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Recent measles virus infection increased the severity of infectious disease in WWI with the exception of pandemic influenza

Steele, L.; Wu, M.; Sinclair, J.; Ignacio, K.; Macauslane, K.; McCallum, G.; Hulme, K.; Verzele, N.; Hocking, I.; Airey, M.; Mese, S.; Waller, M.; Mamelund, S.-E.; van de Sandt, C.; Chew, K. Y.; Carney, M.; Short, K.

2026-03-19 epidemiology
10.64898/2026.03.16.26348545 medRxiv
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BackgroundIn World War 1 (WW1) outbreaks of measles were associated with high case fatality rates amongst soldiers. Recent studies have shown that survivors of acute measles can also develop immune amnesia, increasing their susceptibility to other infections. However, the impact of prior measles infection on infectious diseases during WWI remains unclear. MethodsHere, we create a searchable database documenting the medical history of 1,569 individuals from the Australian, New Zealand, and Canadian forces during WW1. ResultsWe use this novel database to show that a recent measles hospitalisation was associated with a higher chance of death for infectious diseases (excluding pandemic influenza like illness), consistent with immune amnesia. Surprisingly, a prior measles infection was associated with a significant reduction in hospitalisations duration from pandemic influenza like illness. ConclusionThese findings highlight the unique interaction between measles and pandemic influenza, contrasting with other infectious diseases, and underscore the significant health burden measles placed on young adults during WW1.

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