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PubMed2005

Review of the temporal and geographical distribution of measles virus genotypes in the prevaccine and postvaccine eras.

Molecular epidemiological investigation of measles outbreaks can document the interruption of endemic measles transmission and is useful for establishing and clarifying epidemiological links between cases in geographically distinct clusters. To determine the distribution of measles virus genotypes in the prevaccine and postvaccine eras, a literature search of biomedical databases, measles surveillance websites and other electronic sources was conducted for English language reports of measles outbreaks or genetic characterization of measles virus isolates. Genotype assignments based on classification systems other than the currently accepted WHO nomenclature were reassigned using the current criteria. This review gives a comprehensive overview of the distribution of MV genotypes in the prevaccine and postvaccine eras and describes the geographically diverse distribution of some measles virus genotypes and the localized distributions of other genotypes.

Genotype↗
PubMed1998

[A seroconversion study of the measles component of the MMR vaccine in adolescents of the town of Sabrosa].

The Portuguese national programme of vaccination has instituted a two-dose MMR vaccine schedule. The second dose of MMR (measles-mumps-rubella combined vaccine) is given at 11-13 years of age, for both sexes. This study was conducted to evaluate the duration of immunity of the monovalent measles vaccine, and the efficacy of a second dose given as MMR. MMR (Triviraten Berna with the strain Edmonston-Zagreb) was given to the 38 participants. Blood samples were collected before and after vaccination. Thirty-six participants had been vaccinated with measles monovalent vaccine during childhood. To measure anti-measles IgG (mIgG), an enzyme immunoassay was used. Participants were classified as "susceptible" or "immune", using 200 mIU/ml (milli international units per millilitre) as the threshold for "immune". Geometric mean concentration (GMC) of mIgG was 1401 mIU/ml in prevaccination sera (n = 38). Thirty-five (92%) of the adolescents were "immune". Only the two unvaccinated had a positive measles history. GMC in the sera of the 36 vaccinated participants was 1301 mIU/ml. Neither the time since measles vaccination nor age at vaccination were correlated with the levels of mIgG. After receiving MMR, all adolescents became "immune". GMC of mIgG was 2879 mIU/ml in postvaccination sera (n = 38). In 28 (74%) participants, mIgG levels increased after receiving MMR. Mean concentration increase was 1082 mIU/ml. For measles, results support the use of a two-dose MMR vaccine schedule in Portugal.

Adolescent↗
PubMed2000

Gender differences in the reactogenicity of measles-mumps-rubella vaccine.

BACKGROUND: In trials comparing different formulations of measles vaccine, excess non-specific mortality occurred in female children who received high titer vaccine. These findings suggest a gender-specific effect of measles vaccine. OBJECTIVES: To determine whether gender differences exist in the rates of adverse reactions and morbidity in the month following immunization with measles-containing vaccine, and to evaluate whether there is a gender-specific association between the humoral immune response to measles vaccination and post-vaccination morbidity. METHODS: Parents completed questionnaires on the health status of 755 infants aged 15-20 months, during the month preceding and the month following the measles-mumps-rubella vaccination. Blood samples were tested for measles antibody titers in a subsample of 237 infants. RESULTS: After controlling background morbidity in the infants, the relative risk of fever and rash following vaccination was 2.35 in females and 1.36 in males. The geometric mean antibody titers against measles were similar in both sexes and there was no significant association between antibody titer and post-vaccination morbidity in either sex. CONCLUSIONS: Our findings demonstrate higher rates of adverse effects in females following vaccination with MMR vaccine, irrespective of the humoral response. This study emphasizes the need to consider possible gender differences when evaluating new vaccines.

Antibodies, Viral↗
PubMed2005

[Seroprevalence of measles antibody and its attributable factors in elementary students of routine 2-dose schedule era with vaccination record].

OBJECTIVES: We investigated the seroprevalence of the measles antibody and its attributable factors for the students who underwent routine 2-dose Schedule Era. METHODS: The subjects were 996 students of the national measles seroepidemiologic study in December 2000 who had vaccination records. We conducted a questionnaire survey and we performed serologic testing for the measles-specific IgG by using an enzyme linked immunosorbent assay. RESULTS: The coverage for the first dose of the MMR vaccination at 12-15 months of age was 95.1% and the coverage for the second dose of MMR at 4-6 years of age was 35.0%. The proportion of subjects undergoing 2-doses of MMR decreased as the age of the subjects increased. The seropositive rate of the measles antibody was significantly high in the second dose vaccinees (93.5% in the second dose group, 84.7% in the non-second dose group, p<0.001) and it was 72.0% in the 0-dose group, 85.4% in the 1-dose group and 93.7% in the 2-dose group (p<0.001). Two point eight percent of the subjects had a past history of measles infection. On the multiple logistic regression analysis, the first and second dose (odds ratio, 8.54; 95% CI.=3.05-23.91), the first dose (odds ratio, 3.06; 95% CI.=1.20-7.81) and the outbreak in the year 2000 (odds ratio, 1.89; 95% CI.=1.24-2.88) were the significant factors for the seropositivity. CONCLUSIONS: Maintaining high coverage with a 2-dose vaccination program would be the decisive factor to prevent an outbreak of measles and to eliminate measles in Korea.

Antibodies, Viral↗
PubMed2006

[An atypical measles case presenting with severe cervical spasm].

Atypical measles is characterized by high fever, headache, myalgia and atypical rash, in patients who were vaccinated against measles. In this report a 22 years old male patient presenting with severe cervical and shoulder muscles spasms, purpuric and petechial lesions on palm, sole and whole body, has been presented. The patient had not an underlying disease or immunosuppression, and he had experienced single dose of measles vaccine when he was nine months old. Diagnosis of atypical measles was based on the clinical and serological findings (by measles IgM and IgG positivity). The aim of the presentation of this case was to emphasize that atypical measles should be considered for differential diagnosis in the cases complaining of muscle spasms and atypical skin rashes even if vaccinated against measles.

Adult↗
PubMed1991

Measles control in a rural area in Zimbabwe.

In the rural district of Chimanimani in Zimbabwe, the Expanded Programme on Immunisation (EPI) which started in January 1982 has achieved measles coverage of between 50 and 80% in the 12-23 months age group, from 1984 to 1988, through 65 outreach centres, and 15 static health centres serving 93985 people in 119 villages. Facility based data as well as community based surveys have failed to show serious measles transmission in children under nine months of age, a common observation in high population density urban areas in Africa. Instead there has been a reduction in measles incidence and age distribution of measles has shifted to older children. The lowest measles incidence rate of 0.8 per 100 children occurred in the 0-5 months age group and the highest incidence rate of 4.0 per 100 children in the 48-59 months of age group. Only 7.9% of measles cases occurred in children under nine months of age. The high vaccination coverage rates were made possible by the post-independence government commitment, community involvement and dedicated staff. Our observations support the current one-dose 9 months minimum age measles vaccination policy for the low density rural areas in the developing countries.

Age Factors↗
PubMed1990

Field evaluation of measles vaccine efficacy in New Seemapuri, Shahdara Zone-Delhi during 1990.

A field evaluation of measles vaccine efficacy was undertaken in resettlement colonies in New Seemapuri, Shahdara Zone, Delhi, having an estimated population of 20,500 by case-reference method. The standard 30 cluster sampling technique was adopted and 261 measles vaccinated children were matched with 545 measles non-vaccinated children. The attack rate of measles was found to be 4.2 and 30.3 per cent in measles vaccinated and non-vaccinated children respectively, which is statistically highly significant (P less than 0.001). The relative risk of developing measles in non-vaccinated child is seven times more as compared to a vaccinated child. Vaccine efficacy (V.E.) evaluated by different epidemiological and laboratory methods was found to be 86.1 per cent +/- 11 at P = 0.05. Further, a large scale study on measles V.E. is recommended in different parts of the country by case-reference method, as it is found to be simple, reproducible and easy to undertake in a field situation.

Antibodies, Viral↗
PubMedDate not supplied

[Serological evaluation of immunization against measles with 2 doses administered at 6 and 11 months of age: a prospective study].

A prospective study was designed to evaluate the serologic efficacy of a two dose measles vaccination schedule, at 6 months and 11 months of age. Infants were given a further attenuated measles virus vaccine (BIKEN CAM 70, Fundação Oswaldo Cruz) and serum samples were tested for measles antibodies using the indirect immunofluorescence technique (IFA) and ELISA. Seroconversion rates 6 to 12 months (mean of 8.0 +/- 1.7 months) following the second dose of measles vaccine were 88.5% (85/96) by IFA and 96.8% (93/96) by ELISA. No measles cases were reported during the study period. In regions where a significant proportion of measles cases occurs before nine months of age, vaccination with a two doses schedule, at 6 and 11 months of age, may represent an alternative for measles control.

Antibodies, Viral↗
PubMed1994

Measles control in Maputo, Mozambique, using a single dose of Schwarz vaccine at age 9 months.

In Maputo city, immunization is available at government health facilities, all contacts being used to vaccinate children. Door-to-door mobilization is conducted to identify eligible children and refer them for immunization. Card-documented measles vaccine coverage, estimated by community surveys, rose from 48% in 1982 to 86% in 1986 and 92% in 1992. The median age at measles vaccination was 10.2 months in 1986 and 9.2 months in 1992. The reported measles incidence rates per 100,000 population fell by 92% from 569 in 1977-78 (pre-vaccination) to 44 in 1990-92, and the reported inpatient measles mortality fell from 19.8 to 0.7 per 100,000. Among children whose age at measles onset was known, the proportion of reported measles cases in children under 9 months of age fell from 2162 (20.3% of 10,636 cases) in 1982-85 to 1695 (17.8% of 9501 cases) in 1986-92. The proportion of cases in children aged > or = 5 years increased from 15.2% to 32.8% in the corresponding periods. The global goals for measles control can be achieved by a single dose of Schwarz vaccine at 9 months of age.

Child, Preschool↗
PubMed1996

[Study on the subclinical infection of the recipients of measles vaccine].

Through observation to subclinical infection of the 71 children who had been inoculated against measles 12 years ago and then exposed to natural measles from three classes at a primary school, we have noticed: (1) Subclinical infection did exist among the crowd who were inoculation against measles; The rate of subclinical infection of the three classes was between 18.5%-75.0%, with an average of 45.1%. (2) The level of the HI Ab titer was between 1:2-1:16. The peak level was between 1:2 and/or 1:4. So the rate of subclinical infection who had been inoculation against measles but later exposed to natural measles would depend on the proportion of those whose titer of HI Ab was 1:2-1:4 in the crowd. (3) The epidemiological significance of subclinical measles infection lies in that it can actively keep and consolidate the level of immunity to certain extent in a crowd who had been inoculation against measles.

Antibodies, Viral↗
PubMed2003

STAT protein interference and suppression of cytokine signal transduction by measles virus V protein.

Measles virus, a paramyxovirus of the Morbillivirus genus, is responsible for an acute childhood illness that infects over 40 million people and leads to the deaths of more than 1 million people annually (C. J. Murray and A. D. Lopez, Lancet 349:1269-1276, 1997). Measles virus infection is characterized by virus-induced immune suppression that creates susceptibility to opportunistic infections. Here we demonstrate that measles virus can inhibit cytokine responses by direct interference with host STAT protein-dependent signaling systems. Expression of the measles V protein prevents alpha, beta, and gamma interferon-induced transcriptional responses. Furthermore, it can interfere with signaling by interleukin-6 and the non-receptor tyrosine kinase, v-Src. Affinity purification demonstrates that the measles V protein associates with cellular STAT1, STAT2, STAT3, and IRF9, as well as several unidentified partners. Mechanistic studies indicate that while the measles V protein does not interfere with STAT1 or STAT2 tyrosine phosphorylation, it causes a defect in IFN-induced STAT nuclear accumulation. The defective STAT nuclear redistribution is also observed in measles virus-infected cells, where some of the STAT protein is detected in cytoplasmic bodies that contain viral nucleocapsid protein and nucleic acids. Interference with STAT-inducible transcription may provide a novel intracellular mechanism for measles virus-induced cytokine inhibition that links innate immune evasion to adaptive immune suppression.

Animals↗
PubMed1984

Control of measles by annual pulse immunization.

In a village with a population of more than 2,000, with measles outbreaks in alternate years, annual single-day measles immunization campaigns were conducted during four winter seasons. Measles vaccine was offered to children 1 year of age and older, with no previous measles or immunization. There has been no outbreak of measles since the introduction of immunization to date. Four cases of introduced measles did not result in any secondary case. This vaccine delivery strategy (annual pulse immunization), designed to improve coverage and simplify cold chain management, was shown to be suitable for the control of measles in rural communities in the Third World.

Child↗
PubMed1988

Antibody response of children to measles vaccine mixed with diphtheria-pertussis-tetanus or diphtheria-pertussis-tetanus-poliomyelitis vaccine.

The feasibility of giving measles vaccine mixed with either diphtheria-pertussis-tetanus (DPT) or DPT-poliomyelitis (DPTP) vaccine was investigated to simplify the routine immunization schedule. Children 12 to 18 months of age, due for measles immunization, were given measles vaccine alone or mixed with DPT or DPTP. Their prevaccination and four-weeks postvaccination serum samples were tested for the measles virus hemagglutination-inhibition antibody titer. Although 191 children completed the study, only 160 were initially seronegative. The seroconversion rates and geometric mean antibody titers in children given measles vaccine alone, mixed with DPT, or mixed with DPTP were 98%, 96.3%, and 96.4% and 41, 53, and 53, respectively. Local and systemic reactions were no more frequent in children given the mixture of vaccines than in children given DPTP alone. In summary, injecting measles vaccine mixed with DPT or DPTP did not diminish its immunogenic potency or increase adverse reactions. We believe that freshly mixed measles and DPT or DPTP vaccines can be given together, thus avoiding two separate injections.

Antibodies, Viral↗
PubMed1993

Detection of measles, mumps, and rubella antibodies in saliva using antibody capture radioimmunoassay.

Antibody capture radioimmunoassays were developed for detecting virus specific IgM (MACRIA) and IgG (GACRIA) to measles, mumps, and rubella and used to investigate saliva as an alternative specimen to serum for diagnosis. Saliva was collected from 63 patients with measles, 19 with mumps, and 150 with rubella, which were all clinically diagnosed and serologically confirmed. Virus specific IgM was detected in 92% of measles, 75% of mumps, and 100% of rubella saliva samples collected during the first week of illness. Between 1 and 5 weeks after onset virus specific IgM was detected in 100% of saliva specimens. After the 5th week the proportion of reactive specimens declined. The specificity of the MACRIA tests was established by testing saliva samples collected from blood donors for measles (88), mumps (88), and rubella IgM (91). All of the saliva specimens tested for measles and rubella specific IgM were unreactive, 1/88 specimens tested for mumps specific IgM contained significant reactivity. Saliva specimens collected from acute cases of MMR were tested in all 3 MACRIAs. A small proportion of saliva samples contained detectable IgM of more than one virus infection. Rubella and measles specific IgG was detected in the saliva of all cases from the 4th or 5th day of illness, respectively. Detection of mumps specific IgG was less successful. We have demonstrated that virus specific IgM can be reliably detected in saliva samples collected from acute cases of measles, mumps, and rubella and identified 1-5 weeks after onset of illness as the optimum time for collection of samples.

Adolescent↗
PubMed2006

Serological and molecular epidemiology of measles virus outbreaks reported in Ethiopia during 2000-2004.

Twenty-eight outbreaks in six regions and two major cities in Ethiopia from 2000 to 2004 were investigated, with the collection of 207 venous blood and/or oral fluid samples. Measles diagnosis was confirmed by detection of measles-specific IgM and/or detection of measles virus by polymerase chain reaction (PCR). Of 176 suspected cases tested for specific measles IgM, 142 (81%) were IgM positive. Suspected cases in vaccinated children were much less likely to be laboratory confirmed than in unvaccinated children (42% vs. 83%, P < 0.0001). Of 197 samples analyzed by RT-PCR measles virus genome was detected in 84 (43%). A total of 58 wild-type measles viruses were characterized by nucleic acid sequence analysis of the nucleoprotein (N) and hemagglutinin (H) genes. Two recognized genotypes (D4 and B3) were identified. Each outbreak comprised only a single genotype and outbreaks of each genotype tended to occur in distinct geographical locations. B3 was first observed in 2002, and has now been the cause of three documented outbreaks near to the border of Sudan. D4 genotype was previously observed in an outbreak in 1999 and occurs in more diverse locations throughout the country. These data yield insights into geographical and age-related sources of continued transmission. Refinement of measles control measures might include targeting older age groups (5-14 years) and strengthening routine immunization particularly where importation of cases is a concern.

Adolescent↗
PubMedDate not supplied

Antibody response to measles vaccination in Turkish children.

In recent years, there has been a remarkable increase in measles cases among preschool and secondary school children in Turkey, as in many other countries. The seroconversion and coverage rates of measles vaccine should therefore be evaluated in order to obtain data that could be used to determine the vaccination policy for Turkey. Measles immunity status was studied by an enzyme-linked immunosorbent (ELISA) test determining the anti-measles IgG antibody levels. Measles specific IgG antibodies were found to be positive in 77.88% of the entire study group of 800 children aged 11 months to 12 years, while 21.25% had negative sera. Seven (0.87%) subjects had borderline results. The results of this study indicate the need to administer a second dose of measles vaccine, preferably at 18 months of age concomitant with other vaccines. This vaccination policy, together with an increase in the extent of immunization coverage, may help to achieve the World Health Organization's (WHO) target of the complete eradication of measles.

Antibody Formation↗
PubMed1984

Treatment of multiple sclerosis with anti-measles cow colostrum.

Previous virological and immunological studies have suggested that multiple sclerosis (MS) is an auto-immune disease triggered by a virus infection. In order to inhibit the growth of measles virus in the patient's jejunum, we obtained an IgA-rich cow colostrum containing anti-measles lactoglobulin resistant to proteases. This colostrum was orally administered to patients with MS to investigate its effect on the course of the disease. Measles-positive antibody colostrum was orally administered every morning to 15 patients with MS at a daily dosage of 100 ml for 30 days. Similarly, measles-negative antibody (less than 8) control colostrum was orally administered to 5 patients. As a clinical assessment, disability scores developed by the International Federation of Multiple Sclerosis Societies were used. As a result, of 7 high NT titre (512-5120) anti-measles colostrum recipients 5 patients improved and 2 remained unchanged. Among 8 low NT titre (8-32) anti-measles colostrum recipients 5 patients improved and 3 remained unchanged. However, of 5 negative NT titre (less than 8) colostrum recipients 2 patients remained unchanged and 3 worsened. No side-effects were observed in colostrum recipients. These findings suggest the efficacy of orally administered anti-measles colostrum in improving the condition of MS patients (P less than 0.05).

Adolescent↗
PubMedDate not supplied

Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism.

Autoimmunity to the central nervous system (CNS), especially to myelin basic protein (MBP), may play a causal role in autism, a neurodevelopmental disorder. Because many autistic children harbor elevated levels of measles antibodies, we conducted a serological study of measles-mumps-rubella (MMR) and MBP autoantibodies. Using serum samples of 125 autistic children and 92 control children, antibodies were assayed by ELISA or immunoblotting methods. ELISA analysis showed a significant increase in the level of MMR antibodies in autistic children. Immunoblotting analysis revealed the presence of an unusual MMR antibody in 75 of 125 (60%) autistic sera but not in control sera. This antibody specifically detected a protein of 73-75 kD of MMR. This protein band, as analyzed with monoclonal antibodies, was immunopositive for measles hemagglutinin (HA) protein but not for measles nucleoprotein and rubella or mumps viral proteins. Thus the MMR antibody in autistic sera detected measles HA protein, which is unique to the measles subunit of the vaccine. Furthermore, over 90% of MMR antibody-positive autistic sera were also positive for MBP autoantibodies, suggesting a strong association between MMR and CNS autoimmunity in autism. Stemming from this evidence, we suggest that an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to pathogenesis of autism.

Adolescent↗