatment of these neurological disorders and underscore the knowledge gaps and perspectives for future research using disease models of conditions that we see in the continent, some of which are not uniquely African and, where relevant, include discussion of the proposed mechanisms underlying pathogen-induced autoimmunity. This review covers the following conditions as models and highlight those in which a relationship with COVID-19 infection has been reported: a) Acute Necrotizing Encephalopathy; b) Measles-associated encephalopathies; c) Human Immunodeficiency Virus (HIV) neuroimmune disorders, and particularly the difficulties associated with classical post-infectious autoimmune disorders such as the Guillain-Barré syndrome in the context of HIV and other infections. Finally, we describe NMDA-R encephalitis, which can be post-HSV encephalitis, summarise other antibody-mediated CNS diseases and describe myasthenia gravis as the classic antibody-mediated disease but with special features in Africa.

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“…The availability of weekly or monthly and age-specific case reporting (e.g. (2)) could permit the incorporation of these dynamics in the future but would necessarily come at the cost of shorter (though more highly resolved) time series. Finally, we assume that vaccination coverage, due to all sources, is homogeneous at the sub-national level.…”

Section: Discussionmentioning

confidence: 99%

Ensemble model estimates of the global burden of measles morbidity and mortality from 2000 to 2019: a modeling study

Santos

Eilertson

Lambert

et al. 2021

Preprint

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Background: Measles remains a significant source of childhood morbidity and mortality worldwide. Two doses of measles containing vaccine are recommended for all children and delivered through a combination of routine and supplemental immunization activities. Uncertainty about the degree to which second dose opportunities reach previously unvaccinated children presents a challenge in the assessment of vaccination programs and the estimation of the global burden of measles disease and mortality. Methods: We fit an ensemble of models that represent alternative assumptions about the degree to which second dose opportunities reach previously unvaccinated children to routine measles surveillance from 100 countries. Using maximum likelihood we selected the best fit model for each country. We compare the resulting estimates of the burden of measles disease and mortality to existing methods for estimating the burden of measles that assume that second dose opportunities are independent of receipt of the first dose. Findings: We find that 78 of 100 countries are best-fit by a model that assumes that second doses that are delivered through supplemental campaigns are preferentially delivered to children who have received a first dose. Using a country-specific best-fit model we estimate that measles mortality has declined by 73% from 2000-2019 compared to an estimated decline of 83% using an assumption of independent doses in all countries. Interpretation: Despite large decreases in measles cases over the last two decades, the observed trajectories in most countries suggest that supplemental immunization activities are disproportionately reaching previously vaccinated children. To accelerate measles reduction goals efforts to reach unvaccinated children through supplemental activities and second dose opportunities should be intensified. Funding: Bill and Melinda Gates Foundation, World Health Organization

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The Changing Global Epidemiology of Measles, 2013–2018

Cited by 30 publications

References 18 publications

Surprisingly Low Levels of Measles Immunity in Persons With HIV: A Seroprevalence Survey in a United States HIV Clinic

Surprisingly Low Levels of Measles Immunity in Persons With HIV: A Seroprevalence Survey in a United States HIV Clinic

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

Ensemble model estimates of the global burden of measles morbidity and mortality from 2000 to 2019: a modeling study

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