Immune response in malnourished children with measles.

Abstract

Measles is one of the important exanthematous viral infections of childhood the outcome of which depends on the cell-medicated immune system of the host. Several clinical studies have highlighted the synergistic effects of measles and malnutrition. Based in a slum area of Hyderbad India this study investigated the effect of protein energy malnutrition on the clinical course outcome and immune status of children suffering from measles. 273 children under 5 years old were registered for the study. Their nutritional status was assessed in a baseline survey conducted 3-4 months before the peak season of measles and they were classified into various nutritional grades according to weight/age standards. The nutritional status was reassessed during the acute phase. Measles was diagnosed by characteristic features and antibody titres. The duration and complications of measles were similar between well-nourished and malnourished children. Cell-mediated immune response was low in children with measles irrespective of their nutritional status indicating the effect of measles per se on the immune status. Severe malnutrition did not have additional adverse effects. Specific lymphocyte proliferative response to measles antigen was satisfactory and similar in children belonging to all nutritional grades. Hemagglutination inhibition titers of measles antibodies were above protective levels in all the children with measles. These observations indicate that malnutrition per se may not influence the course and outcome of measles among the children in the present study. The differences in the responses and outcome of measles reported from African and Asian countries might be due to factors other than malnutrition. Further studies are needed to understand the racial and genetic factors involved in the differential host response to the virus which until now has been known to belong to only 1 strain worldwide.