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The benefits of the measles vaccine go beyond measles

Dedicated to lilady.

One of the disadvantages of writing for this blog is that sometimes I feel as though I spend so much time deconstructing bad science and pseudoscience in medicine that I’m rarely left with the time or the opportunity to discuss some interesting science. Of course, even when I do that, usually it’s in the context of that very same bad science or pseudoscience, and this post won’t be different. Still, there was some interesting science with respect to vaccines published last week in Science, and I think it’s worth looking over. The only thing that surprises me is that the antivaccine movement hasn’t attacked it ruthlessly yet, even though it’s a week old. On the other hand, its press coverage was relatively minimal, and I didn’t really notice it until an article appeared on (sadly, yes) The Huffington Post entitled “The Measles Vaccine Can Protect Against Much More Than Measles, According To New Study“:

A new study suggests the measles shot comes with a bonus: By preventing that disease, the vaccine may also help your body fight off other illnesses for years.

It’s long been known that contracting measles weakens the immune system for weeks or months, putting people, especially children, at increased risk for potentially fatal infection by a host of germs.

Now, scientists find that this vulnerable period goes on much longer than thought, up to three years. So the benefit of avoiding measles also extends longer than was appreciated. Researchers also found that measles vaccination campaigns were followed by a drop in deaths for other infectious diseases.

Experts said the work is a wake-up call to parents who don’t vaccinate their children out of unfounded fears about a link between vaccines and autism.


Or, as is reported in more detail in this NPR story, this is what happened after the introduction of measles vaccination campaigns:

Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.

Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.

“In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,” says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.

“So it’s really been a mystery — why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine,” he says.

Of course, as I’ve discussed on many occasions, before the introduction of the measles vaccine in the early 1960s, there were routinely a half a million cases of measles per year in the US, an incidence that dropped dramatically, as shown on this graph, which I’ve used periodically whenever I want to make this point:

Measles_US_1944-2007_inset

Also each year, out of those roughly a half million cases, an estimated 400 to 500 people died, and there were around 48,000 hospitalizations, with 4,000 ending up suffering encephalitis (swelling of the brain) from measles. Contrary to antivaccine activists invoking what I like to refer to as the “Brady Bunch” fallacy, a name I chose based on how antivaccinationists like to invoke a 1969 episode of the Brady Bunch in which all six children, the father, and the maid Alice came down with the measles, a situation that was played for laughs. In the episode, the measles was portrayed as no big deal, a normal childhood disease that almost everyone gets, and the kids were shown happily playing board games and rejoicing that they got a few days off from school. The message? Obviously that the measles shouldn’t be feared. But it should. As Clay Jones reminded us not too long ago, the most feared and deadly complication of measles, subacute sclerosing panencephalitis (SSPE) is not as rare as it is portrayed, and after a measles infection it can appear after a latent period lasting 6-8 years to cause an encephalitis that kills most children it affects within three years. Actually, SSPE is rare now, but that’s because its incidence plummeted after widespread measles immunization efforts caused the incidence of measles to plummet. As Clay put it, where there is more measles, there is more SSPE.

All of the above observations are more than adequate reasons to immunize against measles. However, if the recent study in Science is correct, measles vaccination is even more important than the reasons above make it because it prevents more than just measles. Let’s take a look at the study by Mina et al. out of the laboratory of Bryan T. Grenfell, “Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality“, the study that spawned the stories I cited above. It’s a study funded by the Bill and Melinda Gates Foundation that comes out of the Department of Ecology and Evolutionary Biology, Princeton University; Emory University; the Fogarty International Center at the National Institutes of Health; and the Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands. Not only does it provide a possible answer to one of the great mysteries of measles and the measles vaccine, but it suggests that measles vaccination is even more important than it is already known to be. The reason is as described in the stories above, introduction of mass vaccination programs against measles routinely produces a greater drop in mortality than can be attributed just to the decline in measles incidence.

The authors begin by pointing out how successful measles vaccination programs have been; that is, where they have been able to achieve high levels of vaccination. It’s a success that, contrary to what most people realize, goes beyond just preventing measles and causing its incidence to plummet to very low levels in developed countries:

Measles vaccines were introduced 50 years ago and were followed by striking reductions in child morbidity and mortality (1, 2). Measles control is now recognized as one of the most successful public health interventions ever undertaken (3). Despite this, in many countries vaccination targets remain unmet, and measles continues to take hundreds of thousands of lives each year (3). Even where control has been successful, vaccine hesitancy threatens the gains that have been made (1, 4). The introduction of mass measles vaccination has reduced childhood mortality by 30 to 50% in resource-poor countries (5–8) and by up to 90% in the most impoverished populations (9, 10). The observed benefits cannot be explained by the prevention of primary measles virus (MV) infections alone (11, 12), and they remain a central mystery (13).

MV infection is typified by a profound, but generally assumed to be transient, immunosuppression that renders hosts more susceptible to other pathogens (14–17). Thus, contemporaneous reductions in nonmeasles mortality after vaccination are expected. However, reductions in infectious disease mortality after measles vaccination can last throughout the first 5 years of life (5–10), which is much longer than anticipated by transient immunosuppression, which is generally considered to last for weeks to months (16, 17).

They cite a recent report by the World Health Organization (WHO) that examined the nonspecific effect of various vaccines on all-cause mortality (i.e., the effect of the vaccine on causes of mortality other than the disease that it is designed to prevent), which concluded that measles vaccination is associated with large reductions in all-cause childhood mortality, an effect more marked in girls than in boys, but that there is no firm evidence to explain an immunological mechanism for the nonspecific vaccine benefits. To illustrate this, here is a graph from the report summarizing the results:

Measles-results-large

As you can see, most of the studies show a significant decrease in all-cause mortality, an effect that is more marked in girls than in boys. The authors separated studies deemed to be at high risk of bias from those judged to be higher quality, and the effect is still there. Mina et al. note that proposed mechanisms for a nonspecific beneficial effect of measles vaccination include suggestions that the live vaccine might directly stimulate cross-reactive T cell responses or that they might train innate immunity to take on a phenotype like that of immune memory. However, they question whether such effects can explain the long term benefits of measles vaccination and the pre-measles vaccine associations between measles and mortality from other infectious disease. At this point, I can’t help but emphasize that what Mina et al. found is not a new finding that measles vaccination has a robust effect on all-cause mortality, including infectious diseases other than measles. This is a finding that has been observed enough times that it is generally agreed upon. Rather, what Mina et al. did was to test a hypothesis using population-level data that the reason for this effect has to do with modulation of the immune system by the measles virus such that it is less effective in warding off other infectious diseases for a significant period of time after.

So what might explain this effect? The authors invoke a different hypothesis, proposed by Rory D. de Vries at the Department of Viroscience, Erasmus MC, Rotterdam, that a loss of immune memory cells after measles virus infection “resets previously acquired immunity, and vaccination prevents this effect.” The idea is this. Measles often causes depletion of lymphocytes, which rapidly rebound after the disease clears. However, de Vries et al. hypothesize that “massive expansion of MV-specific and bystander lymphocytes masks the fact that pre-existing memory lymphocytes have been depleted” and conclude that “measles virus infection wipes out immunological memory, leaving individuals susceptible to opportunistic infectious agents that would normally be controlled by the immune system.” In a commentary, de Vries argues:

Experimental MV [measles virus] infections in animal models have demonstrated that percentages of infected lymphocyte subsets are higher than previously thought, especially in secondary and tertiary lymphoid tissues [11], [13]. We believe that measles immune suppression mainly results from depletion of immune cell subsets, which is masked by the rapid proliferation of MV-specific and bystander lymphocytes (Fig. 1D). This model is fully compatible with the measles paradox. Clinical studies are required to test our hypothesis that measles immune suppression is mainly a numbers game.

Consider Mina et al. a first attempt at testing this hypothesis at a population level using mathematical modeling of measles cases and mortality from other infections before and after the introduction of widespread measles vaccination campaigns in the US, England and Wales, and Denmark. In fact, the raw data (in Figure 1, if you have access to Science) suggest a very strong correlation between measles infection and death rates from other infections. To provide supportive evidence for the hypothesis, the following had to be true

  1. Nonmeasles mortality should be correlated with measles incidence data, especially because the onset of vaccination reduces the latter.
  2. An immune memory loss should present as a strengthening of this association when measles incidence data are transformed to reflect an accumulation of previous measles cases.
  3. The strength of the association should be greatest when the mean duration over which the cases are accumulated matches the mean duration required to restore immunological memory after measles infection.
  4. The estimated duration should be consistent both with the available evidence of increased risk of mortality after measles infection compared with uninfected children, and with the time required to build a protective immune repertoire later in life.

Finally, as the authors stated, “To explicitly address whether the observed nonspecific benefits of vaccination can be attributed to the prevention of MV immunomodulation, evidence for the four hypotheses must be present separately within the pre-vaccine eras.” Let’s just say that they were.

For example, when the authors transformed the data as described in #2 and #3, for England and Wales, the best fit occurred centered at a 28 to 28.3-month duration of measles-induced immunomodulation in the pre-vaccine era. In the pre-vaccination era, they obtained an estimated 29.2 month duration for measles-induced immunomodulation in the post-vaccine era. These results were robust and held up to a number of manipulations, including examining various age groups and different disease classes. Looking at the different countries, the authors found strong evidence to support “a generalized prolonged (roughly 2- to 3-year) impact of measles infection on subsequent mortality from other infectious diseases.”

Additional controls only strengthened the authors’ observations. For example, because previous evidence suggests that the immunomodulatory effect of measles virus is stronger in girls, thus leading to a greater nonspecific benefit of measles vaccination, the authors tested whether their model showed this same effect by comparing genders. Using their model, they found “consistently stronger associations among females,” in agreement with existing data, an agreement that held over multiple tests using either the full data set or the pre-vaccine data set. Finally, as an additional control, the authors repeated their analysis, only this time for pertussis, because pertussis is also vaccine-preventable and is not known to be immunosuppressive, like measles. They found no correlation between pertussis incidence and mortality from infectious diseases other than pertussis, and no correlation was observed even when the authors transformed their data in the same way they did the measles data to reflect the sum of previous pertussis cases.

Of course, this study is not perfect. One can always criticize choices made in mathematical models, and the authors do point out a caveat of their study and its strong agreement with previous observations in that other studies have failed to detect long-term immunological sequelae from measles. However, they point out that these cohort studies focused on low-income countries, where high rates of death from opportunistic infections during the acute measles infection tend to drive mortality; in other words, in these countries, so many children die of opportunistic infections and other acute sequelae of measles that effects from long term immunological sequelae are probably masked, given that approximately 50% of all childhood deaths recorded after five years of followup occurred within two months of infection.

The authors end up concluding:

MV infection and vaccination produce strong and durable herd immunity against subsequent epidemics (40). Our results thus suggest an extra dynamical twist: MV infections could also reduce population immunity against other infections in which MV immunomodulation could be envisioned as a measles-induced immune amnesia (17); hence, measles vaccination might also be preserving herd protection against nonmeasles infections.

Measles vaccination is one of the most cost-effective interventions for global health, and our results imply further immunological dividends: mortality (and probably morbidity) reductions linked to measles vaccination might be much greater than previously considered. This is of particular importance today where, especially in wealthy nations, reduced opportunistic infections during acute measles immunosuppression, added to the comparative rarity of infection, has led to a public view of measles as a benign childhood disease. Our findings help dispel the mystery surrounding the disproportionately large reductions in mortality seen after the introduction of measles vaccinations and reinforce the importance of measles vaccination in a global context.

Indeed, it has been noted that, after the introduction of the measles vaccine, not only did measles cases decline in the US, but deaths from infections such as respiratory and diarrheal diseases also fell from 18 per 100,000 before vaccination to 6 per 100,000 after vaccination, or, as the authors state earlier in their study:

Our results show that when measles was common, MV infections could have been implicated in as many as half of all childhood deaths from infectious disease, thus accounting for nearly all of the interannual fluctuations in childhood infectious disease deaths. The reduction of MV infections was the main factor in reducing overall childhood infectious disease mortality after the introduction of vaccination.

Of course, this is just one study and will require replication and studies to expand upon its results, assuming they hold up, but it fits in with other, earlier studies, suggesting that the benefits of vaccinating against measles go beyond preventing just measles. It is also yet another piece of data that puts the lie to claims by the antivaccine movement that measles is not dangerous and that we should believe a silly old sitcom’s view of the measles over the view of pediatricians and scientists, who knew that the measles is not a benign disease but had little to offer with respect to prevention or treatment of the disease other than supportive care. Think of it this way: if measles were such a benign disease and no big deal to worry about, why was such a major effort made to develop a vaccine in the late 1950s and early 1960s? Why was it the next big vaccine after the polio vaccine? This story in the New York Times from 1963 tells the tale:

In terms of frequency, measles is the number one disease of childhood, and it is far from harmless. It renders its victims highly susceptible to other infections. The most dreaded complication is encephalitis, an inflammation of the brain and spinal cord that may lead to permanent damage. In 1958 there were 522 deaths in the United States compared with 255 deaths from polio. In 1960 there were 410 deaths from measles, compared with 260 deaths from polio.

Fifty-two years later, we are now beginning to understand that measles doesn’t just render its victims susceptible to other infections during its acute phase, but that its immunomodulatory effects last as long as three years. Antivaccinationists frequently claim that vaccines “damage” the immune system, despite all the evidence that they do not. Rather, if anything “damages” the immune system, it’s the measles virus, and the protection against that damage is a vaccine.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

130 replies on “The benefits of the measles vaccine go beyond measles”

I’m not surprised by this finding. Infectious diseases are very good at messing with different parts of our immune systems to their own benefit. And that the damage caused by one infection can be taken advantage of by other infections should be expected. Reminds me of the mouse study a few years ago that found pertussis toxin increased the severity of a subsequent influenza infection. Which reminds me, I should see if there have been any followup studies to that one.

Findings like this really mess with the natural-infection-is-good-for-you-and-vaccines-don’t-provide-real-immunity crowd.

@DB

They’ll just say the study is worthless because it’s just a computer model…oh, and GATES!!!eleventy!!1!

If further study proves this out, it opens up all kinds of innovative research on how to tailor and possibly even repair the immune system, especially in cases of auto-immune disorders, like Lupus, for instance.

#2 dangerous bacon,

“Findings like this really mess with the natural-infection-is-good-for-you-and-vaccines-don’t-provide-real-immunity crowd.”

Although those immunological memories that the measles depletes are probably natural, right? So that lends some support to the natural infection argument.

zebra- Try thinking for five seconds before you post. Natural or not, the vaccine causes far less damage to those immunological memories.

I find this study very interesting, as the year my mother and uncle both had measles, after they recovered from the infection, both were constantly ill with one cold after another. Comparing that winter to the previous winter (the year my mom started school, (when one would expect frequent illnesses due to exposure to new children) and the following winter, it’s obvious that *something* had depressed their immune systems for that year.

Oh, and they had very healthy diets, municipal water, municipal sewage systems, only the smallpox vaccine, and were outside and very active most of the time. No antibiotics.

So what was different about that year over the others besides the measles?

zebra- That’s because you don’t understand the concepts of cause and effect.

#9

?

Sounds like you are a bit confused about what the study said.

What cause and what effect are you talking about?

The natural measles infection wipes out immunological memories. The vaccine does not. It’s that simple.

#11

Yes, exactly. So what in the world are you disagreeing with in my very simple observation?

Where the immunological memories came from does not change that risk-benefit analysis.

zebra’s comment at 5 makes sense under the hypothesis that zebra does not know what the word “deplete” means.

#13,

Well, we are back to ?– no clue what you are talking about.

You need to explain what you disagree with in what I said; I didn’t say anything about risk-benefit analysis.

I assumed Zebra’s comment was a facetious “oh, they’ll say it’s ok as long as it’s natural immunological memory loss, not that artificial stuff.”

That does bring up the point that a fair number of antivaxxers don’t believe in immunological memory to begin with!

I find it indescribably delicious that the measles vaccine actually “boosts the immune system!”

@zebra: Yes you did: you outright said “So that lends some support to the natural infection argument.”

zebra, your comment was:

Although those immunological memories that the measles depletes are probably natural, right? So that lends some support to the natural infection argument.

Except that natural measles infection is the thing that causes the depletion, so I (and the rest of the commenters) fail to understand how that “lends [any] support to the natural infection argument”.

#17

Maybe you have some misconception about “the natural infection argument”? I was responding to what dangerous bacon said:

“Findings like this really mess with the natural-infection-is-good-for-you…”

I quote it right there, so if you have some other “natural infection argument” in mind, that would again indicate some real confusion on your part.

@zebra: Yes you did: you outright said “So that lends some support to the natural infection argument.”

Right. And you were replying to this:

“Findings like this really mess with the natural-infection-is-good-for-you-and-vaccines-don’t-provide-real-immunity crowd.”

The study shows that natural infection weakens real immunity and vaccines are good for you. Therefore, it does not support the natural-infection argument.

What part of that could possibly be unclear?

Please, this topic is way to interesting to derail the thread with 100 comments trying to decipher Zebra’s enigmatic comment.

Anyway, I predict that some antivaxer will start saying that this is great because when your child gets NATURAL IMMUNITY to measles it gives your child yet another opportunity to get NATURAL IMMUNITY to whatever they were already fortunate enough to get NATURAL IMMUNITY to, for even more natural goodness.

“Although those immunological memories that the measles depletes are probably natural, right? So that lends some support to the natural infection argument.”

1. Why would losing immunological memory ever be a good thing?

2. Why would losing natural immunity from a natural infection be better than losing immunity due to a vaccine?

3. Still trying to wrap my head around this but why would losing natural immunity from a natural illness somehow be better than any other way of losing your immunity and having to get an illness again.

4. Is there some kind of theory that the immunity from having to be sick all over again would be better than immunity from getting that illness once and never getting it again?

Add me to those really confused about what point you were trying to make that seems to be along the lines of shouldn’t we be encouraging more people to get more measles? Because I don’t see more people dying from things they survived once but didn’t on the repeat is a good thing?!

@justthestats

Please, this topic is way to interesting to derail the thread with 100 comments trying to decipher Zebra’s enigmatic comment.

Agreed. One of the reasons I just ignore zebra entirely. Unfortunately, I’m still exposed to zebra’s nonsense because people respond.

My parents immunized scores of children in the 70s and 80s in a developing country. Time and again, they’d see the following: a child would get measles, recover, then acquire something else – influenza, varicella, pertussis, gastro, the list goes on. Often, this would be a previously healthy child – healthy relative to the context in which they were living.

This is a great read. I’m glad you’ve dedicated it to lilady, Orac. Thank you.

love the graph in the leader of the thread, shows GP notifications against time, not mortality. then the graph is ‘tweaked’ to make it look like measles vaccine did the job.

Yes it is a fitting tribute to Lilady

@26, How was the graph tweaked exactly? It shows a drop in cases after the measles vaccine was introduced.

johnny, mortality is not the only bad outcome. Mortality is only a measure of how well medical care improves, it is not a measure of cases.

Only those who want to lie about vaccine effects mention mortality, and ignore morbidity.

No one says that antibiotics for secondary bacterial infections or other improvements in care or general health didn’t reduce the death rate or claim the vaccine did that all buy itself.

Would you prefer the graph that clearly shows that while death rates declined the number of people falling ill each year stayed the same done on a scale that shows there was and additional decline in death rate after the vaccine even though most people like to use the graph where you can’t see that.

http://4.bp.blogspot.com/-XVcLQoVCgFM/U6IXVqNEBbI/AAAAAAAABCc/erlgz0Jcpa0/s1600/Measles+Cases+and+Mortality+1912-1974+-+Log+Scale.jpg

I am old enough to to be born before the Measles Vaccine became available. Unfortunately, when I was about three years of age, I contracted Measles. It was not fun becoming stone deaf, and I can still remember feeling so ill. I was stone deaf for six weeks only, but the GP was very worried that I would be permanently deaf. Soon after the measles I managed to be infected by the Mumps Virus.
Measles is not a joke, but a disease to be feared. I had it bad, but some young people have it far worse, eg: ending up with meningitis and becoming permanently brain damaged. The Federal Goverment in Australia are toying with the idea of withholding family benefits paid to parents who refuse to vaccinate their children. This will not stop the anti-vaccinationists. The best way to protect others from these people is to prevent these unvaccinated children from going to preschool and/or school.
The anti-vaccinationists need to learn that the the health of the greater population is far more important than their stupid and very misguided beliefs about the dangers of vaccines.
I am so sorry to read of the death of lilady, Vale.

Good to see people are back in their comfort zone with someone at their own intellectual level.

Not wasting time on thinking….

@Chris, that is why I posted the graph that shows that the one the anti-vax people like to use hides some important data.

zebra: “Not wasting time on thinking…”

When have you bothered to think on anything? There is a reason most of us ignore you.

KayMarie, I know. Though that old article shows even worse cherry picking. The guy dropped data points, and created a graph that would had cause a fifth grade teacher write a big read “F” on it.

OMFG. There are tetanus denialists. People who are against the tetanus vaccine because they believe that tetanus cannot survive in oxygen, and blood has oxygen, so long as a wound bleeds it means you are safe from infection.

I had no idea this was a thing, but it seems to have currency among a subset of off-the-grid preppers.

It isn’t that measles infection wipes out “immune memory”. They’re saying it suppresses the immune response, which isn’t the same thing. Your body remembers stuff like influenza; it just isn’t doing as good a job of responding to it. And I suspect it’s more than just immunosuppression. Up to a third of measles patients who do not have access to good medical care will die, and this is because they can’t be given the supportive care they need to stay alive while they fight it. They’ll come out of it weak and malnourished, less able to feed and care for themselves during another infection than they were before the measles. They may have lung damage. Even ignoring any immune suppression, I don’t see why this result is even surprising.

Elsewhere, I was talking to people who were saying that since measles is only bad if you are weakened, therefore their kids didn’t need to be vaccinated against it. I pointed out that “weakened” might just mean “caught a cold the week before being exposed to measles”. Just becuase you’re not weakened now doesn’t mean you won’t be later, so even the smug ones should see it in their own self-interest to get vaccinated.

Obligatory addendum: I’m a software engineer, not an immmunologist, and probably have misunderstood something badly. But that’s just what I thought after reading the article. I have never understood why getting sick would ever be a good thing if you had another way of getting the same immunity.

The problems of submitting a comment at 2.30 in the morning is that the brain doesnt work to the best capacity. I meant to say encephalitis not meningitis.

Zebra, with comments like those you appear to have the intellect of a gnat.

I’m not surprised that the measles vaccine is helping reduce the complications from other disease. I have another reason why this is. My son recently had pneumonia. I wrote about it (http://michaelsiegel.net/?p=6667). One thing that made his diagnosis a LOT easier was that the doctors knew he had been vaccinated. It massively narrow the possibilities so that they could focus on just a few things and thus diagnosis him faster and treat him better.

Zebra, you made a comment that was so badly phrased that nobody reading it could understand what you were getting at. Instead of clarifying it, you imply that everyone else is too stupid to understand you.

No wonder everyone thinks you’re a fool.

Callie, yes, you do seem to be missing something. NB I’m no expert either, but as I read it, the study is saying that on the one hand, measles produces profound immune suppression that lasts for a couple of months, which, along with the other factors you mention, explain why “approximately 50% of all childhood deaths recorded after five years of followup occurred within two months of infection;” but on the other hand, the immune system regenerates itself after that period, and yet measles survivors are still at an elevated risk of disease for the next 2-3 years — so why? This study offers a hypothesis to explain the latter finding, namely that the measles virus wipes out nearly all memory cells; they regenerate after a while, but without the memories that the old population carried.

Calli [email protected]:

I have never understood why getting sick would ever be a good thing if you had another way of getting the same immunity.

Because to disease perverts, Mother Nature hospitalizing their child is an enormous badge of pride.

@Calli Arcale:
Kill off enough leukocytes, and there won’t be any left that remember you’ve had plague before.

TBruce,

The eternal complaint of the spoiled child and spoiled parent– “it’s the teachers fault little boo-boo didn’t understand the question”.

I thought I was saying something trivially obvious, but if you find it mysterious, stick to challenges like repeating stock answers to Johnny’s stock fallacies.

Perhaps it is a generational thing– some of the spoon-fed freshman students I encountered a while back have grown up and are now expert epidemiological commenters here.

zebra- I’m a computer programmer. If someone doesn’t understand me, it’s my job to explain what I meant. If what you said was so obvious, you should have no trouble explaining yourself.

I suggest you look up the Dunning–Kruger effect. You are not as smart as you think you are.

#46

And yet, you can’t articulate what it is you don’t understand.

Instead you talk about “risk-benefit analysis”, which sounds like you are having a conversation in your own head, but not with me.

sounds like you are having a conversation in your own head, but not with me.

Oh, the irony.

Undergraduate students that you’ve encountered where and in what capacity, zebra? Were you teaching, or are you just trying to imply that you were?

zebra- Look up the phrase “risk-benefit analysis” first. Then we’ll talk.

Zebra:

If it were just me, yes, you might have a point. However, everybody who replied to your comment was confused by it.

Generational thing? I’m old enough to qualify for the Senior’s discount. Shall I get off your lawn now?

And yet, you can’t articulate what it is you don’t understand.

– as opposed to someone who can’t articulate what they claim to understand?

TBruce,

Actually, what “everybody” did was have a knee-jerk negative response to what is a trivially obvious and relatively minor point.

“I’m confused” is another typical response of students who are looking for someone to tell them the answer so they can regurgitate it. If you can’t *explain* what it is you don’t understand, that’s your problem not mine. Disagreeing is not explaining.

Okay, let me explain my problem with your statement zebra: You frabled the granwich inside the blurblachen. That’s trivially obvious, and I should not have to explain what that means to you unless you gargle bleach on a daily basis.

TBruce,

And yet it is exhibited all the time by the author of and regulars on this blog. Heat, kitchen.

If it were just me, yes, you might have a point.

He doesn’t, though. It fails right out of the gate with the assumption that the immunological memory that is being lost is infection based, whereas the actual argument is exposure based.

Actually, y’know, reading the paper (and the supplementary material) makes this clear, but not really knowing what he’s talking about has never stopped Z. before.

” Up to a third of measles patients who do not have access to good medical care will die, and this is because they can’t be given the supportive care they need to stay alive while they fight it. They’ll come out of it weak and malnourished, less able to feed and care for themselves during another infection than they were before the measles. They may have lung damage. Even ignoring any immune suppression, I don’t see why this result is even surprising.” Cauliflowerbrain

What an utter pile of medical peer review/Offit mongering. This is an utter joke! If a third of people, in the Western world died from measles, how come with the recent apparent Disney outbreak that was supposed to be a biggy, not one American fatality!!!! Do you make this stuff up or are you a pubmed freak?

“Oh, and they had very healthy diets, municipal water, municipal sewage systems, only the smallpox vaccine,” Sewage dawn

I mean, maybe I am totally stupid, but, what are adults doing contracting measles – is that displacement from their childhood vaccine. Saying that they only had the Smallpox vaccine is enough to shaft anyone’s immune response. How can these people be classed as “health”!!!!!

“In terms of frequency, measles is the number one disease of childhood,” Fantasy football

Hey, I thought vaccination had got rid of it, now it is the most common childhood disease – what kind of result is that?

“For example, when the authors transformed the data as described in #2 and #3, for England and Wales, the best fit occurred centered at a 28 to 28.3-month duration of measles-induced immunomodulation in the pre-vaccine era.” fiddler

So, they transformed the data to fit………………….for the best fit..
Is this not medical peer review speak for ‘fixed the stats’

“The study, released Thursday by the journal Science, was funded by the Bill and Melinda Gates Foundation and federal grants…………………………”

hey your study, lord Oracus, was funded by Bill and Melinda!!!!!

It is a great example of the sacred cow in action. This study is total and utter utter gabonka…Well done for spinning it into gold. A fitting tribute to Lilady

I mean, maybe I am totally stupid,

First true thing lower-case johnny has said EVAR.

(Cheap shot, but how could I resist?)

The webcomic xkcd has a strip that sums up zebra nicely. Keep in mind, however, that even when zebra makes statements that seem to have a perfectly obvious meaning, once cornered he will fall back on claiming that you misinterpreted his words, generally after a 100+ comment discussion in which you referred back to them multiple times without him correcting you. He’s not as painfully obvious a troll as – just to take a completely random example – johnny, but he’s every bit as much a waste of time.

Narad– probably was always the one who just couldn’t stop himself from raising his hand and spoiling it for all the other kids.

@Sarah A

Nicely put. Very appropriate comic.

Now, let’s see, what did I say up at comment #3? Oh yeah:

Todd W.
http://www.harpocratesspeaks.com
May 15, 2015

@DB

They’ll just say the study is worthless because it’s just a computer model…oh, and GATES!!!eleventy!!1!

And here we have lower-case johnny at #61:

hey your study, lord Oracus, was funded by Bill and Melinda!!!!!

If a third of people, in the Western world died from measles, how come with the recent apparent Disney outbreak that was supposed to be a biggy, not one American fatality!!!!

That would be they did have access to good medical care–thought that would have been obvious.

With medical care the mortality rate we see associated with measles infection is 1 death per every 1000 infections.

johnny quoted:
Up to a third of measles patients who do not have access to good medical care will die
then commented:

If a third of people, in the Western world died from measles, how come with the recent apparent Disney outbreak that was supposed to be a biggy, not one American fatality

Did you miss the part about “access to good medical Care”? Not everyone in the world has that, johnny.
“In terms of frequency, measles is the number one disease of childhood,”…
Hey, I thought vaccination had got rid of it, now it is the most common childhood disease – what kind of result is that?
Not every country has a vaccination program, you champion ignoramus. Where MMR vaccine is used, the rate plummets, that we can show.

So Bill and Melinda Waltons pay for a study………………

Do we need to know anymore? Are you serious, these people fund new disease classifications – next we will have Bill Gates variant measles….LOL
“The webcomic xkcd has a strip that sums up zebra nicely.” Sarahahole

Well Sarah A sounds interesting, well done girl – now put the kettle on and make some buns

“Did you miss the part about “access to good medical Care”? Not everyone in the world has that, johnny.” Julianfrott

What a plonker – no one needs access to good medical care with measles – it’s the doctors who over medicate and kill the patients.
“Not every country has a vaccination program, you champion ignoramus. Where MMR vaccine is used, the rate plummets, that we can show.” Julianfrott

More pedical meer repoo from the woolii one. I mean, do you honestly think it is still credible to quote these papers when they are funded by the people who want to sell the ‘medicine’. What a complete nonk

“Measles control is now recognized as one of the most successful public health interventions ever undertaken ” Woo

So what is it, the most successful or the number one childhood disease, the article the Oracus posted says both.

I suppose it depends on whether you are trying to scare someone into vaccine woo or demonstrate how brilliant it is.

funded by Bill and Melinda……………LOL

I agree Todd – old johnny is approaching “Thingy-level” stupidity at this point.

“By preventing measles, “you preserve your ability to fight off all of these other infections,” said Michael Mina, a medical student at Emory University who led the study while at Princeton University.

While vaccination played a role, other factors such as better nutrition and smaller family size may also explain the drop in non-measles infections, said Dr. James Cherry, a pediatric infectious disease expert at the University of California, Los Angeles, who had no role in the study.”

There you go, those who had a role in the study creamed their nuts over the stats, those who didn’t have a role in the study said the result could be explained by better nutrition and smaller family size. You are all full of complete wazoo, this thread was started as a complete cherry picking pile of…. Citation neeeeeeded
Brown logs in a sea of urine

A student led the study too, the person who dissed it as in consequential was a pediatric expert. So SBS and the Oracus puts some student who was probably being shaggged by Bill or Melinda – ahead of the expert!

Didn’t really expect more

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