Association of pertussis and measles infections and immunizations with asthma and allergic sensitization in ISAAC Phase Two

Nagel G, Weinmayr G, Flohr C, Kleiner A, Strachan DP and the ISAAC Phase Two Study Group

Background: Pertussis and measles infection as well as vaccination have been suspected as possible mediating factors of allergic disease in childhood.

Methods: Between 1995 and 2005 cross-sectional studies were performed in 29 centers in 21 countries. Parental questionnaires were used to collect information on allergic diseases and exposures. We analyzed data from 54,943 randomly selected schoolchildren aged 8–12 yr. A subgroup of 31,759 children was also skin prick tested (SPT) to common environmental allergens. Combined odds ratios were calculated by random effect models for meta-analysis.

Results: Pertussis and measles vaccination were not significantly associated with any of the allergy outcomes or SPT positivity. However, pertussis infection was associated with wheeze (ORad 1.68; 95% CI 1.44–1.97) and rhinoconjunctivitis (ORad 1.63; 95% 1.33–2.00). Pertussis infection was also significantly associated with a higher prevalence of reported eczema during the past year in non-affluent countries. Measles infection was associated with a higher prevalence of wheeze (ORad 1.26; 95% 1.10–1.43) and reported eczema (ORad 1.22; 95% 1.08–1.39). No association with SPT positivity was found, suggesting that these associations are unlikely to be mediated by an allergic component.

Conclusions: Associations of pertussis and measles infection with symptoms of asthma, rhinoconjunctivitis and eczema were found in both affluent and non-affluent countries and are unlikely to be mediated by IgE.

Pediatr Allergy Immunol 2012: 23: 736–745.

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