The strategy for prevention of measles and rubella prevalence with measles–rubella (MR) vaccine in Japan

To eliminate the indigenous measles and rubella virus by 2012 in Japan, the strategy for prevention of measles and rubella prevalence with measles-rubella (MR) vaccine was proposed. Since the vast majority of 1-year old infants are susceptible to measles and rubella, the first MR vaccine should be administered at 1-year old to sustain the herd immunity. Since significant elevation of measles and rubella antibody titers was estimated in a half of children after the second dose, the second dose of MR vaccine within 1 year before elementary school entry is the effective maneuver. Moreover, supplement MR vaccination to the teenage group and 20–29 years’ group might be necessary, because the mean measles antibody titers in this group were significantly lower compared with those in the older individuals’ groups.     

Negative impact of clinical misdiagnosis of measles on health workers' confidence in measles vaccine

We conducted a survey to determine the accuracy of the clinical diagnosis of measles in Zimbabwe. Between December 1996 and February 1997, we collected blood samples and clinical and demographic information from a sample of 105 children with a clinical diagnosis of measles. A clinical case of measles was defined as a person with a history of fever, rash for three or more days, and either cough, coryza, or conjunctivitis. A laboratory-confirmed case of measles or rubella had IgM antibodies against measles virus or rubella virus respectively. A total of 91% of children met the clinical case definition. Among those who met the clinical case definition for measles, 72% were IgM-positive for measles virus only, 23% were IgM-positive for rubella virus only, 3% were IgM-positive for both measles and rubella viruses, and 2% were IgM-negative for both viruses. This study demonstrates the importance of considering selective laboratory confirmation of measles in periods of high disease incidence when the effectiveness of the vaccine is questioned.     

Prevalence of antibodies to measles and rubella in Sana'a, Yemen

Prevalence of antibodies to measles and rubella was tested in sera collected from 1368 subjects in urban and rural Sana'a. Overall, 11.7% had no antibodies to measles and 14.6% had no antibodies to rubella, despite the fact that measles but not rubella vaccine is included in the vaccination program in Yemen. Of 89 children <5 years of age 49 (55.1%) had no detectable antibodies to measles, demonstrating that supplementary measles immunization campaigns are required to prevent virus circulation. Assessment of measles immune status among infants in the first year of life is required to determine the optimum age for measles vaccination. Rubella vaccination should be considered with care in Yemen.     

Rash after measles vaccination: laboratory analysis of cases reported in São Paulo,Brazil

OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19) using ELISA commercial techniques, and human herpes virus 6 (HHV 6) using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR). RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months), had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17) HPV B19 infection; 76.5% (13 in 17) HHV 6 infection; 5.9% (1 in 17) rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.     

Molekulare Surveillance belegt Fortschritt im Eliminationsprozess der Masern

Measles is a severe disease caused by infection with the measles virus. Complications after the onset of infection lead to 1–3 fatalities per 1,000 cases in industrialized countries. If more than 95?% of the global population were vaccinated twice with the measles, mumps, and rubella (MMR) vaccine, measles could be eliminated worldwide. The elimination of measles and rubella should be reached in the WHO Europe region in 2015. One important criterion for elimination of the measles virus consists in the analysis of the duration of transmission chains initiated by the import of measles virus. To assign measles viruses to outbreaks and transmission chains, genetic characterization is necessary. These investigations have been performed continually at the National Reference Center Measles, Mumps, Rubella since 1999, when the German Intervention Program was launched. This article summarizes our experiences with measles virus genotyping and new developments with respect to measles elimination in Germany.     

北京市2009～2012年接种含麻疹成分疫苗后疫苗相关麻疹病例的流行病学分析

目的分析北京市2009～2012年接种含麻疹成分疫苗（Measles-containing Vaccine,MCV）后,疫苗相关麻疹病例（vaccine-associated Measles Case,VAMC）的流行病学特征,进一步完善VAMC的诊断方法。方法对北京市2009~2012年通过麻疹监测信息系统报告的麻疹疑似病例,按照世界卫生组织VAMC定义进行分类诊断,使用多重实时荧光聚合酶链反应扩增病毒基因并测序,鉴别麻疹疫苗病毒与野病毒,采用描述流行病学方法对VAMC进行分析。结果北京市2009~2012年共报告VAMC52例,年发生率为3．0/10万剂～7．3/10万剂,51例为接种首剂麻疹．风疹联合减毒活疫苗后的小月龄婴儿,VAMC呈现时间均匀分布而无地区聚集性的特征,所用疫苗均为合格疫苗,预防接种门诊和疫苗批号均无聚集性。部分VAMC采集病原学标本基因分型为疫苗株A基因型。结论VAMC的流行病学特征与麻疹野病毒感染有所不同。在鉴别诊断方面,应对于接种MCV后一段时间发生出疹性疾病的病例开展病原学标本基因分型,为VAMC提供实验室诊断依据。     

国产冻干麻疹-风疹二联活疫苗临床安全性研究

为考核国产冻干麻疹 -风疹二联活疫苗的临床安全性 ,以证明其可以在人群中推广使用 ,采取对照试验法对国产麻疹 -风疹二联活疫苗与市售商品国产单价风疹疫苗、单价麻疹疫苗及国外麻风腮三联疫苗的临床安全性进行了研究。结果显示 ,国产冻干麻疹 -风疹二联活疫苗具有与它们有同等的安全性 ,可以在人群中推广使用     

Measles,mumps, and rubella virus vaccine (M–M–R™II): A review of 32 years of clinical and postmarketing experience

M–M–R™II (measles, mumps, and rubella virus vaccine live; Merck, Sharp, & Dohme Corp.) is indicated for simultaneous vaccination against measles, mumps, and rubella in individuals ≥12 months of age. Before the vaccine era, these viruses infected most exposed individuals, with subsequent morbidity and mortality. One of the greatest achievements of public health has been to eliminate these 3 diseases in large geographic areas.     

Detection of measles vaccine in the throat of a vaccinated child

Measles vaccine is widely used, most often in association with mumps and rubella vaccines. We report here the case of a child presenting with fever 8 days after vaccination with a measles-mumps-rubella vaccine. Measles virus was isolated in a throat swab taken 4 days after fever onset. This virus was then further genetically characterised as a vaccine-type virus. Fever occurring subsequent to measles vaccination is related to the replication of the live attenuated vaccine virus. In the case presented here, the vaccine virus was isolated in the throat, showing that subcutaneous injection of an attenuated measles strain can result in respiratory excretion of this virus.     

2011年北京市大兴区麻风疫苗基础免疫成功率监测结果

目的了解北京市大兴区2011年8月龄儿童接种麻疹风疹联合减毒活疫苗(简称麻风疫苗)后的免疫效果,为制定麻疹免疫策略提供依据。方法采集40名8月龄儿童麻风疫苗免疫前、免疫后1个月双份血标本,分别进行麻疹、风疹IgG抗体测定。结果免后麻疹抗体阳性40人,阳性率100%,GMT 1∶1 385.52;风疹抗体阳性33人,阳性率82.50%,GMT 1∶31.18。结论该区现行的麻风疫苗所包含的麻疹成分免疫原性好,风疹成分免疫效果较差,应进行风疹疫苗复种弥补。     

Semliki Forest virus vectors expressing the H and HN genes of measles and mumps viruses reduce immunity induced by the envelope protein genes of rubella virus

A Semliki Forest virus (SFV) recombinant particle vaccine vector was constructed expressing the viral E1 and E2 envelope proteins of the RA27/3 vaccine strain of rubella virus. This vector induced high titres of antibody after intramuscular administration to Balb/C mice, both following initial vaccination and a boost 4 weeks later. This occurred for antibody as measured by ELISA and as measured by a latex agglutination test. However, co-administration of similar particles expressing the measles virus H protein and the mumps virus HN protein with the rubella protein expressing vector resulted in reduction of the anti-rubella immune response.     

IgG antibody prevalence suggests high immunization needs in newcomers to Luxembourg, 2012

Vaccine coverage of the general population in Luxembourg is high, but refugees or asylum seekers may be incompletely vaccinated and susceptible to vaccine-preventable diseases.In order to assess protection rates, serum and oral fluid samples were collected from 406 newcomers aged between 13 and 70 years arriving between May and September 2012. Sera were screened for IgG antibodies against measles, rubella, mumps, hepatitis B, tetanus, diphtheria and pertussis. Oral fluid samples were screened for antibodies against measles, mumps and rubella virus to investigate their suitability for antibody prevalence studies.More than 90% of the participants had IgG antibodies against rubella, 73% against measles and 56% against mumps. Less than 19% had anti-HBs antibodies. Nearly 84% of the participants had an adequate protection against tetanus, 73% against diphtheria and 40% had pertussis antibodies. 93%, 95% and 78% of the measles, rubella and mumps test results obtained with serum and oral fluid were concordant.The majority of the participants lacked antibodies against at least one of the measles/mumps/rubella (58%) and diphtheria/tetanus/pertussis (72%) vaccine components and against hepatitis B virus (82%) and might thus profit from vaccination. Oral fluid is a suitable alternative and non-invasive specimen for measles/rubella antibody prevalence studies.     

全国2004—2006年麻疹流行病学特征和预防控制措施分析

麻疹是由麻疹病毒引起的急性呼吸道传染病,该病传染性强,好发于儿童,容易引起气管炎、中耳炎、肺炎等多种严重并发症。自我国开始推广麻疹疫苗以来,麻疹疫情得到了有效控制。2020年6月1日起,上海市儿童的含麻疹成分疫苗免疫程序调整为8月龄、18月龄和6岁各接种1剂麻疹流行性腮腺炎风疹联合减毒活疫苗（MMR疫苗）。MMR疫苗注射后一般无局部反应,个别接种者可能出现一过性发热以及散在皮疹,一般可自行缓解。但由于其为减毒活疫苗,所以在极个别受种者可能会引起疫苗相关疾病,本文报道2例接种MMR疫苗后发生麻疹的病例。