Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MEASLES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 973 records · Page 54Linked to original sources
PubMed1994

Measles mortality in India: a review of community based studies.

This paper reviews the measles Case Fatality Ratios (CFRs) reported in the community based studies from India. Measles mortality varied considerably in outbreaks, prospective and retrospective studies. A median CFR of 2.5 per cent (0.2-3.7), 0.1 per cent (0-2.2) and 3.7 per cent (0-23.9) was recorded in prospective, retrospective and outbreak studies respectively. The retrospective studies seem to underestimate the measles mortality in Indian setting. Most of the outbreaks recording CFRs equal to or less than the median, 3.7 per cent, occurred in the areas where health care facilities were available for treatment of measles associated complications. Virtually in all studies, the age specific CFRs wherever recorded, were found to be the highest among infants and thereafter the ratios declined progressively. Although suggestive of, the studies did not provide sufficient data to establish an association between malnourishment and the risk of dying from measles. Measles mortality was not consistently high in any particular sex. The study makes a strong case for measles immunization at the earliest recommended age and the provision of better health services as the important public health measures for reducing the measles CFRs.

Age Factors↗
PubMed1994

[A case of severe measles encephalitis in a pregnant woman].

A 23-year-old woman in her 23rd week of gestation became febrile and then developed cutaneous eruption typical of measles on July 16, 1993. Two weeks prior to this, her 8-month-old daughter has developed measles. The woman became comatose in a few days and was admitted to our hospital where coma, flaccid paralysis of all four limbs and midbrain corectopia were apparent. High titers of anti-measles antibodies were found in the serum and cerebrospinal fluid. She received a 3-day course of pulse-dose intravenous methylprednisolone, however, without effect. Her consciousness gradually improved and after 1 month, subtle volitional movements were observed. However, fetal death was found and the fetus was removed by cesarean section. In MRI T2-weighted images, earlier in her illness, high signal intensity areas were scattered deeply in the cerebral white matter and the posterior limbs of the internal capsule. However, T1-weighted image was unremarkable. Marked, diffuse cerebral atrophy was noticed 3 months later by both CT and MRI, which was accompanied by wide spread high signal intensity areas around the lateral and fourth ventricles. Regarding the pathogenesis, there are two possibilities, i.e., her encephalitis was due to direct measles viral invasion into the CNS, or due to the autoimmune processes triggered by measles infection. Immune dysfunction known to occur during pregnancy might be responsible for the severity of encephalitis the patient suffered from. A recent increase in the number of adult measles infection might be an admonition that pregnant women are not exceptional to measles infection and that the infection could give rise to a severe form of measles encephalitis.

Adult↗
PubMed1993

Measles severity and serum retinol (vitamin A) concentration among children in the United States.

BACKGROUND: Studies in developing countries have shown that children with measles have low serum retinol concentrations and that lower retinol levels are associated with measles-related mortality. Vitamin A therapy has been shown to reduce mortality among African children with acute measles. OBJECTIVES: To determine whether serum retinol concentration is low among children with measles in the United States and to determine whether retinol concentration is associated with illness severity. SETTING: Pediatric referral hospital and clinic in Milwaukee, WI, during the measles outbreak of 1989-1990. PATIENTS: One hundred fourteen patients < or = 5 years of age evaluated for serologically confirmed measles with serum obtained within 5 days following rash onset. METHODS: Serum retinol concentration was determined by high-performance liquid chromatography. Clinical data were collected by hospital record review. A modified Pediatric Risk of Mortality (PRISM) score was used to assess physiologic instability as a measure of illness severity. RESULTS: Retinol concentrations ranged from 0.25 to 1.18 mumol/L (median 0.58 mumol/L); 82 (72%) patients had low retinol concentration (< or = 0.70 mumol/L). Median retinol concentrations were lower among hospitalized patients (0.56 vs 0.70, P = .006) and patients with pneumonia (0.52 vs 0.64, P = .02) but higher among children with otitis media (0.63 vs 0.54, P = .01). Higher modified PRISM scores, reflecting greater physiologic instability, were associated with lower retinol concentration (beta coefficient -.0147, P = .025). In multivariate analysis, higher modified PRISM scores were associated with lower retinol concentration (beta coefficient -.0144, P = .025) even after controlling for hospitalization, presence of complications, race, age, receipt of Aid to Families With Dependent Children, gender, and interval from rash onset until serum was collected. CONCLUSIONS: Among these children with measles in an urban United States community, retinol concentrations were depressed, and the degree of depression was associated with illness severity. Vitamin A therapy should be considered for children with measles in the United States who require hospitalization.

Child, Preschool↗
PubMed1997

Subtypes of HIV-1 and the impact of dual infections of HIV-1 and measles virus on micronutrient levels of pregnant women in Harare, Zimbabwe.

OBJECTIVE: To determine subtypes of HIV-1, simultaneous prevalence of HIV-1 and measles virus antibodies and their impact on micronutrient levels of pregnant women in Harare, Zimbabwe. DESIGN: Cross sectional. SETTING: Budiriro and Edith Opperman Antenatal Clinics Harare; Departments of Medical Microbiology, Medical Laboratory Technology and Institute of Food, Nutrition and Family Sciences, University of Zimbabwe. SUBJECTS: Pregnant women attending antenatal clinics in Harare, Zimbabwe. MAIN OUTCOME MEASURES: HIV-1 subtypes, measles virus seropositivities and levels of micronutrients among the pregnant women. RESULTS: Results showed that 101 (22.7%) out of a total of 444 pregnant women screened were HIV-1 positive. A separate group of 238 (inclusive of the 444) were screened for measles antibody and 118 (49.5%) were positive, whereas 41 (17.2%) were HIV-1 positive. Thirty five (29.7%) were seropositive for both HIV-1 and measles virus (simultaneous infection). HIV-1 subtypes revealed subtype C (70.4%) as the predominant subtype. HIV-1 subtypes B, A and D accounted for 40.8%, 39.8% and 22.4% respectively whereas HIV-1 subtypes E and F were not detected. Dual infections showed that 37.7%, 36.7%, 7.1% and 4.4% harboured subtypes A and C; B and C; A and D and B and D respectively. Multiple infections with subtypes A, B, C and D (5.1%) were also recorded whereas 9.2% were non-reactive. Results on micronutrients portrayed that HIV-1 positive pregnant women had significantly lower zinc than the control but co-infection with measles virus did not cause further decrease. Infection by either HIV-1 or measles virus increased serum copper (p < 0.05) but co-infection by the two viruses reduced the copper level significantly (p < 0.05). HIV-1 seropositivity did not affect serum magnesium level but was lower (p < 0.05) in women positive for both HIV-1 and measles virus. CONCLUSION: This is a single report on HIV-1 infection, HIV-1 subtypes, simultaneous prevalence of HIV-1 and measles virus antibodies and their impact on micronutrient levels of pregnant women in Harare, Zimbabwe. The study is of nutritional, clinico-epidemiologic importance.

Amino Acid Sequence↗
PubMed1997

Experimental measles. II. Infection and immunity in the rhesus macaque.

Measles infection and the host immune response to measles virus was compared using naive and immunized rhesus monkeys. The monkeys were experimentally challenged with a wild-type strain of measles virus inoculated intranasally. After pathogenic virus challenge, measles virus was detected in mononuclear cells of peripheral blood, lymph node, and spleen in naive monkeys and viremia peaked on Day 7. However, only one of five vaccinated monkeys had a lower virus titer in peripheral blood mononuclear cells at one time point after challenge. No virus was detected in the lymphoid tissues from an immunized monkeys that was euthanized on Day 7 of infection. Measles-specific IgM, IgG, neutralizing antibody, and cytotoxic T lymphocytes were detected in vaccinated monkeys before challenge, but antibody titers were significantly lower in immunized monkeys than in naive monkey after challenge. Measles-specific IgG antibody and cytotoxic T cell responses were still detected more than 1 year after vaccination or infection. This animal model is useful for the further study of measles pathogenesis, immunosuppression, and immunologic memories.

Animals↗
PubMed1991

Measles, killer of millions in developing countries: strategy for rapid elimination and continuing control.

Measles, which is still killing about two million children a year in poor countries, was mostly eliminated within two to three months after the conclusion of a special, national mass vaccination campaign in which all children of a selected age group received measles vaccine subcutaneously during a period of days to months, regardless of a history of previous vaccination or measles. This strategy was tested in the Dominican Republic in 1985, in Cuba in 1986-87, and in the State of São Paulo, Brazil May 11-June 10, 1987. Subsequent control was maintained by different procedures in the three states. A simple, rapid indirect immunofluorescent test for IgM measles antibody, used in Greater São Paulo, was more efficient in confirming concurrent infection with measles virus than the hemagglutination inhibition test for IgG antibody, and only one blood specimen taken during the course of the rash was needed to confirm the etiologic diagnosis in 97.5% of 240 cases confirmed by IgM. In Greater São Paulo and Cuba, it was found that over 90% of the small number of suspect measles cases reported during the first year after the mass campaign, were not caused by measles virus. The cost of disposable syringes and needles in the State of São Paulo, where 8,565,230 children were vaccinated in 10,527 centers in 30 days, was U.S. $2,057,753 or 63% of the total. Immunization by aerosol could have vaccinated this number of children more easily and effectively in one day if each of the vaccination centers had been supplied with one plastic foot or hand pressure pump and nebulizer at a cost of only about U.S. $300,000.

Adolescent↗
PubMed2003

Current status of measles in Japan.

Approximately 20,000 to 30,000 cases of measles are reported annually in Japan, although the actual number of measles infections is considered to be five to ten times higher than the number of reported cases. Despite the availability of effective and safe live attenuated vaccines, regional outbreaks in Okinawa, transmission in adults, and secondary vaccine failures continue. Recent advances in molecular technology have contributed to molecular epidemiological studies, new concepts of asymptomatic infection, and the identification of different characteristics among measles virus genotypes. Measles virus strains isolated in Japan since 1984 were classified into the genotypes C1 (-1985), D3 (1985-1990), D5 (1990-1997), and Chicago-type D3 (1997-1999) from the results of sequencing the hemagglutinin gene. After 2000, the D5 genotype emerged, and, recently, the H1 genotype, which is now dominant, was introduced from Korea. Some of the currently circulating wild-types have different characteristics (high growth rate at 39 degrees C-40 degrees C). The cumulative vaccine coverage has reached 81%, but most measles cases involved unvaccinated individuals. Measles is a preventable disease and can be eradicated by increasing the vaccine coverage, and promoting the motivation for vaccination, in accordance with the worldwide measles strategy.

Antibodies, Viral↗
PubMed1986

Long-term antibody response after measles vaccination in an isolated arctic society in Greenland.

Scoresbysund is an isolated district on the east coast of Greenland with 500 inhabitants, mainly Polar Eskimos, which had never been exposed to natural measles. In 1968 more than 90% of the population were vaccinated with the Schwarz live further-attenuated measles vaccine and subsequently children born after 1968 likewise received the measles vaccination. Upon the initial measles vaccination no clinical cases of measles have been observed. The immunity status of the isolated population has been followed for 16 years after vaccination by IgM, IgA, and IgG ELISA tests and by HI test on a series of serum samples taken at intervals. Immunoblotting was performed on sera obtained 16 years after the vaccination. In general, antibody studies have demonstrated some decline in antibody titres after the initial measles vaccination. However, a temporary moderate increase in measles antibodies occurred in some individuals 2-4 years after vaccination, probably due to a reinfection of vaccinees. Most of these individuals did not have demonstrable IgA antibodies prior to the supposed reinfection.

Antibodies, Viral↗
PubMed1995

MMR vaccination, measles epidemiology and sero-surveillance in the Republic of Ireland.

OBJECTIVE: Following the introduction of a national measles and subsequent MMR vaccination programme, to determine the susceptibility of 3-14-year-old children to measles, mumps and rubella and to relate the results to the epidemiology of measles and the need for vaccination policy changes. DESIGN: Cross-sectional sero-survey and trends in measles notifications and mortality. SETTING: Paediatric hospital outpatient departments in Dublin. SUBJECTS: Sera were collected from 837 children attending the clinics in 1991 and 1992. RESULTS: The prevalence of antibodies in children aged 3-6, 7-10 and 11-14 years was 84, 83 and 95% for measles; 48, 60 and 65% for mumps; and 78, 63 and 74% for rubella, respectively. The prevalence of mumps antibodies may be underestimated. Ninety-six per cent of girls aged 13-14 years had rubella antibodies. A widespread outbreak of measles occurred in 1993. Over recent years, an increasing proportion of measles notifications were in older children. CONCLUSION: Given sub-optimal uptake of MMR vaccine, outbreaks of infection in pre- and primary school children are inevitable. In such circumstances, a 2-shot MMR vaccine programme with high uptake is essential to prevent a shift of disease into older age groups.

Adolescent↗
PubMed1983

Need for measles revaccination in adolescents: correlation with birth date prior to 1972.

Measles hemagglutination inhibition (HI) antibody titers of less than 1:4 were significantly (P less than 0.05) more prevalent among subjects born from 1962 through 1971 and vaccinated with a single dose of live measles virus vaccine at 12 months of age (14.5%) than among subjects born during the same years but vaccinated at 13 months or older (2.3%). For subjects born in 1972 through 1976, however, this difference was not statistically significant; titers of less than 1:4 occurred in 6.2% of those vaccinated at 12 months, compared to 0% in those vaccinated at 13 months or older. A decline in maternally derived measles HI antibody may be related to the increased rate of HI antibody titers of 1:4 or greater following vaccination of more recently born subjects. Following revaccination of subjects whose measles HI antibody titers were less than 1:4, measles HI titers were lower than would be expected after successful primary vaccination. Nevertheless, measles HI antibody persisted at a level of 1:4 or more until the latest titer measurement of this study (one to two years after revaccination) in 87.5% of those whose initial vaccination had been at 11 or 12 months of age. No adverse reactions to revaccination occurred. Revaccination programs should be considered for adolescents and young adults born before 1972 who received live measles virus vaccine at or before 12 months. Children born from 1972 through 1976 who were vaccinated at 12 months or later are not in need of revaccination.

Adolescent↗
PubMed1984

Immunisation of 4-6 month old Gambian infants with Edmonston-Zagreb measles vaccine.

Five different vaccination schedules were used to immunise Gambian infants aged 4-6 months against measles with the attenuated Edmonston-Zagreb strain of virus, which has a history of passage in human diploid cells. Vaccine aerosol given either by mask in a dose of 3500 or 7000 plaque-forming units (PFU) or from a plastic bag at a dose of 7000 PFU raised haemagglutinin-inhibiting or plaque-inhibiting measles antibody 16-24 weeks after vaccination to a titre of 1 in 8 or greater in all but 3 of the 51 children so vaccinated. All 21 infants given 11 400 PFU of vaccine intradermally in two divided doses and the 21 given 39 000 PFU of the virus subcutaneously also had satisfactory levels of measles antibody 16 weeks after vaccination. None of the vaccinated children had clinical evidence of measles in the 12 to 17 months after vaccination. The Edmonston-Zagreb vaccine, given subcutaneously or by other routes at 4-6 months, may be useful in preventing measles in infants in African cities, where 15-30% of children have measles before they are 9 months old, which is the recommended age for immunisation with the chick-cell-adapted strains of measles virus.

Aerosols↗
PubMed1988

Trial of high-dose Edmonston-Zagreb measles vaccine in Guinea-Bissau: protective efficacy.

In a randomised study of 558 children in an urban African community, the protective effect of the Edmonston-Zagreb (EZ) measles vaccine given in a dose of 40,000 plaque forming units from the age of 4 months was compared with the effects of a standard dose (6000 tissue culture infectious units) of Schwarz measles vaccine given from the age of 9 months. During two years of follow-up, all 14 clinical cases of measles occurred in the Schwarz group; 10 of the children contracted measles before vaccination and 4 after measles vaccination. Thus the EZ vaccine provided significant protection against measles both before and after the usual age of vaccination. Among the children who were exposed to measles at home, those given EZ vaccine were better protected than either unvaccinated children or those given the Schwarz vaccine.

Age Factors↗
PubMed2001

Serological and epidemiological effects and influence factors of primary immunization with current live attenuated measles vaccine (Hu191) among infants aged 6-15 months.

A study of the serological and epidemiological effects of primary immunization with current live attenuated measles vaccine (Hu191) among 503 children aged 6-15 months, was conducted in Jingzhou, Hubei province, China from 1991 to 1998. The results showed that the positive conversion rate of measles IgG was 91.65%, geometric mean titer (GMT) was 1:266.74 and its ratio reaching protective titer was 46.52% at 1 month after first immunization. As time goes on, the above-mentioned indexes reduced rapidly. Short-term and long-term efficacy of 0.2, 0.3 and 0.5 ml measles vaccine was similar. The positive conversion rate, GMT and ratio of protective titer of IgG of different potency measles vaccine were not significantly different, however, latter two indexes showed a tendency to increase gradually with the rise of vaccine potency. The age for primary immunization was a main factor influencing immune response to measles vaccine. Immune efficacy of 6 months old group by primary vaccination was significantly lower than those of > or = 8 months old group. The result indicated it is practicable that infant aged 8 months be vaccinated with measles vaccine in China. Twenty-nine suspected measles cases were reported, out of them, 26 cases were negated in time from December 1991 to November 1998. The study showed that the short-term positive conversion rate of the enzyme immune assay IgG antibody of the Hu191 is higher, but its serological endurance isn't ideal, and its epidemiological effect should be evaluated further.

Age Factors↗
PubMed2001

Current overview of the pathogenesis and prophylaxis of measles with focus on practical implications.

Measles is one of the most important diseases of mankind, which is so highly contagious and evokes such persistent immunity that the virus cannot be sustained in a population of less than about 500,000 persons. The first of the licensed live virus vaccines against measles was developed empirically and was approved in 1963. It provides high level and lasting immunity and is a paradigm for solving major medical problems without really understanding them. In spite of means for control by prophylactic immunization, research on measles infection continues to be part of the effort to understand the pathogenesis of many different viruses, which may have important similarities and differences and provide important insights. Measles, usually, is spontaneously reversible and is a prime model for understanding virus-induced immunodeficiency disease (AIDS) which is rarely reversible. Much has been learned of basic immunology and vaccinology in measles through observation of the inappropriate use of vaccines of appropriate composition, and through inappropriate host response to measles vaccines of inappropriate composition. This review provides a current overview of selected highlights of measles, the virus, its immunopathogenesis, and its control by use of live virus vaccine which may lead to elimination of the disease and eventually to eradication of the virus.

Animals↗
PubMed1998

A model to estimate the potential economic benefits of measles eradication for the United States.

Measles incidence is at a nadir in many parts of the world due to vaccination efforts. Although the technical feasibility of eradication has been acknowledged, financial and political commitment need to be concomitantly identified on the national and global level. We demonstrate the potential value of measles eradication by identifying the potential cost-savings to one country resulting from measles eradication. For the US, measles eradication would save $45 million annually. If achieved by the year 2010, the US would save $500 million to $4.1 billion depending on the year of elimination, post-eradication schedule and discount rate. Intensification of measles control efforts in the US beyond current levels would have minimal marginal benefits on disease burden reduction. Allocation of resources to achieve global measles eradication is the next level of efficiency which would provide substantial savings. Countries may adapt this model to estimate their savings for consideration of the required political and financial contribution towards a global measles eradication program.

Adolescent↗
PubMed2006

Global measles elimination.

Measles remains a leading vaccine-preventable cause of child mortality worldwide, particularly in sub-Saharan Africa where almost half of the estimated 454,000 measles deaths in 2004 occurred. However, great progress in measles control has been made in resource-poor countries through accelerated measles-control efforts. The global elimination of measles has been debated since measles vaccines were first licensed in the 1960's, and this debate is likely to be renewed if polio virus is eradicated. This review discusses the pathogenesis of measles and the likelihood of the worldwide elimination of this disease.

Animals↗
PubMedDate not supplied

Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for a new eradication strategy.

Measles continues to occur in epidemic waves in Israel, Gaza, and the West Bank, causing morbidity and mortality. In Israel, immunization of infants against measles began in 1967, and 90% had been immunized by the mid-1980s. In Gaza and the West Bank, where immunization of infants against measles began in 1973 and 1976, respectively, the immunization rate reached 75% in the late 1970s and increased to greater than 90% in the 1980s. Measles epidemics, which previously had occurred in 5- to 7-year cycles, occurred every 2-4 years in the 1980s and affected individuals who were older than those affected in previous years. Israel's commitment to eradicating measles by 1992 will require a substantially expanded immunization program in comparison with the traditional program that requires immunization of infants alone. The benefits of several alternative immunization strategies considerably exceed their costs. A new, two-dose immunization will be needed as a minimal strategy, and a campaign for administering booster doses to school-aged children may be required as well to achieve control and eradication of measles. Measles is a serious but preventable public health problem; appropriate strategies must be devised by national and international public health officials to control the disease in developing and developed countries.

Adolescent↗
PubMed2003

Seroconversion after measles vaccination at nine and fifteen months of age.

BACKGROUND: Despite high vaccination coverage, single dose measles immunization programs have been unsuccessful in eliminating the disease. Because seroconversion rates are lower in infants vaccinated before 12 months of age, a second dose of measles vaccine is recommended at 15 months. The aim of this study was to determine the seroconversion rates in children after the first and second doses of measles vaccinations at 9 and 15 months of age. METHODS: Study population comprised 116 infants attending the Well Baby Clinic of Istanbul University, Faculty of Medicine. Serum specimens were obtained from children before and 1 month after the first measles (Rouvax, Schwarz strain 1000 TCID(50)) vaccine given at 9 months. A second dose was given to 72 children at 15 months of age as measles-mumps-rubella (Trimovax, Schwarz measles strain, 1000 TCID(50); Urabe Am 9 mumps strain, 5000 TCID(50); Wister RA 27/3 rubella strain, 1000 TCID(50)). Third blood samples were collected 20 months after the second vaccine. RESULTS: Passive antibody positivity rate was 5.2% at the age of 9 months. Seroconversion rate was 77.6% after the first dose and 81.9% after the second dose of measles vaccine. Of 15 children who were seronegative, 13 (86.7%) became seropositive after the immunization at 15 months. Eleven children (19.2%) seroconverted from positive to negative after the second vaccine. CONCLUSION: The two dose schedule seems to increase the seropositivity rate. Our findings also indicate that increasing vaccination coverage and revaccination at 6 years of age are important even with the early two dose schedule.

Antibodies, Viral↗