Abstract
BackgroundThe pandemic of COVID-19 has occurred close on the heels of a global resurgence of measles. In 2019, an unprecedented epidemic of measles affected Samoa, requiring a state of emergency to be declared. Measles causes an immune amnesia which can persist for over 2 years after acute infection and increases the risk of a range of other infections.MethodsWe modelled the potential impact of measles-induced immune amnesia on a COVID-19 epidemic in Samoa using data on measles incidence in 2018–2019, population data and a hypothetical COVID-19 epidemic.ResultsThe young population structure and contact matrix in Samoa results in the most transmission occurring in young people < 20 years old. The highest rate of death is the 60+ years old, but a smaller peak in death may occur in younger people, with more than 15% of total deaths in the age group under 20 years old. Measles induced immune amnesia could increase the total number of cases by 8% and deaths by more than 2%.ConclusionsSamoa, which had large measles epidemics in 2019–2020 should focus on rapidly achieving high rates of measles vaccination and enhanced surveillance for COVID-19, as the impact may be more severe due to measles-induced immune paresis. This applies to other severely measles-affected countries in the Pacific, Europe and elsewhere.
Highlights
The pandemic of COVID-19 has occurred close on the heels of a global resurgence of measles
A study in Switzerland showed that measles immune amnesia increases the risk of a wide
We used data from the WHO situation reports of the measles epidemic in Samoa [11, 19, 20], and an assumption that immune amnesia would be present in children infected from November 2019 onward for at least 12 months and up to 36 months [2], to model the morbidity and mortality impact of a COVID-19 epidemic in the country
Summary
The pandemic of COVID-19 has occurred close on the heels of a global resurgence of measles. Measles causes an immune amnesia which can persist for over 2 years after acute infection and increases the risk of a range of other infections. Asia and the Pacific have experienced unprecedented measles epidemics in 2019 [1]. Other than direct viral morbidity and mortality, measles causes an immune amnesia which can persist for over 2 years after acute infection and increases the risk of a range of other infections [2,3,4,5,6]. The measles virus is shown to directly infect memory CD4+ and CD8+ T cells as well as naïve T cells [8]. A study in Switzerland showed that measles immune amnesia increases the risk of a wide
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