Emergent measles-containing vaccination recommendation for aged 6–11 months and detection of vaccine-associated measles during a large measles outbreak in Okinawa, Japan, in 2018

Kuba, Yumani; Kyan, Hisako; Iha, Yoshiyuki; Kato, Takashi; Oyama, Minori; Miyahira, Masato; Kakita, Tetsuya; Takara, Taketoshi; Yamauchi, Miyuki; Kamiya, Hajime; Sunagawa, Tomimasa; Kawakami, Yoshino; Nidaira, Minoru; Kudaka, Jun; Yamakawa, Munesada; Itokazu, Toru; Itokazu, Kiyomasa

doi:10.1016/j.vaccine.2020.01.067

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…However, measles vaccine-associated rash illness (VARI) was detected during the measles case-based surveillance (9)(10)(11)(12). VARI is a reaction that occurs after measles vaccination in 5 to 15% of recipients (13).…”

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confidence: 99%

Measles Vaccine-Associated Rash Illness in China: an Emerging Issue in the Process of Measles Elimination

et al. 2020

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Along with the implementation of the measles case-based surveillance, measles vaccine-associated rash illness (VARI) cases were detected in China. To better understand the characteristics of VARI, 101 VARI cases confirmed by measles virus genotyping in 2011-2018 were analyzed in this study. With the decrease in measles incidence, the detection rate of VARI cases increased among the cases confirmed by genotyping. Compared with genotype H1 wild-type measles, VARI occurred throughout the year without obvious seasonal distribution. Infants/children aged 8-23 months were the main population of VARI. VARI mainly occurred within 14 days after measles vaccination. The number of VARI cases peaked on the 8th day after measles vaccination, which was later than that of genotype H1 wild-type measles cases with a measles vaccination history. VARI presents clinical symptoms similar to measles. The frequencies of the “3Cs”, Koplik spots and complications in VARI cases were significantly lower than those in wild-type measles cases. In total, 94.06% sequences from VARI cases were identical to measles vaccine strain S191 in the C-terminal 450 nucleotide sequence of the nucleoprotein (N-450) gene. A few substitutions were found in N-450 sequences of the VARI cases. The confirmation of VARI has become an emerging issue in the process of measles elimination. Rapid confirmation of VARI is critical for measles surveillance and will help to determine the response measures for measles, especially in measles pre-elimination and elimination settings. The suspected measles cases with MCV vaccination were recommend to be detected by the laboratory to identify wild-type measles or VARI.

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confidence: 99%

Measles Vaccine-Associated Rash Illness in China: an Emerging Issue in the Process of Measles Elimination

et al. 2020

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“…The vaccination histories of the 4 adult patients were unknown. Of note, 12 infants 6–11 months of age received MCV because the Okinawa prefectural government made infants in that age range eligible for MCV vaccination as an emergency response to measles outbreak ( 7 ). None of the patients with inconsistent test results had epidemiologic links to laboratory-confirmed measles cases.…”

Section: Resultsmentioning

confidence: 99%

“…We performed rRT-PCR as reported previously ( 7 ). We used MVN1139F (5′-TGGCATCTGAACTCGGTATCAC-3′) and MVN1213R (5′-TGTCCTCAGTAGTATGCATTGCAA-3′) primers and an MVNP1163P probe (5′-FAM-CCGAGGATGCAAGGCTTGTTTCAGA-TAMRA-3′) targeting the nucleocapsid (N) gene of measles virus ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

“…In March 2015, the World Health Organization Western Pacific Regional Office verified Japan as a country having achieved measles elimination ( 3 ). However, although measles frequency has decreased since the achievement of elimination ( 4 ), outbreaks initiated by measles-susceptible persons traveling to or from measles-endemic countries still occur ( 5 – 7 ). Therefore, enhanced measles surveillance has been ongoing in Japan since achieving elimination status.…”

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confidence: 99%

“…In Okinawa Prefecture, Japan, no confirmed measles case had been reported since 2014, then a prefecture-wide measles outbreak occurred during March–May 2018 ( 7 ). Samples were collected from all persons suspected of having measles and were subjected rRT-PCR and IgM testing at the Okinawa Prefectural Institute of Environment and Health (OPIEH).…”

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confidence: 99%

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Analysis of Suspected Measles Cases with Discrepant Measles-Specific IgM and rRT-PCR Test Results, Japan

Kuba,

Nidaira,

Maeshiro

et al. 2024

Emerg. Infect. Dis.

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We investigated clinically suspected measles cases that had discrepant real-time reverse transcription PCR (rRT-PCR) and measles-specific IgM test results to determine diagnoses. We performed rRT-PCR and measles-specific IgM testing on samples from 541 suspected measles cases. Of the 24 IgM-positive and rRT-PCR–negative cases, 20 were among children who received a measles-containing vaccine within the previous 6 months; most had low IgG relative avidity indexes (RAIs). The other 4 cases were among adults who had an unknown previous measles history, unknown vaccination status, and high RAIs. We detected viral nucleic acid for viruses other than measles in 15 (62.5%) of the 24 cases with discrepant rRT-PCR and IgM test results. Measles vaccination, measles history, and contact history should be considered in suspected measles cases with discrepant rRT-PCR and IgM test results. If in doubt, measles IgG avidity and PCR testing for other febrile exanthematous viruses can help confirm or refute the diagnosis.

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Shedding of measles vaccine RNA in children after receiving measles, mumps and rubella vaccination

Washam,

Leber,

Oyeniran

et al. 2024

Journal of Clinical Virology

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Emergent measles-containing vaccination recommendation for aged 6–11 months and detection of vaccine-associated measles during a large measles outbreak in Okinawa, Japan, in 2018

Cited by 5 publications

References 18 publications

Measles Vaccine-Associated Rash Illness in China: an Emerging Issue in the Process of Measles Elimination

Measles Vaccine-Associated Rash Illness in China: an Emerging Issue in the Process of Measles Elimination

Analysis of Suspected Measles Cases with Discrepant Measles-Specific IgM and rRT-PCR Test Results, Japan

Shedding of measles vaccine RNA in children after receiving measles, mumps and rubella vaccination

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