AUTHOR=Bühl Daniel , Staudacher Olga , Santibanez Sabine , Rossi Rainer , Girschick Hermann , Stephan Volker , Schmidt Beatrix , Hundsdoerfer Patrick , von Moers Arpad , Lange Michael , Barker Michael , Mall Marcus A. , Heininger Ulrich , Matysiak-Klose Dorothea , Mankertz Annette , von Bernuth Horst TITLE=Specifically Increased Rate of Infections in Children Post Measles in a High Resource Setting JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.896086 DOI=10.3389/fped.2022.896086 ISSN=2296-2360 ABSTRACT=Objectives

Post-measles increased susceptibility to subsequent infections seems particularly relevant in low-resource settings. We tested the hypothesis that measles causes a specifically increased rate of infections in children, also in a high-resource setting.

Methods

We conducted a retrospective cohort study on a large measles outbreak in Berlin, Germany. All children with measles who presented to hospitals in Berlin were included as cases, children with non-infectious and children with non-measles infectious diseases as controls. Repeat visits within 3 years after the outbreak were recorded.

Results

We included 250 cases, 502 non-infectious, and 498 infectious disease controls. The relative risk for cases for the diagnosis of an infectious disease upon a repeat visit was 1.6 (95% CI 1.4–2.0, p < 0.001) vs. non-infectious and 1.3 (95% CI 1.1–1.6, p = 0.002) vs. infectious disease controls. 33 cases (27%), 35 non-infectious (12%) and 57 (18%) infectious disease controls presented more than three times due to an infectious disease (p = 0.01, and p = 0.02, respectively). This results in a relative risk of more than three repeat visits due to an infection for measles cases of 1.8 (95% CI 1.3–2.4, p = 0.01), and 1.4 (95% CI 1.0–1.9, p = 0.04), respectively.

Conclusion

Our study demonstrates for the first time in a high-resource setting, that increased post-measles susceptibility to subsequent infections in children is measles-specific—even compared to controls with previous non-measles infections.