Modern Measles

Babbott, Frank L.; Gordon, John E.

doi:10.1097/00000441-195422830-00013

Cited by 9 publications

(13 citation statements)

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“…Birth during the vaccine era was defined as births in 1957 and later. Although measles vaccine was licensed in 1963, many persons born during 1957-1962 were vaccinated in school or in early childhood and had a reduced risk of measles; therefore, we consider them to be a part of the vaccine era [12][13][14]. Persons born during the prevaccine era had a higher prevalence of antibody than those born during the vaccine era (average, 99% vs. 87%) [6].…”

Section: Prevalence Of Measles Antibody Among Persons у6 Years Oldmentioning

confidence: 99%

Population Immunity to Measles in the United States, 1999

Hutchins

Bellini

Coronado

et al. 2004

The Journal of Infectious Diseases

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To estimate population immunity, we examined measles immunity among residents of the United States in 1999 from serological and vaccine coverage surveys. For persons aged >or=20 years, serological data from the third National Health and Nutrition Examination Survey (1988-1994) were used. For persons <20 years of age, immunity was estimated from results of the National Immunization Survey (1994-1998), state surveys of school entrants (1990-2000), and vaccine coverage surveys of adolescents (1997). To estimate immunity from vaccine coverage data, 95% vaccine efficacy was used for recipients of a single dose at >or=12 years of age and 99% vaccine efficacy was used for those with failure of a first dose who were revaccinated. Overall, calculated population immunity was found to be 93%. Although there was not much variation in immunity by region and state, in some large urban centers immunity among preschool-aged children was as low as 86%. Overall, geographic- and age-specific estimates of a high population immunity support the epidemiological evidence that measles disease is no longer endemic in the United States.

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Section: Prevalence Of Measles Antibody Among Persons у6 Years Oldmentioning

confidence: 99%

Population Immunity to Measles in the United States, 1999

Hutchins

Bellini

Coronado

et al. 2004

The Journal of Infectious Diseases

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“…Post infectious encephalitis may occur in approximately one per 1000 reported measles cases. [3,4]. In Childhood measles, approximately two to three deaths may occur for every 1000 reported measles cases [4].…”

Section: Introductionmentioning

confidence: 99%

“…The ages of those who died were 9 months and 4, 5, 17, and 24 years. Therefore, it was suggested that despite high immunization coverage, additional susceptible persons could be expected to join this non-immune cohort because the vaccine is only 85% effective [3,4,6]. Therefore, a second dose of measles vaccine was introduced to all children at the age of 3 years since 2001 in combination with rubella vaccine [MR (Measles and Rubella vaccine)].…”

Section: Introductionmentioning

confidence: 99%

Sporadic cases of adult measles: a research article

et al. 2017

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BackgroundMeasles caused by a paramyxovirus, characterized by fever, malaise, cough, coryza conjunctivitis, a maculopapular rash is known to result in pneumonia, encephalitis and death. Fatal cases of measles in Sri Lanka are rare after implementation of the National Immunization Programme in 1984. Thereafter 0.1% case fatality rate was observed during October 1999–June 2000 which is a very low figure compared to other regional countries. Immunization guidelines were further revised in 2001, 2011 and in 2012 when additional immunization was recommended to age group 4–21 years; who are likely to have inadequate immunization, in order to achieve elimination of Measles by 2020. However, in 2013–2014, 4690 cases were reported and the majority were children less than 1 year of age. The occurrence in adults is hard to retrieve in published epidemiological reports, however had been 38% (out of 1008 patients) in the 3rd quarter of 2013. During this outbreak 73/101 (72%) reported from the North Central Province of Sri Lanka had been more than 12 years of age with 50% being more than 29 years. 14 Sri lankan adult patients [median age 32 years (range 25–48)] who presented sporadically from June 2014 to March 2016, with confirmed measles infection were enrolled retrospectively after informed consent. Details with regards to their clinical presentation, immunization and other relevant areas were collected using an interviewer administered questionnaire or using patient management records.ResultsThe patients presented with high fever, headache, severe body aches, sore throat, dry cough, intense tearing, red eyes and posterior cervical lymphadenopathy over 3–5 days duration. Later they developed discrete maculopapular rash helping the diagnosis. They had a variable degree of leucopenia, lymphocytosis, thrombocytopenia and derangements in the liver functions mimicking any other acute febrile illnesses such as dengue, chikungunya, leptospirosis or Zika virus infection.ConclusionAt least a 3–5 day delay in the diagnosis was observed (even after the appearance of the rash in some patients), due to non-awareness of its occurrence, unfamiliarity of measles in adults, non-specific nature of the illness and non-availability of rapid diagnostics, risking transmission to the immune-compromised or non-immune staff or patients. Identification of the source of infection in these sporadic adult cases and their virologic surveillance and molecular epidemiology will be important to interrupt the transmission and to achieve the targeted elimination of measles from Sri Lanka by 2020.

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“…In the case of measles, clinical experience demonstrates that a critical maturation of the host response occurs between 6 and 12 months, based on the subsequent decline in measles mortality. [1][2][3][4][5] The high rate of infant morbidity and mortality observed in developing countries and during recent outbreaks in the United States has renewed interest in evaluating measles immunization of infants at the youngest possible age. 1,6,7 Past studies showed a high failure rate of measles vaccination in infants younger than 12 months.…”

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confidence: 99%

Deficiency of the Humoral Immune Response to Measles Vaccine in Infants Immunized at Age 6 Months

Gans¹

1998

JAMA

246

166

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Context.-Measles causes serious morbidity in infants, with the highest risk among those who are 6 to 12 months of age. In the United States, measles vaccine has been given at age 12 to 15 months to minimize interference by passive antibodies and to achieve the high seroprevalence required for herd immunity. Infants of mothers with vaccine-induced immunity may lose passively acquired antibodies before 12 months, leaving them susceptible to measles infection. Objective.-To assess the immunogenicity of measles vaccine in infants younger than 12 months. Design.-Cohort study conducted before and after measles immunization. Setting.-Pediatric clinic in Palo Alto, Calif. Participants.-Infants 6 (n = 27), 9 (n = 26), and 12 (n = 34) months of age were enrolled; 72 provided both initial and follow-up samples. Main Outcome Measures.-Evaluation of immunogenicity before and 12 weeks after measles vaccination, including measles neutralizing antibody titers, measlesspecific T-cell proliferation, and cytokine profiles. Results.-Measles neutralizing antibodies were present before vaccination in 52% (12/23), 35% (7/20), and 0% (0/22) of 6-, 9-, and 12-month-old infants, respectively. In the absence of detectable passive antibodies, geometric mean titers after vaccination were significantly lower in 6-month-old infants compared with 9-month-old infants (27 vs 578, P = .01) and 12-month-old infants (27 vs 972, P = .001). The seroconversion rate, defined as a 4-fold rise in antibody titer, in these 6-month-old infants was only 67%, and only 36% of these infants achieved seroprotective neutralizing antibody titers of 120 or higher after vaccination compared with 100% of 9-and 12-month-old infants lacking detectable passive antibody prior to vaccination. T-cell proliferation and cytokine responses to measles did not differ with age. Conclusions.-Humoral immunity was deficient in 6-month-old infants given measles vaccine, even in the absence of detectable passively acquired neutralizing antibodies. Comparison of their responses with those of 9-and 12-month-old infants indicates that a developmental maturation of the immune response to measles may occur during the first year of life, which affects the immunogenicity of measles vaccine.

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Modern Measles

Cited by 9 publications

References 0 publications

Population Immunity to Measles in the United States, 1999

Population Immunity to Measles in the United States, 1999

Sporadic cases of adult measles: a research article

Deficiency of the Humoral Immune Response to Measles Vaccine in Infants Immunized at Age 6 Months

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