Humoral Immunity against Measles in Mother-Infant Pairs during the First Year of Life in Greece: A Cross-Sectional Study.

Florentia Kanakoudi-Tsakalidou,Styliani Glykou,Eleni Papadimitriou,Evangelia Farmaki,Eleni Agakidou,Anna Taparkou,Fotiοs Papachristou

doi:10.3390/vaccines9020143

Florentia Kanakoudi-Tsakalidou, Styliani Glykou + Show 5 more

Open Access

https://doi.org/10.3390/vaccines9020143

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Abstract

Measles outbreaks have surfaced in Europe during the last decades. Infants <12 months of age were the most severely affected pediatric population. The aim of this study was to investigate the duration of maternally derived measles antibodies in infants aged 1 to 12 months in relation to maternal humoral immune status and other parameters. In a prospective, cross-sectional cohort study, 124 mother/infant pairs and 63 additional infants were recruited from October 2015 through December 2019. Infants were hospitalized in a university pediatric department of a general hospital. Demographic and epidemiological data were recorded and blood samples were collected from mothers and their infants. Commercially available enzyme-linked immunosorbent assay (ELISA) was used for measuring measles antibodies. Fifty nine percent of mothers had vaccine-induced and 15% infection-acquired measles immunity. Eighty-eight percent and 94% of infants were unprotected by 5 and 10 months of age, respectively. Maternal antibody levels and infant age were significant independent predictors of infants’ antibody levels whereas the method of maternal immunity acquisition, age, and origin [Greek/non-Greek] were not. Our findings suggest that about 90% of infants are susceptible to measles beyond the age of 4 months. To our knowledge, these are the first data from Greece reported under the current community composition and epidemiological conditions.

Highlights

Measles and rubella had been targeted for eradication in Greece by 2020, as in the whole World Health Organisation (WHO) European Region, following the WHO Global Measles and Rubella strategic plan 2012–2020 [1]
Most women of childbearing age have obtained their immunity following immunization rather than by a community-acquired measles infection and their measles immunoglobulin gamma (IgG) levels are gradually waning with time, without a chance for immune boosting
The findings of our study showed that most infants in our cohort were born to mothers who obtained their measles immunity following immunization (58.8%) rather than through infection (15.5%)

Summary

Introduction

Measles and rubella had been targeted for eradication in Greece by 2020, as in the whole World Health Organisation (WHO) European Region, following the WHO Global Measles and Rubella strategic plan 2012–2020 [1]. The “measles elimination settings” are defined as lack of endemic transmission of the virus for ≥12 months [3]. In these settings, most women of childbearing age have obtained their immunity following immunization rather than by a community-acquired measles infection and their measles immunoglobulin gamma (IgG) levels are gradually waning with time, without a chance for immune boosting. Sporadic measles outbreaks could occur from year to year, presumably due to imported cases, potentially causing severe complications and deaths [4,5,6]. Previous studies have shown that infants born to measles-vaccinated mothers have lower levels of maternally derived antibodies at birth and a shorter duration of protection than infants born to measles-infected mothers [8,9,10,11,12,13,14,15,16]

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