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A mixture modelling technique is applied to age-specific frequency distributions of quantitative results from serological surveys for measles, mumps and rubella using samples collected across the age range in England and Wales in 2000. In accordance with previous studies the analysis suggests that the antibody response to natural infection is stronger than that produced by vaccination, that vaccine-induced antibody levels wane with time and that levels of vaccine-induced antibody response vary for each virus infection being strongest for rubella and weakest for mumps. The current mumps epidemic in the United Kingdom is focused in cohorts born during 1982-1987 who were too old to have received routine MMR vaccination. In the cohort born in 1981-1985 the model estimates that 7.5% have no evidence of mumps specific IgG and 24.9% have the lowest level of detectable antibody. The similar proportions of mumps antibody in these categories among cohorts with opportunity for 1 or 2 doses of vaccine is a concern, as the degree to which these individuals are protected is unclear. Investigations into the efficacy of two doses of a mumps containing vaccine should be a priority during the current epidemic.

SUMMARYSerological surveillance of measles immunity has been carried out in England since 1986/7. Results from sera collected in 1989-91 revealed that the proportion of school age children who were susceptible to measles was increasing, following the introduction of the measles, mumps and rubella vaccination programme in October 1988. Mathematical models are used to interpret these data and determine whether this increasing susceptibility is sufficient to allow a resurgence of disease from the low levels achieved by 1993. The models summarize serological profiles by a single parameter, the reproduction number R, which quantifies the level of herd immunity in the population. Results showed that there was cause for concern over the levels of susceptibility to measles, with an epidemic of over 100000 cases likely in 1995/6. These predictions are consistent with trends in the incidence and age distribution of measles and have enabled the planning of a major vaccination campaign.

We screened 36 strains of Streptococcus sanguis biotype I and 8 strains of S. sanguis biotype HI for the presence of surface structures and for their ability to coaggregate with Actinomyces viscosus, Actinomyces naeslundii, and Fusobacterium nucleatum. Negative staining under an electron microscope revealed detectable surface structures on all S. sanguis strains. The majority of strains (38 of 44) carried peritrichous fibrils, which have an irregular profile and no distinct width. They usually appeared as a fringe with a constant width around the cell. Strains selected for measurement had a fringe with an average length of 72.4 ± 8.5 nm on biotype I strains and 51.6 + 3.3 nm on biotype II strains. Some fibrillar biotype I strains carried an additional, longer (158.7 ± 33.1 nm) type of fibril projecting through the shorter fibrils. Fibrillar density was characteristic for each strain, ranging from very dense on all cells in a population to very sparse on a few cells in a population. A small group of six strains carried tufts of fibrils in a lateral or polar position on the cell. Either one or two lengths of fibril were present in the tuft depending on the strain. One strain carried both peritrichous fibrils and fimbriae. Fimbriae are flexible structures with a constant width (4.5 to 5.0 nm) all along their length but very variable lengths (.0.7 ,um) on each cell. S. sanguis I and II both included strains with peritrichous fibrils and tufts of fibrils, but the mixed morphotype strain was confined to biotype II. Fibrils were present on cells at all stages throughout the growth cycle for the strains tested. Freshly isolated fibrillar strains coaggregated consistently well with A. viscosus and A. naeslundii, although some fibrillar reference strains lacked the ability. In addition, all tufted strains could not coaggregate, but the strains with the mixed morphotype coaggregated well. Coaggregation with F. nucleatum was very strong for the fibrillar strains, but less strong for the tufted strains. We discuss the possible correlation between S. sanguis surface structure and ability to coaggregate.

The ESEN (European Sero-Epidemiology Network) project was established to harmonize the seroepidemiology of five vaccine preventable infections including measles, mumps and rubella in eight European countries. This involved achieving comparability both in the assay results from testing in different centres and also sampling methodology. Standardization of enzyme immunoassay results was achieved through the development of common panels of sera by designated reference centres. The panels were tested at the reference laboratory and then distributed to each participating laboratory for testing using their routine methods. Standardization equations were calculated by regressing the quantitative results against those of the reference laboratory. Our study found large differences in unitage between participants, despite all using an EIA method standardized against an international or local standard. Moreover, our methodology adjusted for this difference. These standardization equations will be used to convert the results of main serosurvey testing into the reference country unitage to ensure inter-country comparability.

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SUMMARYThe European Regional Office of WHO has targeted measles for elimination from the region in 2007. Large national, age and sex stratified serological surveys of measles antibody were conducted in seven Western European countries from 1994-8 as part of the European Seroepidemiology Network. Three patterns were observed in the country-specific measles seroprofiles, ranging from (very) low susceptibility (four countries) to high susceptibility (one country). Susceptibility levels amongst 2-4-year-olds ranged from 2n9 to 29n8 %, in 5-9-yearolds from 2n5 to 25 % and 10-19-year-olds from 2n1 % to 13n9 %. A country's susceptibility profile was highly associated with vaccine coverage for the first dose. First dose coverage ranged from 91 to 97n5 % for low susceptibility countries, 75 to 85 % for intermediate susceptibility countries and 55 % for the high susceptibility country. Only the high susceptibility country still reports epidemic measles. In low susceptibility countries, which have achieved or are very close to measles elimination, the priority will be to maintain high MMR vaccine coverage in all geopolitical units for both vaccine doses. In moderate susceptibility countries