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PubMedDate not supplied

Increased measles mortality in households with multiple cases in the Gambia, 1981.

Analysis of previously collected data from measles outbreaks in three Gambian villages demonstrated that an age of less than 3 years was the primary risk factor for death in the months following measles infection. No association was found between overall measles mortality and size of household or number of measles cases in a household. When the analysis was confined to patients less than 3 years of age (i.e., those most likely to die), measles mortality was strongly associated with the occurrence of more than five measles cases in a household. Intensive exposure to measles virus may, therefore, be a secondary risk factor for death following measles. Reducing measles mortality by altering social patterns and elevating socioeconomic status to reduce exposure to the virus is beyond the scope of most public health programs. Age-appropriate immunization, therefore, remains the principal strategy for preventing death following measles.

Age Factors↗
PubMed1994

Measles virus induction of human endothelial cell tissue factor procoagulant activity in vitro.

Measles virus infection of microvascular endothelium in vivo and ensuing endothelial cell activation may be important in the pathogenesis of subsequent inflammation in target organs. This study investigated the capacity of measles virus to induce procoagulant activity, in vitro, in endothelial cells isolated from human umbilical cord veins. Endothelial cells were infected with a clinical isolate of measles virus propagated in Vero cells. Cells were also incubated with bacterial lipopolysaccharide (10 micrograms/ml), herpes simplex virus type 1, cytomegalovirus or culture medium alone as positive and negative controls, respectively. Endothelial cell procoagulant activity was measured in a one-stage clotting assay. Measles virus stimulated both a time and dose-dependent endothelial cell procoagulant response by the induction of tissue factor synthesis, confirmed by both immunocytochemistry and its dependence on factor VII for activity. This activity was reduced by u.v.-irradiation of the virus. Infected cells were analysed by double immunofluorescent staining for both tissue factor and measles virus N-protein, and examined using confocal scanning laser microscopy. Cells expressing tissue factor were also positive for the measles virus N-protein. Low levels of interleukin-1 were detected in some viral inocula derived from measles virus-infected Vero cells, however neutralising antibody to interleukin-1 failed to inhibit the endothelial cell procoagulant response to measles virus, whereas it significantly reduced procoagulant activity induced in endothelial cells by recombinant interleukin-1. The capacity of measles virus to induce endothelial tissue factor in vitro, may be relevant to the thrombotic vasculopathy associated with measles virus infection in vivo.

Animals↗
PubMed2000

Performance of indirect immunoglobulin M (IgM) serology tests and IgM capture assays for laboratory diagnosis of measles.

As progress is made toward elimination of measles, the laboratory confirmation of measles becomes increasingly important. However, both false-positive and false-negative results can occur with the routinely used indirect measles immunoglobulin M (IgM) serology tests. The measles IgM capture assay is considered to be more specific, and therefore, its use is indicated for confirmatory testing, but its relative performance has not been fully assessed. Four commercial indirect measles IgM serology test kits (the Behring, Clark, Gull, and PanBio assays) and a commercial IgM capture assay (the Light Diagnostics assay) were evaluated for their abilities to detect measles virus-specific IgM antibody with a total of 308 serum samples from patients involved in a measles outbreak and with confirmed cases of measles and 454 samples from subjects without measles. The Centers for Disease Control and Prevention (CDC) IgM capture assay was also used in a part of the evaluation. Among the indirect assays, the overall sensitivities ranged from 82.8% (Clark assay) to 88.6% (Behring assay) and specificity ranged from 86.6% (PanBio assay) to 99.6% (Gull assay). These rates were 92.2 and 86. 6%, respectively, for the Light Diagnostics capture assay and 87.0 and 94.8%, respectively, for the CDC capture assay. While the Light Diagnostics capture assay had the best detection rate (80%) with the acute-phase samples compared with those for the rest of the tests (CDC capture assay, 77%; Behring assay, 70%; Gull assay, 69%; PanBio assay, 58%; and Clark assay, 57%), all tests showed a significantly improved sensitivity in the range of 92% (Clark and PanBio assays) to 97% (Light Diagnostics and CDC capture assays) with the convalescent-phase samples, as expected. The best seropositivity rates (in the range of 92 to 100%) were observed with samples collected 6 to 14 days after the onset of symptoms. The Gull assay showed the highest positive predictive value (99.6%), followed by the Behring assay (97.8%) and the CDC capture assay (96.1%). Overall, the Gull and Behring assays were found to be as good as or better than the capture assays. In conclusion, laboratory diagnosis of measles based on IgM serology varies depending on the timing of specimen collection and the test used, and the case for the use of the IgM capture assay as the confirmatory test appears to be uncertain.

Antibodies, Viral↗
PubMed1995

Gamma interferon is a major mediator of antiviral defense in experimental measles virus-induced encephalitis.

Measles virus infection of the central nervous system in the murine model of experimental measles virus-induced encephalitis is successfully controlled by virus-specific T-helper lymphocytes. T cells from BALB/c mice that are resistant to measles virus encephalitis proliferate well against measles virus in vitro, and bulk cultures recognize viral nucleocapsid and hemagglutinin as well as fusion proteins. The measles virus-specific T cells secrete large amounts of interleukin 2 (IL-2), gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) but no IL-4, IL-6, or IL-10, and hence the cytokine pattern is consistent with that of subtype 1 T-helper lymphocytes. In contrast, cells obtained from measles virus-infected susceptible C3H mice recognize measles virus proteins only weakly and secrete little IFN-gamma and TNF-alpha. Treatment of infected mice with anti-TNF-alpha antibodies has no effect on survival or virus clearance from the brain. Upon neutralization of IFN-gamma in vivo, the phenotype of measles virus-specific T-helper cells isolatable from BALB/c mice is reversed from subtype 1 to subtype 2-like. Anti-IFN-gamma antibody-treated BALB/c mice are susceptible to measles virus encephalitis, and viral clearance from the central nervous system is impaired. These results indicate that IFN-gamma plays a significant role in the control of measles virus infection of the central nervous system.

Animals↗
PubMed1999

Measles virus infection induces terminal differentiation of human thymic epithelial cells.

Measles virus infection induces a profound immunosuppression that may lead to serious secondary infections and mortality. In this report, we show that the human cortical thymic epithelial cell line is highly susceptible to measles virus infection in vitro, resulting in infectious viral particle production and syncytium formation. Measles virus inhibits thymic epithelial cell growth and induces an arrest in the G0/G1 phases of the cell cycle. Moreover, we show that measles virus induces a progressive thymic epithelial cell differentiation process: attached measles virus-infected epithelial cells correspond to an intermediate state of differentiation while floating cells, recovered from cell culture supernatants, are fully differentiated. Measles virus-induced thymic epithelial cell differentiation is characterized by morphological and phenotypic changes. Measles virus-infected attached cells present fusiform and stellate shapes followed by a loss of cell-cell contacts and a shift from low- to high-molecular-weight keratin expression. Measles virus infection induces thymic epithelial cell apoptosis in terminally differentiated cells, revealed by the condensation and degradation of DNA in measles virus-infected floating thymic epithelial cells. Because thymic epithelial cells are required for the generation of immunocompetent T lymphocytes, our results suggest that measles virus-induced terminal differentiation of thymic epithelial cells may contribute to immunosuppression, particularly in children, in whom the thymic microenvironment is of critical importance for the development and maturation of a functional immune system.

Apoptosis↗
PubMed1995

Difficulties in clinical diagnosis of measles: proposal for modified clinical case definition.

OBJECTIVE: To examine the accuracy of clinical diagnosis of measles and to develop an improved measles clinical case definition. DESIGN: Case survey. SETTING: Eastern Sydney, December 1990 to August 1993. SUBJECTS: All cases of measles notified to the Eastern Sydney Public Health Unit without or before serological confirmation. OUTCOME MEASURES: Demographic and clinical details, measles- and rubella-specific IgM and measles complement fixation titres in acute and convalescent (when available) sera and epidemiological links with confirmed measles cases. RESULTS: Of 49 subjects reported and with complete follow-up, 24 were confirmed with measles, four with rubella and 21 had no definite diagnosis. Clinical diagnosis of measles had a false positive rate of 51%. Subjects with confirmed measles were significantly more likely to have a cough (23/24) than those with no definite diagnosis (15/21; P = 0.03) and to be febrile on the day of rash onset (23/24 versus 10/21; P = 0.001). The Centers for Disease Control definition had a sensitivity of 92% but specificity of only 24%. A modified case definition of rash, cough and fever present at onset of rash had equal sensitivity but greater specificity (57%). CONCLUSIONS: As measles is no longer common in Australia, clinical diagnosis is unreliable. When a public health response is needed, cases should be confirmed by serological tests or, if not available, we propose use of our modified clinical case definition.

Adolescent↗
PubMed2001

Isolation of measles virus from cerebrospinal fluid of children with acute encephalopathy without rash.

OBJECTIVE: To determine the viral agent involved in cases of acute encephalopathy in children during an outbreak in Northern India. DESIGN: Virological and serological studies using serum and cerebrospinal fluid specimens from patients. METHODS: Serum and CSF specimens were tested by IgM ELISA for IgM antibodies to variety of viruses like Japanese encephalitis, West Nile, Dengue and Measles. The specimens were inoculated into Vero cell monolayer for virus isolation. The viral strains isolated were identified by indirect immunofluorescence test and qualitative in-vitro neutralization test using polyclonal and monoclonal antibodies to measles. Identity of the isolates was reconfirmed using RT-PCR method. RESULTS: Of the 28 specimens tested, 17 had IgM antibodies to measles. Commercial IgM ELISA kits confirmed the serological findings. Vero cell cultures yielded 4 isolates from CSF and 2 from serum specimens of six different patients. Cytopathic effect was typical of measles. Indirect imunofluorescence using polyclonal and monoclonal antibodies to measles HA protein, confirmed the measles etiology. Neutralization tests reconfirmed the measles strain isolation. RT-PCR amplified product was confirmed as measles. CONCLUSION: The isolation of measles virus from CSF and serum of children with acute encephalopathy without rash proved the etiological role of measles virus in this outbreak.

Acute Disease↗
PubMed2003

Comparative evaluation of measles, mumps & rubella vaccine at 9 & 15 months of age.

BACKGROUND & OBJECTIVES: Measles, mumps and rubella (MMR) contribute to significant amount of mortality and morbidity in our country. Though MMR vaccine has been a part of immunization schedule in the developed countries, it is yet to be included in our national immunization schedule. Hence this study was conducted to assess the serological status of measles, mumps and rubella in young children and to evaluate the seroconversion of measles, mumps and rubella vaccine at 9 and 15 months of age. METHODS: The cohort study was carried out at the out patient department of a tertiary care hospital in north India. A total of 240 normal children, 120 each in the age group 9-10 and 15-18 months attending the hospital for immunization were enrolled for the study. None of them had been vaccinated with MMR vaccine in the past, or gave any history of measles, mumps or rubella infection, or were on any immunosuppressive agent. The pre-vaccination blood sample was taken and each child was administered a single dose of trivalent MMR vaccine. The post-vaccination sample was taken 6-8 wk later. The paired serum samples were analysed for the presence of measles, mumps and rubella antibodies using commercially available ELISA kits. RESULTS: Of the 120 infants in the age group of 9-10 months, 102 (85%) were seronegative for measles and 96 (80%) were seronegative for both mumps and rubella. Following MMR vaccination, 102 infants came for post vaccination sampling of which 92 per cent were seropositive for measles, 100 per cent for mumps and 98 per cent for rubella. In the age group of 15-18 months, of the 120 children, 67 (56%) were seronegative for measles, 84 (70%) for mumps and 86 (71.6%) for rubella. In 50 per cent of the children, there was a history of measles immunization at 9 months of age. After MMR vaccination, 100 children came for post vaccination sampling and seropositivity of 92, 96 and 94 per cent was observed for measles, mumps and rubella, respectively. The rise in the pre- and post-immunization geometrical mean titre was significant (P < 0.05) for each component of the vaccine in both the age groups. INTERPRETATION & CONCLUSION: The MMR vaccine can be offered safely and with equal efficacy to children at 9 and 15 months of age.

Age Factors↗
PubMedDate not supplied

Measles enteritis in infants and children.

The incidence, mortality and clinical features of measles enteritis were reported among 6484 infants and children admitted to the Pediatric Ward Dr. Pirngadi General Hospital Medan from 1st January 1987 until 31st December 1988. Of these 6484 children, 2685 suffered from gastroenteritis and 82 from measles. There were 31 cases of measles enteritis (1.2% of all gastroenteritis cases or 37.8% of measles cases). Most of measles enteritis cases (74.2%) were in the age group of 6-24 months and no case was found under six months old. The mortality of measles enteritis with bronchopneumonia and encephalitis was 25.0% while the mortality of measles enteritis with bronchopneumonia was 13.3%. There were no deaths in children just with measles enteritis alone. The overall mortality of measles enteritis with or without accompanying disease was 12.9%. The age specific death rate of measles enteritis was highest (23.1%) in the 13-24 month age group.

Child↗
PubMed1990

Measles-associated diarrhoea in the Infectious Diseases Hospital, Rangoon.

A study was conducted in the Infectious Diseases Hospital in Rangoon (Burma) to determine the magnitude of measles-associated diarrhoea morbidity and mortality in children under 6 years of age contributing to the overall diarrhoeal morbidity and mortality, and to determine the bacterial pathogens of measles-associated diarrhoea cases. Measles-associated diarrhoea cases occur most frequently in younger age groups (12-23 and 0-11 months). Although not directly comparable, their contribution to the total diarrhoeal cases (8%) was high but the proportion of measles-associated diarrhoeal deaths contributing to total diarrhoeal deaths was lower than the theoretical estimates. A low fatality rate (2%) among the measles-associated diarrhoea cases was found and this suggests a much lower rate in the community. This implies that measles-associated diarrhoeal mortality is probably not a major public health problem in Burma. Chest infection was the most common complication (32%) and was found in the majority of deaths resulting from complicated measles. A definite seasonal distribution of measles and measles-associated diarrhoea cases was found. Only 10% of the stool samples examined were positive for bacterial pathogens and all were shigellae. We found that a significant number of measles-associated diarrhoeal cases were malnourished.

Acute Disease↗
PubMed1998

Measles IgM immunoreactivity in patients with inflammatory bowel disease.

AIM: The purpose of our study was to examine measles IgM immunoreactivity in patients with inflammatory bowel disease. PATIENTS AND METHODS: In an International collaborative study, serum measles IgM immunoreactivity was assayed in consecutive outpatients with Crohn's disease (n = 95), ulcerative colitis (n = 79), viral hepatitis (n = 63) and blood donors (n = 30). Two commercial measles assays--enzyme linked immunosorbent assay and indirect fluorescence assay--and a Public Health Laboratory Service (PHLS) "in house" antibody capture radioimmunoassay were used. Results were compared with serum rubella and Epstein-Barr virus-specific IgM immunoreactivity, total serum IgM, and measles IgG immunoreactivity. Twenty patients with inflammatory bowel disease were studied serially over a 4-month period. RESULTS: By enzyme linked immunosorbent assay, the prevalence of raised serum measles IgM immunoreactivity was significantly greater in patients with Crohn's disease 23/95 (24%) and ulcerative colitis 20/79 (27%) compared with hepatitis patients 2/63 (3%) and normal controls 0/30 (0%) (p < 0.001). Indirect fluorescence assay produced significantly more positive results than enzyme linked immunosorbent assay in both Crohn's disease (50/87; 57%) and ulcerative colitis (35/68; 51%) but not in controls (0%) (p < 0.001). In contrast, no sera were positive using MCRIA. In the enzyme linked immunosorbent assay, measles IgM immunoreactivity did not correlate with either total IgM, rubella or Epstein-Barr virus IgM immunoreactivities-which were not raised-measles IgM immunoreactivity, or disease activity. Patients not receiving steroids were more likely to have raised measles IgM immunoreactivity (p < 0.5). All sera tested for Rheumatoid factor were negative. Of 20 patients with inflammatory bowel disease studied by ELISA over a 4-month period, 50% showed raised measles IgM immunoreactivity at some stage. CONCLUSION: The data suggest a specific and fluctuating immune response to measles virus in patients with Crohn's disease and ulcerative colitis, that may be modified by corticosteroid therapy.

Adult↗
PubMed2002

Measles IgG seroprevalence prior to mass vaccination in Taiwan.

OBJECTIVES: Measles vaccine was licensed for use in Taiwan in 1968 and mass vaccination has been implemented since 1978. Serological surveys were conducted to characterize measles seroepidemiology prior to mass vaccination. METHODS: Measles IgG was quantitatively measured in 1564 serum samples collected from four populations (nationwide, urban, rural, and mountain areas) during 1974-80 with a commercial EIA kit. The nationwide samples covered age groups from 3 months to 19 years, but the other three samples only covered school-aged children. The cut-off value of seropositivity was set at 100 mIU/ml. RESULTS: In the nationwide samples, measles IgG seroprevalence decreased from 50% at 3-5 months to 13% at 6-11 months, then increased rapidly to 55% at 1-1.9 years and reached 98% at 7-7.9 years of age; this was maintained to young adulthood. In all four samples, seroprevalence also reached >97% in individuals >10 years of age. Semiquantitative analysis found that 24%(10/42) of 1-1.9-year-old children but only 4%(1/24) of 15-19-year-old adolescents had low level measles IgG (100-399 mIU/ml). In addition, the distribution of measles IgG level in 1-1.9-year-old children had two peaks at 200-399 and 1600-3199 mIU/ml, whereas only one peak at 1600-3199 mIU/ml had been found in 15-19-year-old adolescents. The median age of measles infection (i.e. 50% seroprevalence) in Taiwan was 1.4 and 2.1 years, respectively, before and after excluding individuals with measles IgG 100-399 mIU/ml that may have resulted from vaccination. CONCLUSIONS: Measles seroepidemiology in Taiwan in the 1970s seemed to be more similar to that in a developing country rather than in an industrialized country, and there was a low median age of infection.

Adolescent↗
PubMedDate not supplied

Measles is more prevalent in Crohn's disease patients. A multicentre Israeli study.

The question whether there is a transmissible pathogenetic agent as a cause for Crohn's disease, remains unanswered. Measles virus has been the subject of many intensive studies, in the attempt to find a role for it in the pathogenesis of inflammatory bowel disease. Whether an early infection with measles virus may predispose to Crohn's disease in later life is still not clear. We conducted a large scale multicentre study, in order to obtain sufficient data to answer this question. To do so, we compared inflammatory bowel disease patients, with Crohn's disease or ulcerative colitis, with two matched control groups: clinical controls, and community controls. A total of 531 patients, 271 with ulcerative colitis and 260 with Crohn's disease were interviewed, as well as 903 matched controls. Blood from 104 inflammatory bowel disease patients and 50 controls was tested for antibodies to measles virus. We did not find any differences related to measles vaccination, either in Crohn's disease or in ulcerative colitis. Exposure to measles in childhood was more frequent in Crohn's disease patients than in their controls, the difference being statistically significant (p < 0.05) in relation to community controls. The presence of IgG antibodies to measles virus was higher in patients with Crohn's disease than in patients with ulcerative colitis or controls (p = 0.084). Another observation of interest was the finding that Crohn's disease patients who had measles in childhood, more frequently had large bowel disease than those who had not had measles. These data lead us to postulate that there may be a role for measles infection in Crohn's disease, even if, at present, this role remains unclear.

Adult↗
PubMed2006

Measles virus-specific IgG4 antibody titer as a serologic marker of post-vaccinal immune response.

In previous research, we concluded that measles virus specific IgG4 antibody titer could be used to differentiate between natural [IgG4 GMT 80 (95% CI, 33 to 191)] and vaccinal source of measles infection [IgG4 GMT 13 (95% CI, 7 to 26)]. The aim of this paper is to show that this new serologic marker (IgG4 measles antibody titer) can be applied to help interpret rare but well documented cases of measles Ig M-positive results in vaccinated individuals who, 1-2 months after vaccination, developed rash and fever and therefore do not meet the criteria for post-vaccinal measles infection. Six measles IgM-positive serum samples obtained from measles vaccinated individuals who developed rash/fever 1 to 2 months post-vaccination were studied by Immunofluorescence assay for the quantification of IgG4 measles specific antibody. IgG4 antibody titers from all these samples were between 1:10-1:20, consequently, the IgM positive results from the study cases could be ascribed to post-vaccinal immune response. Thus, measles virus specific IgG4 antibody titer could be used as a serologic marker of post-vaccinal immune response.

Antibodies, Viral↗
PubMedDate not supplied

Further-attenuated measles vaccine: characteristics and use.

Further-attenuated strains of measles virus may be distinguished from virulent strains by the following characteristics. Unlike virulent strains, attenuated strains of measles virus can be propagated in chick embryo fibroblast cultures, induce production of interferon in tissue culture cells, and produce plaques that can be distinguished from those produced by virulent strains. Unlike virulent measles virus, attenuated strains induce an inapparent infection in approximately 85% of vaccines. Symptoms such as fever, cough and rash, if present, are usually transient. Bacterial and central nervous system complications associated with natural measles infection are extremely rare after immunization. A 16-year, prospective study of immunologic response of 47 children who had natural measles and of 70 children immunized with live, further-attenuated measles vaccine revealed (1) that all 47 children with natural measles infection had high titers of hemagglutination-inhibiting (HAI) antibody (greater than or equal to 1:64) one month after vaccination and 15% had low titers (1:2-1:4) 16 years after vaccination; and (2) that all 70 children who received live, further-attenuated measles vaccine had high titers of HAI antibody (greater than or equal to 1:64) one month after vaccination, but in 36% of the group the titers declined to less than 1:8 16 years later. Neutralizing antibody was detectable in convalescent sera that had lost detectable HAI antibody. Reimmunization of children with undetectable HAI antibody induced a classic booster response. These prospective immunologic studies confirmed that immunity persists after immunization as well as after natural measles infection.

Antibodies, Viral↗
PubMed2004

Measles virus prevalence in otosclerotic stapes footplate samples.

HYPOTHESIS: The cause of otosclerosis is still unknown. Persistent measles virus infection of the otic capsule is supposed to be one of the etiologic factors in otosclerosis. Chronic viral antigen expression on the surface of infected cells can induce a secondary autoimmune reaction against the otic capsule. BACKGROUND: In the past 15 years, some reports proposed the possible etiologic role of measles virus in otosclerosis. The presence of measles virus was shown in otosclerotic patients by reverse-transcriptase polymerase chain reaction amplification of the viral RNA, detecting the viral proteins by immunohistochemistry and detecting antimeasles immunoglobulin G in the perilymph samples. Many concerns were elicited by these results. METHODS: Nucleic acid was extracted from pulverized, frozen stapes footplate samples of otosclerotic patients. Measles virus RNA was amplified by reverse-transcriptase polymerase chain reaction: reverse transcription and the first round polymerase chain reaction amplification was performed by heat stable recombinant Thermus thermophilus polymerase, whereas in the nested round, polymerase chain reaction Taq-polymerase was used. Measles virus nucleoprotein RNA-specific oligonucleotide primers were used in these reactions. An Edmonston-type measles virus served as a positive control and cortical bone fragments or stapes superstructures served as negative controls. RESULTS: Among 34 otosclerotic patients, 20 stapes footplate samples contained measles virus RNA. Measles virus RNA was not detected in other bone specimens of the patients. CONCLUSION: The etiologic role of measles virus in the pathogenesis of otosclerosis should be considered. The 14 negative samples may be genetically determined otosclerotic cases.

Adult↗
PubMed2026

The return of measles: a dangerous comeback.

PURPOSE OF REVIEW: Measles has reemerged as a significant global public health threat, with increasing morbidity and mortality associated with declining vaccination rates. This review summarizes current global outbreaks, history of measles, vaccination and elimination status, vaccine hesitancy, and outbreak response and lessons learned highlighting different novel digital epidemiological tools. RECENT FINDINGS: Measles continues to surge worldwide with an estimated 11 million infections in 2024, which is more than prepandemic levels. Developing and developed countries are both facing measles outbreaks, with the United States at risk of losing measles elimination status. Recent studies have showed that worldwide percentages of two-dose measles vaccination were lower than 95% that is required to interrupt measles transmission in all WHO regions. Novel epidemiological tools such as interactive simulators, real-time use of dynamic models, serosurveillance, and others are transforming measles outbreak response and enable earlier outbreak detection, tracking, and targeted public health interventions. SUMMARY: Vaccine hesitancy is one of the top global health threats and developing a tailored evidence-based approach is necessary to establish and maintain measles elimination.

Humans↗
PubMed1988

Serological evaluation of a measles, mumps, and rubella vaccine.

Combined measles, mumps, and rubella vaccination is soon to become available in Britain in the routine immunisation programme. A controlled study was performed in 319 children, aged 13 months, to assess the antibody response and clinical reactions to a new combined measles, mumps, and rubella vaccine in comparison with a single component measles vaccine. In the children who received the combined vaccine, seroconversion was established in 93% for measles, 99% for rubella, and 100% for mumps. In the children who received the single measles vaccine, seroconversion was established in 92% for measles and in none for rubella and mumps. There was no increase in clinical reactions after the measles, mumps, and rubella vaccine compared with the measles vaccine. These results suggest that this combined vaccine would be effective and safe in a British population and give further support for the introduction of the combined measles, mumps, and rubella vaccine to Britain.

Antibodies, Viral↗