Oompa-Loompa doom-pa-de-doo. I've got another puzzle for you. To which types of intestinal bacteria does measles virus preferentially bind?

Viruses like sugar. They bind to sugar. But it's not a simple matter of dietary sugar. This article explores susceptibility to injury, including lethality, by measles and vaccination. It may come down to sugar.

Roald Dahl, candy man author of "Charlie and the Chocolate Factory" has done more to promote sugar consumption than any person in the history of art and literature. And he tragically lost his daughter at age seven to measles in 1962. What's the connection? Intestines and the immune system.

After his young daughter passed, Dahl wrote a moving essay promoting measles vaccination. Measles vaccination is likely most effective of all childhood vaccines, but the MMR vaccine is also associated with injury including autism. This article explores susceptibility to injury, including lethality, by measles and vaccination. It may come down to sugar.

Viruses like sugar. They bind to sugar. But it's not a simple matter of dietary sugar. It's the sugar produced through our genetic code called glycans which also feed our gut flora. These host glycans are the genetic aspect of our individual microbial balance.

But perhaps more importantly, viruses bind to the sugar in the cell wall of our microbes. Some types of microbes are more attractive to viruses than others. The types of microbes a person has can make them more susceptible to injury by viral infection. Might this be an effective way to screen infants pre-vaccination for safety? And also a way toward keeping measles a mild childhood disease leading to lifelong immunity?

A little known fact is that up to 95% of all polio cases are asymptomatic. Why would that be? Why do most people walk around with polio and don't even know it? And why do the unfortunate few succumb to disease? Could it be their microbial makeup?

Dr. Benjamin P. Sandler developed the idea in the 1940s that a diet high in sugar and starch makes a body more susceptible to the polio virus. Dr. Sandler understood the ironic truth that a diet high in sugar and starch increases insulin production leading to low blood sugar. This hypoglycemia made an individual prone to polio infection, he reasoned, because cells require sugar to "protect themselves against invasion by the virus."

Exposure to B. cereus increased poliovirus infectivity over 500%. Enhancement of poliovirus infectivity did not require live bacteria.

Intestinal microbiota promote enteric virus replication and systemic pathogenesis, 2011  PMC3222156

But there's something Dr. Sandler couldn't have known in the 1940s, that a high sugar diet feeds overgrowth of pathogenic microbes leading to hypoglycemia. Gut microbiota are now strongly associated with blood sugar control. These microbes build their bodies with sugar associated with massive increases in polio infectivity. The sugar in question is component of the cell wall of certain microbes, perhaps most especially gram-negative LPS (lipopolysaccharide) producers, but also gram-positive organisms such as B. cereus, the presence of which was found to increase polio virus infectivity over 500%. Even dead bacterial cells allowed the polio virus to flourish. Poliovirus binding with bacterial LPS enhances polio infection in the host. So, intestinal microbiota can increase polio infectivity by way of sugar.

Measles virus may operate in a similar way, preferentially binding to certain types of microbes to dramatically increase infectivity.  The measles virus is known to bind to a membrane cofactor protein (MCP), also called CD46, in the initial stage of infection.

But what appears not yet studied is how the measles virus may interact with gut microbes as with polio discussed above. Bacteria also utilize receptor CD46, the very same MCP measles binds in initial stage of infection. Research is focused on host-pathogen interaction, not yet on interaction between pathogens. So, which types of bacteria may increase measles virulence? The same microbes overgrowing on a diet of sugar and starch?

Thus, the question of what makes CD46 a pathogen's magnet remains, and the answer may have to be sought inside the cell.

Four Viruses, Two Bacteria, and One Receptor: Membrane Cofactor Protein (CD46) as Pathogens' Magnet, 2004 

PMC387720

They are likely the same set of microbes discovered prevalent in meconium from infants of gestational diabetic mothers, many of which are LPS-producers such as Bacteroides. Gestational diabetes is a global epidemic based on intestinal flora imbalance. This imbalance is passed generationally, a matter of microbial predisposition.  Most recently, gestational diabetes was linked with the autism epidemic.  It's also linked with hyperinsulinemia, a cause of hypoglycemia.

Poor microbial predisposition explains both measles infectivity and risk of MMR vaccine injury based on viral preferences for sugar in the cell wall of microbes. But after birth, infant gut colonization flourishes based on glycans in breast milk regulated by maternal genes. Mothers who are non-secretors (FUT2) based on genetics feed their infants different types of glycans and, therefore, different sets of microbes multiply in their infants, i.e., less of the protective strains of Bifidobacteria. But non-secretors also appear protected against some viral infections. 

Measles is known to respond well to vitamin A supplementation. Vitamin A deficiency is a global pandemic based on malabsortion syndrome due to imbalanced flora, largely caused by poor sanitation in the developing world, not necessarily poor diet. The dramatic irony is sugar being fortified with vitamin A in many countries. Bile acid is required to convert carotenes to vitamin A where quality of bile is regulated by bile salt hydrolases of intestinal bacteria, especially Bifidobacteria.

Here in the developed world where viruses are abundantly found in wastewater treatment plants, virus-packed effluent pollutes surface waters. 

As mentioned, there are no studies about how measles virus interacts with gut microbiota, however, several papers reveal how HIV progression is associated with gut microbiota. HIV infection is associated with abundant Prevotella suggesting those with the Prevotella enterotype may be more prone to HIV. This enterotype includes high levels of E. coli where HIV was found to escape via manipulating the host immune system to attack E. coli. Most interestingly, the microbiome in HIV shows significant decrease in Bacteroides. Are Bacteroides under attack by HIV due to sugar in the cell wall? Bacteroides fragilis, was surprisingly found to reverse autistic symptoms in mice. Restoration and modulation of gut flora is now viewed as therapy to manage HIV progression as well as autism.

"Not only can gut flora influence the development and function of the immune system, but perhaps also pre-determine our reaction to certain infections such as HIV," Haynes said.

HIV-1 Envelope gp41 Antibodies Can Originate from Terminal Ileum B Cells that Share Cross-Reactivity with Commensal Bacteria  PMID 25121750

Prevotella and Bacteroides were also found abundant in African children due to a polysaccharide-rich diet of grains. Increased risk of autism in African American males by MMR vaccination per CDC Senior Scientist, William Thompson may be explained by this microbial predisposition where Bacteroides induce higher immune response than Lactobacillus. 

Might sugar be mechanism of success behind virotherapy, starving cancer? Viral infection associated with fever eases autistic symptoms perhaps because the virus is targeting LPS-producing and/or gram-positive culprits, the same reason antibiotics are known to improve autism. Perhaps a healthy virome is protective against pathogenic viruses. Our virome is now considered part of our immune system, adhering to our gut mucosal lining to protect surfaces from pathogens.

How does vaccination affect the virome, altering bacterial balance? How does the virome affect vaccine response associated with adverse reactions? And what about shedding viruses after vaccination affecting family members? Is that a measles factory?

Roald Dahl was a man proud of his bigotry with capacity to be a cruel parent. He was obsessed with sugar and medicine; one wonders what drug may have caused his wife's untimely strokes given prescription drugs are the fourth leading cause of death. Emotional stress is known to lower protective bacterial counts.

Moral of the story: Try not to overfeed microbes preferred by viruses. Bolster and protect those responsible for keeping pathogens and opportunists in check, which happen to be antiviral.