Using Serology to Anticipate Measles Post-honeymoon Period Outbreaks

• Published in: Trends in microbiology (Regular ed.) Vol. 28; no. 8; pp. 597 - 600
• Main Authors: Metcalf, C.J.E., Wesolowski, A., Winter, A.K., Lessler, J., Cauchemez, S., Moss, W.J., McLean, A.R., Grenfell, B.T.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2020; Elsevier Science Ltd; Elsevier; The Author(s). Published by Elsevier Ltd
• Subjects: Age; Antibodies, Viral; Disease Outbreaks; Disease Susceptibility; Epidemics; Humans; Immunization; Life Sciences; Mass Vaccination; Mathematics; Measles; Measles Vaccine; Nonlinear dynamics; Nonlinear systems; Outbreaks; Public Health; Santé publique et épidémiologie; Science & Society; Serologic Tests; Serology; Vaccination
• ISSN: 0966-842X; 1878-4380
• DOI: 10.1016/j.tim.2020.04.009

Measles vaccination is a public health ‘best buy’, with the highest cost of illness averted of any vaccine-preventable disease (Ozawa et al., Bull. WHO 2017;95:629). In recent decades, substantial reductions have been made in the number of measles cases, with an estimated 20 million deaths averted from 2000 to 2017 (Dabbagh et al., MMWR 2018;67:1323). Yet, an important feature of epidemic dynamics is that large outbreaks can occur following years of apparently successful control (Mclean et al., Epidemiol. Infect. 1988;100:419–442). Such ‘post-honeymoon period’ outbreaks are a result of the nonlinear dynamics of epidemics (Mclean et al., Epidemiol. Infect. 1988;100:419–442). Anticipating post-honeymoon outbreaks could lead to substantial gains in public health, helping to guide the timing, age-range, and location of catch-up vaccination campaigns (Grais et al., J. Roy. Soc. Interface 2008003B6:67–74). Theoretical conditions for such outbreaks are well understood for measles, yet the information required to make these calculations policy-relevant is largely lacking. We propose that a major extension of serological studies to directly characterize measles susceptibility is a high priority.