"Measles is completely erased by immunity"

Is it too early to talk about the Corey epidemic in Russia, is it dangerous and how not to get sick - explains the molecular biologist Olga Matveeva

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In the early days of May, Moscow State University announced the transfer of several faculties to remote training, explaining this to the measles epidemic. In April, other metropolitan universities were also reported about the same quarantine. According to Rospotrebnadzor, measles were found in January in Novosibirsk, then in Yekaterinburg and Ufa, and by the end of April, the outbreak of this disease was recorded in 40 regions of Russia. At the same time, in 2022, Kory in the country was either not at all, or they simply did not notice it. Where did she come from now and what is dangerous?

- Officially, more than a thousand cases of measles have already been recorded in Russia. Is this a large flash?

- The measles were found in the forty regions of Russia, three universities in Moscow and several faculties of Moscow State University were quarantined, but the number of cases that officially talk about, if this is true, then this is really not so much.

- At the same time, only one hundred cases have been recorded for the entire last year. What are the flashes depend on?

-Some kind of hesitation is associated with where the brood cases come from. In the United States, there was a serious outbreak when the children were infected in Disneyland, and they go there from all over the world. The measles all the time circulates in the population, but it is the greedy infection that is responsible for the outbreak. And now, after Covid, with measles, the situation is dysfunctional in several countries, not only in Russia.

- Well, what are our conventional cases, after all, half the world is now closed?

- One of the dysfunctional countries now is India, the incidence is sharply growing there. And with India, Russia has just a good relationship. By the way, two years ago, during the pandemic [coronavirus], the Velta version came from India first to Russia, and then to Europe. In addition to India, if we talk about countries close to Russia, this is Pakistan, Tajikistan and Türkiye. These are countries with large outbreaks, and there are quite a lot of communication with the Russians there now.

But first of all, the occurrence of outbreaks depends on the level of vaccination. Due to Covid, children's vaccinations were also delayed, and, of course, the movement of anti-Vaxers was generally activated. And measles are extremely sensitive to the threshold of population immunity, it is necessary that 95% of people are either vaccinated or ill. The main part is now still composed of vaccinated people, and not ill.

But during Covid in so many countries there was a shift in attention, and the number of measles vaccinated from measles decreased. This is a very favorable situation for measles outbreaks.

In the United States, the situation also changes from year to year, and in some years sharp outbreaks occur. In 2000, they were about to announce that the measles were eliminated-defeated. And after that flashes began. Because people are very relaxed when they are told that the disease is defeated. And this can be seen even by changes in the legislation: at some point in the United States, it became very easy to get a discharge from vaccinations on the basis of religious beliefs. And immediately it turned out that very large communities remained not vaccinated. And measles are terribly contagious disease.

- I read that every sick on average infects 18-20 people.

- Exactly. This is the most contagious viral disease. And if a person does not have immunity, if he is not vaccinated and not sick, but even in a large room with the sick, then almost one hundred percent of the probability that he will get sick. In some year, in New York, the outbreak began with the community of orthodox Jews, and when they tried to reproduce the ways of infection, it turned out: the sick person went into the elevator-and everyone who was traveling in this elevator fell ill. In general, it turns out that everything is good, good, and then once - and in several places in the country outbreaks begin.

- How much is this virus tenacious outside the human body? That is, is it possible to get infected by holding on the handrails after the sick?

-Getting on some surfaces, this virus quickly becomes non-hazardous to a person. As a rule, the main transmission occurs by airborne droplets, with cough and breathing. But in the air it can last long and move far enough.

- Even it seems to be spread and infect through ventilation.

-Yes, it falls into the lungs and after a short period of reproduction in them spreads throughout the body, so the first signs of measles are catarrhal phenomena: coughing, sneezing.

And this is the most dangerous period, because it is at this time when there is still no rash and it is not clear what kind of illness is the most contagious person.

- We are used to believing that measles are an unclear childhood illness, well, who was not sick with measles in childhood. And now I read that measles gives a fairly high mortality. Is it so scared of us?

- If you look at statistics, then one of a thousand dies among the children, it is 0.1%. This, of course, is still a lot. But measles, first of all, are terrible complications: it can be blindness, deafness, and meningitis, and so on. In general, complications after measles are a lottery, but often it leads to sad consequences. In addition to blindness and deafness, it can be, for example, encephalitis.

Scientists discovered a very interesting and very unpleasant property of measles relatively recently, in 2012.

This virus does something that no other does: it completely erases, like an eraser, the entire preceding immunity of the body, all the vaccinations you have made, all the immunity of the disease that has been transferred.

In this sense, he has some similarities with the immunodeficiency virus, which settles in lymphocytes and then travels around the body as a bus. The measles virus does almost the same, only settles in other lymphocytes. Lymphocytes are very important cells, these are our defenders, and the measles virus have “keys” to penetrate them.

-How then can a vaccine from measles itself work if it is made of a living virus, and he kills T-lymphocytes?

- “Wild” virus erases the immune memory, and the vaccine virus does not possess such “keys”. This is a living virus, but it was passed for a very long time - weakened. There is a certain attenuation procedure, as a result of which the virus has lost, among other things, the ability to open a lymphocyte with his “key”.

- And if a person now gets sick with measles, then all the vaccinations from the Covid to which we were called, or the Covid, which was transferred and giving us immunity, all vaccinations from the flu, from which there is still ...

- Yes, yes, yes, all this will be reset. But if a person is vaccinated from measles, then his disease will pass in a mild form, and, apparently, the body of memory will not completely lose, and so, something will “come up” a little. The same can occur with the immune system as with human memory after injury: not complete amnesia, but partial. But if there is a lot of virus in the body, this is called viremia, then it begins to “open” all lymphocytes with his “key”, and all memory cells that store information about previous infections and vaccinations die.

When children are vaccinated against measles, mortality is reduced from other diseases. This phenomenon was known for a long time, but scientists did not know how to explain it.

Then it turned out that during vaccination from measles, much fewer children falls ill, that is, much less children lose immunological memory. Accordingly, more children remain protected from all other infections.

- How long does the immunity of measles last? I still knew that once you were ill in childhood - and that’s all, the measles are not terrible for you anymore. But here I read that immunity is enough for 15–20 years. And then what? An adult who has been ill in childhood can still get sick?

- I think, if it can, then in a mild form. Although in fact we certainly do not know this statistics. More precisely, I did not see the work about how many ecclaced in childhood they later became ill in adulthood. However, there are commercial laboratories that determine the antibodies to the measles virus, they conducted research in the population and in several regions of Russia found that antibodies can detect only 20% of the tested ones.

- This is how, if the vaccine was done before all children?

- The representative of this laboratory says: 80% of the population does not have antibodies, so they all need to be vaccinated. This is very similar to a commercial trick: go all the tests to us. And here we are returning to the conversation that many times conducted during Covid: about antibodies. The amount of antibodies with age really decreases, but a very important part of the immunity is T-cell immunity, and we cannot just measure it. And this memory for measles at the immune system is very good. Of course, immunity is reduced with age, the older a person, the more chances he has to get sick. But still, the chances of getting sick in severe form, which were vaccinated even in childhood or a chilled person, are much lower. Although the virus is dangerous for the elderly, they have a weak immunological memory.

The measles virus differs from coronavirus in that it is genetically very stable. It does not change for centuries.

The family of the paramixoviruses to which it belongs is generally very genetically stable, extremely little change. In order for him to change and learn, like a virus causing a Covid, to run away from antibodies, this is not the case.

- How does the measles vaccine work if this virus erases the immune memory? After all, in theory, he should wash his memory.

- Yes, but he can kill all lymphocytes, except for those that arise after its penetration into the body. That is, he erases the whole memory, but he cannot erase his memory to himself. Because it is at the moment when he kills T-lymphocytes that new ones arise-that is, memory to him. And this memory is already very strong.

- If it is such a stable virus, then how does it retain the ability to infect? We often talked with you about this in relation to coronavirus: he mutates to leave antibodies. And how does this survive, remaining dangerous and contagious?

- He survives because small infection tanks are constantly preserved. They are completely not visible on the radars of society, they fall into radars when the level of vaccination decreases in society. That is, the virus constantly circulates somewhere. There is WHO that 80% of the population received one vaccination against measles in the world and 75% are fully vaccinated. In order for the virus not to circulate at all, it is required, I repeat, 95%.

-This is a lot, if we recall how we achieved at least 50 percent vaccination from Covid.

- This is a lot.

- If during the Covid the authorities could not force people to go to vaccinations, then how will they achieve this with measles, which no one is afraid of?

- The problem is not only this. After all, imported measles from measles have disappeared in Russia.

- But there is Russian - the production of Microgena.

- Certainly. And I looked at how they were doing it. These are very good strains, they have passed a good attenuation, produce them on quail eggs fibroblasts, and this is a very good technology. Western vaccines are also produced on bird fibroblasts, because the virus is better on them athen. That is, it does not grow on human cells, so it does not retrain again infecting human cells.

There is also an Indian vaccine, and now it is produced on human fibroblasts. It is much easier to do, and it is a very cheap vaccine. The SH was terribly delighted, certified it, and all developing countries receive exclusively it.

- And what is the catch?

- The catch is that this vaccine can be more reactogenic. It can cause a greater increase in temperature, more catarrhal phenomena. I am not saying that this vaccine is worse, but it has the potential to be more reactogenic.

The Russian vaccine is apparently better, but it is more expensive, and it is much more difficult to scale. Two enterprises produce it: one - “microgen”, but the second is our favorite “vector” with you, famous for the “epivaccorone”.

- Oh…

- At the Vector, the chief sanitary doctor Anna Popova in 2015 personally opened the line for the production of the measles vaccine.

- But this is not the development of "from the creators of" Epivakkorons ", but only the production site on the" vector ", so we will not suspect the vaccine in advance.

- Certainly. Although the reputation of the “vector” soaked. But the problem is that this vaccines may now need a lot. She is no longer enough, I know that Russian journalists called the clinics and found out that there were no vaccines for adults.

- For adults? Are they different for adults and for children?

- It's not that the vaccines are different.

Just for children, the immunization is planned, and how many vaccines ordered a clinic for a year for children - there is so much it. Can you imagine how much vaccines will need if the campaign becomes mass?

I don’t know if they can quickly scale her release. The quail eggs necessary for this are quite expensive and complex in production, because they should be completely clean from any pathogens.

-We somehow discussed this problem with you: you said that these absolutely clean eggs in Russia are not produced in principle, they were previously purchased in Germany.

- With this vaccine, the situation is simpler, not the eggs themselves are required, but the cells. And there are such quail eggs in Russia. As far as I know, chicken have already appeared, which were not there before. The problem here is in the volume and speed of production. Well, if some imported components are required in the vaccine, then this, as you know, is also now a problem. As for the Indian vaccine, the epidemic also began in India, so we do not know whether their vaccine will be available in Russia.

The chief sanitary doctor Anna Popova assures that the vaccines in the country are enough. But then the question arises of how many people are really needed, and how much they go to vaccinate, succumbing to panic.

- But how many people will not go to vaccinate, although they should ... How can a person understand whether he should be vaccinated? Someone was vaccinated or ill for a very long time, someone may not remember at all, someone was born before vaccinations appeared.

- There are recommendations for WHO, according to which children should be vaccinated in a year and at six years old. And here the question immediately arises: is there a risk that the baby will fall ill for up to a year, is it possible to instill a child earlier?

- Doesn't infants protect the immunity of the mother?

- Protects while the baby is breastfeeding. But not everyone feeds the baby with breast milk for up to a year. And the answer is this: in principle, you can vaccinate a child from six months, but this vaccination will be considered zero, still the first one per year, the second at the age of six. Firstly, because up to a year, the child has a still immature immune system. That is, the child’s immunity is worse than a year, so it is still necessary to vaccinate again a year. Secondly, the very antibodies of the mother that protect the child at the same time interfere with the formation of his immunity against measles.

And the main requirement is that more than a month pass between the zero and the first vaccinations, otherwise the two vaccinations will interfere with each other.

- Why is the second vaccine at the age of six? It turns out that until this time the child is half protected? Is it possible to get a second vaccine earlier?

- Here the reason is not medical, but more social: at six, the child goes to school, and he increases the probability of encountering infection. Therefore, you can make a second vaccine earlier, if, for example, the Cori epidemic around, but the requirement is the same: there should be more than a month between the two vaccinations.

Another important point: it is extremely recommended to be vaccinated for a woman during bimmicity, pregnancy is a contraindication for measles from measles. There are recommendations to be vaccinated at least three months before conception. Still, the vaccine consists of a living virus.

“And what to do to a woman if she is pregnant, and Coror is around?” As for the rubella, let's say, this virus for pregnant women is completely trouble ...

- And measles - trouble. Very often in pregnant women the measles virus causes miscarriages. Therefore, the vaccination must be done in advance, and after vaccination at least three months from pregnancy is protected.

- Is it possible to vaccinate “in reserve”, just in case? Will it not be harmful?

-There will be no harm in this, over time, immunity is reduced, although it still protects a person. For outbreaks of measles, the fall of vaccination is responsible for precisely among children. One way or another, adults protects immunity.

Just if everyone rushes to make a “reserve” vaccine, then the vaccine will not remain even in paid clinics.

And here it is interesting who the state cares about, that is, who in Russia can get vaccinated for free. This is, firstly, adults under 35 years old, if they were not sick, not vaccinated or remember whether there was vaccination. After 35 years, you are no longer so valuable to the state, and you will be blocked for free only if you are at risk: a health worker, a social worker, a teacher, and so on. And after 55 years - that's it.

- The homeland is no longer needed?

- In any case, you do not have to vaccinate free vaccination.

- Do I need to be afraid of measles?

- Necessary. The measles virus multiplies very violently in the body, this is called viremia. It forms viral particles very quickly. And while a person still has no immunity, while the body still understands what kind of enemy it is, how to produce antibodies, which lymphocytes are specific to the destruction of the cells infected with this virus, time passes. During this time, the virus was already living here, he walked there, destroyed there. That is, it is very destructive in itself. It falls into a variety of fabrics. It falls, for example, in the eye - and so it can cause blindness.

Поскольку корь очень ослабляет иммунитет, следом часто возникают бактериальные осложнения. Глухота, даже слепота и другие подобные осложнения связаны часто не с тем, что вирус что-то делает, а с тем, что он ослабил иммунитет.

И вот тут врач должен очень вовремя поймать начало бактериального осложнения, которое уже можно лечить антибиотиками. С самого начала антибиотики давать нельзя.

Поэтому, если вы точно знаете, что были в контакте с человеком, который потом заболел корью, лучше всего в течение 72 часов сделать прививку.

— Именно прививку? Или есть какое-то специфическое противовирусное средство?

— Именно прививку. Если вы сделаете прививку как можно раньше, в течение 72 часов после контакта с заболевшим, она вас защитит. Что касается специфических препаратов, то тут вам лучше спросить грамотного врача.

— Вот эта ужасная сыпь, которая появляется при кори, это тоже признак какого-то разрушения или просто реакция организма?

— Это кожная реакция, и она сама по себе очень человека ослабляет. Но уменьшить ее, ослабить, как-то запретить ей появляться мы все равно не можем.

— А зачем ее мажут зеленкой? Вот что ей зеленка?

— Это из-за вероятности вторичных инфекций, потому что сыпь может приводить к ранкам на коже, которые послужат входными воротами для бактерий.

— Сколько времени человек может не знать, что он уже заразен? Какой инкубационный период у кори?

— В том-то и дело, что большой, от двух недель до трех. Поэтому все, кто контактировал с больным корью, должны просидеть на карантине 21 день.

— А сколько времени человек, заболевший корью, остается заразным?

— С момента появления симптомов — больше недели.

— Симптомов — но ведь не сыпи? Сыпь ведь не сразу появляется?

— Не сразу, но человек очень плохо себя чувствует.

— Как определить, что это именно корь, если нет сыпи? Это ведь может быть и ковид, и грипп, и что угодно.

— Совершенно верно Человеку плохо, он вызвал врача, ему поставили ОРЗ, потом только появляется сыпь…

— …а человек уже успел кучу народу заразить.

— В этом тоже коварство кори. Это действительно опасная болезнь еще и потому, что характерные признаки, отличающие ее от ОРЗ, появляются далеко не сразу. А люди ведь у нас как поступают? Мне плохо, но на работу все равно пойду.

— И как выявить именно корь? Тоже по тестам ПЦР, как с ковидом?

— В России есть коммерческие ПЦР-тесты на корь, но диагностируют ее все-таки по анализу крови на антитела IgM, они показывают, что инфекция у человека в острой фазе. Опытные врачи ставят корь по характерным клиническим признакам, но это уже позже, когда эти признаки появились.

— Как менялись знания о кори, о ее лечении, особенно в те годы, когда болезнь считалась почти побежденной? Ее исследовали или получили вакцину — и успокоились?

— У кори очень длинная и интересная история, вакцину разрабатывали в 1960-е годы с большим трудом, и все десятилетия после начала работ наполнены взлетами и падениями. Вирус кори оказался очень непростым. Сначала вакцины пытались сделать из убитого вируса. Они оказались, с одной стороны, малоэффективными, с другой — вызывали сильные осложнения. Дальше вирус пытались аттенуировать — ослабить, а как это сделать — было непонятно, он никак не ослаблялся достаточно. Часть детей переносила прививку нормально, а у части были тяжелые осложнения, лихорадка, сыпь. Наконец получили нужный штамм, но, прежде чем он стал действительно безопасным, прошли десятилетия усилий. Зато сейчас мы собираем плоды этих усилий, потому что современные вакцины от кори действительно безопасны и очень эффективны.

В XXI веке выяснилось, что корь очень коварна, вам кажется, что ее в популяции уже нет, а она откуда ни возьмись вспыхивает. Тогда ее вновь начали изучать. Десять лет назад обнаружили то свойство, о котором я уже сказала: способность стирать иммунитет.

— На картинке вирус кори очень красивый, не какой-то там шарик с иголками, а такая сложная конструкция. Кто у него родственники?

— Родственники у него очень интересные. Он принадлежит к семейству парамиксовирусов, и к нему же принадлежит вирус сёндай, он заражает грызунов, но абсолютно безобиден для человека. Этот вирус обладает онколитическими свойствами, у него замечательная способность размножаться именно в раковых клетках, а не в нормальных. Мой папа, экспериментальный онколог, лечил с помощью вируса сёндай самые тяжелые случаи раковых заболеваний у людей, а я пытаюсь вдохновить современных исследователей продолжать эту тематику.

К этому же семейству принадлежит вирус, вызывающий у людей свинку, — инфекционный паротит. К нему же относится возбудитель чумки у собак, это жуткий вирус, непривитые собаки умирают мучительно, но для человека он безобиден. Из этого же семейства — вирус болезни Ньюкасла, настоящая чума птиц, куры мрут сразу во всех окрестных хозяйствах, поэтому для них тоже делают специальные вакцины.

И вот в ходе исследований кори открылась еще одна вещь: именно у вакцинного, то есть безопасного, я подчеркну, вируса тоже есть онколитические свойства. Он очень хорошо размножается в раковых клетках и не трогает здоровые. Поэтому в США появились клиники, изучающие онколитические свойства вакцинного вируса кори. Там проводят испытания, есть уже примеры того, как люди выздоравливают. Вакцинный вирус кори оказался интересен для науки с разных сторон.

— Это что же, вакциной от кори можно лечить рак? Может, она и для профилактики рака полезна?

— К сожалению, такой вывод мы сделать не можем, хотя, конечно, хотелось бы. Пока мы только знаем, что если у человека уже есть в организме раковые клетки, то вакцинный вирус кори может размножаться именно в них, убивая их таким образом. Для этого этот безопасный вирус вводят системно, это отдельная технология. И она, к сожалению, применима далеко не ко всем видам рака и не для всех пациентов. То есть такой способ лечения раковых заболеваний далеко не всегда срабатывает.

У подобных исследований будет еще много этапов. И качественные клинические испытания, то есть испытания на людях, очень дорогие. В России Петр Чумаков ( вирусолог, заведующий лабораторией пролиферации клеток Института молекулярной биологии в Москве. — И. Т. ) тоже пытался исследовать вакцинный вирус кори, как и многие другие безопасные вирусы в качестве агентов для лечения рака. Увы, я не знаю, на какой стадии сейчас его работа именно в отношении вакцинного вируса кори. Но в отношении других онколитических вирусов успехов много. Петр Чумаков и молодая исследовательница из его лаборатории Анастасия Липатова связаны с медицинскими учреждениями в Москве и организуют ряд небольших клинических испытаний. В США это продолжается последние 20 лет, уже есть много публикаций, есть результаты клинических испытаний. Относительно некоторых пациентов считается, что у них долгая ремиссия, с исчезновением абсолютно всех признаков заболевания, достигнута за счет лечения таким образом. Но пока это, что называется, research in progress.