Superiority of varicella skin test antigen over purified varicella-zoster virus glycoproteins in monitoring booster response to Oka varicella vaccine

Varicella skin test antigen has been developed based on the induction of delayed-type hypersensitivity (DTH) to varicella-zoster virus (VZV). The booster immune response to Oka varicella vaccine was assessed by cutaneous reactivity to purified VZV glycoprotein complexes, gB, gE:gI, gH:gL, and varicella skin test antigen. Skin tests with these antigens significantly augmented antibody production to glycoproteins and VZV antigen resulting in no further augmentation by the subsequent vaccination. All glycoprotein complexes induced the cutaneous reaction similarly to varicella skin test antigen. Cutaneous reaction to glycoproteins and varicella skin test antigen was boosted after vaccination. However, the magnitude of cutaneous reaction to each glycoprotein complex before and after vaccination was rich in variety. These results indicated that skin test with varicella skin test antigen is a more suitable indicator in monitoring cell-mediated immunity to VZV than that using purified glycoproteins.     

Seroprevalence of measles, mumps and rubella antibodies in Luxembourg: results from a national cross-sectional study

A serological prevalence survey was carried out in Luxembourg during 2000-2001 to determine the antibody status of the Luxembourg population against vaccine-preventable infections. Blood samples of children and adolescents were collected prospectively in randomly selected schools. Samples of adults were obtained through volunteer patients of the national health laboratory or of the mandatory pre-nuptial test. Measles, mumps and rubella (MMR) virus antibody concentrations were measured using commercial ELISA tests. Age-standardized prevalence of measles, mumps and rubella virus antibodies was found to be 96.58, 75.40 and 95.69% respectively. Significant age-dependence of serology was observed for all three infections, with study participants born after the introduction of the MMR vaccine experiencing a gradual decline of antibodies following vaccination in childhood. Older study participants who were more likely to have antibodies from natural infection had consistently higher titres than younger individuals. Present vaccination coverage with MMR appears to be sufficient to prevent large local outbreaks of measles and rubella, but probably not mumps.     

Mumps outbreak in Israel's highly vaccinated society: are two doses enough?

Mumps outbreaks in recent years have given rise to questions about the effectiveness of the mumps vaccine. This study examined the epidemiological data from a recent mumps outbreak in Israel and from outbreaks in other countries with high vaccination coverage, and considered whether long-established vaccination policies designed to protect against mumps are in need of revision. Of over 5000 case patients in the Israeli outbreak, half of whom were in the Jerusalem health district, nearly 40% were aged ≥15 years and, of those whose vaccination status was known, 78% had been fully vaccinated for their age - features similar to those in recent mumps outbreaks in Europe and North America. The epidemiological and laboratory evidence suggests that many previously vaccinated adolescents and young adults are now susceptible to mumps because their vaccine-based immunity has waned. Booster vaccination programmes for those at high risk of infection during mumps outbreaks - particularly those in congregate living environments - merit priority consideration.     

Waning immunity and potential asymptomatic infection in 3–7 years old children who received one dose of measles-mumps-rubella vaccine: A 4-year prospective study

BackgroundMumps outbreaks in adolescents who received two doses of measles-mumps-rubella vaccine (MMR) during childhood have been reported worldwide. In China, one dose of MMR administered in children aged among 18–24 months has a limited effect on the mumps epidemic. There are limited prospective studies evaluating the mumps immunity profile of children aged 3–7 years who received one dose of MMR. This study aimed to describe mumps immunity profile over a span of 4-years in kindergarten and primary school children.MethodsAn observational, prospective study on one-dose MMR in children aged 3–7 years who underwent blood sample collection in 2015, 2016, and 2018 was conducted from 2015 to 2018. The seropositivity and geometric mean concentration of mumps IgG antibodies over time were analyzed.ResultsA total of 3346 eligible children aged 3–7 years who underwent three rounds of blood sample collection were included. The overall seropositivity (79.6%) in 2015 was significantly higher than those recorded in 2016 (73.1%) and 2018 (71.4%). Approximately 11.6–15.9% of the participants were seropositive for mumps in 2015, and converted to negative in 2016. Meanwhile, 11.1–14.6% of the participants were seropositive for mumps in 2016, and the results converted to negative in 2018. Over 6.1–7.4% of the participants had asymptomatic infection from 2015 to 2016, while 9.0–9.9% of the participants were infected without clinical symptoms from 2016 to 2018.ConclusionsKindergarten and primary school children who only received one dose of MMR were at higher risk of developing mumps. Waning immunity, seronegative conversion, and asymptomatic infection coexist in children who received one dose MMR. Determining the optimal age for administering the second dose of MMR in children should be prioritized to improve the control and prevention of mumps in China.     

Topical application of diethylcarbamazine to detect onchocerciasis recrudescence in west Africa

The Onchocerciasis Control Programme in West Africa (OCP) has succeeded in eliminating blinding onchocerciasis as a public health problem throughout much of West Africa. The efforts of the OCP are now turning towards surveillance, with the goal of rapidly detecting and controlling outbreaks of infection in the onchocerciasis-free zone. With this goal in mind, cutaneous application of a solution of diethylcarbamazine (the DEC-patch test) was evaluated in 1996-99 as a method to detect patent Onchocerca volvulus infection in children and adolescents, a sentinel population for the detection of recrudescence. In an analysis of 1887 individuals in C?te d'Ivoire and Burkina Faso, the DEC-patch test produced prevalence estimates comparable to those obtained by skin snip. The sensitivity of the DEC-patch assay was marginally greater in children and adolescents than in adults, and was greater in individuals who had received prior Mectizan treatment. These data suggest that the DEC-patch test may be a useful tool for detecting recrudescence of O. volvulus infection in a sentinel population of children and young adults within the onchocerciasis-free zone created by the OCP.     

The Seattle Virus Watch. VI. Observations of infections with and illness due to parainfluenza, mumps and respiratory syncytial viruses and Mycoplasma pneumoniae.

Seattle Virus Watch families were observed, 1965-1969, for infections with paramyxoviruses and M. pneumoniae by agent isolation and antibody assay of serial sera. Infection rates, based on serology, exceeded those in Tecumseh where families contained fewer young children. Rates per 100 person-years were 44.4 for parainfluenzavirus, 21.6 for respiratory syncytial (RS) virus and 12.3 for M. pneumoniae. Preschool children experienced the highest rates for RS and parainfluenza-viruses but, for the latter, rates were also high among older children and adults. Within invaded families infection rates generally varied inversely with age, although for M. pneumoniae the rates for adults and 6-9 year old children nearly equalled the infant rate. The introducers' identity and/or the age-specific infection rates in invaded families support the role of young schoolchildren in community spread of M. pneumoniae and, together with older children and adults, of RS virus. Young schoolchildren were less important than infants, preschoolers, and adults in spreading parainfluenza-viruses and less important than preschoolers and infants for mumps. The frequent infection of exposed older children and adults suggests that reinfection with all the agents studied is common. All agents spread significantly within families and secondary attack rates for the mostly non-immune infants indicated high infectivity of parainfluenza and mumps viruses. The basic high pathogenicity of these agents and of RS virus is indicated by the high frequency of illness among virus shedders (80-90%) and among seroconverting infants (greater than or equal 68%). The less frequent illness of older persons with serologically proven infection is consistent with diminished clinical response to reinfection. Parainfluenza-associated illnesses were relatively severe and contributed up to 9.3% to total respiratory illnesses. RS virus-related illnesses also were severe but contributed less (4-5%) to total respiratory disease. Mumps-associated illness was largely respiratory, 65% overall, 77% in infected infants and 75% above age 9. Thus, mumps virus emerges as another respiratory pathogen which is spread largely by 2-5-year old children rather than by schoolchildren with "typical" parotitis.     

Clinicopathologic understanding and control of varicella-zoster virus infection

As reflections by the recipient for the Japanese society for vaccinology Takahashi award, clinicopathologic understanding and control of varicella-zoster virus (VZV) infection was briefly reviewed. In 1974, a live varicella vaccine was developed by attenuating the Oka strain of VZV after the passages in non-human cells at a low temperature. The vaccine was immunogenic, well tolerated, and effective, and distributed worldwide so far. For post-exposure prophylaxis of varicella, the vaccine and acyclovir is effectively used in the incubation period of varicella. The delayed type hypersensitivity to VZV skin test antigen was applied for evaluation of cell-mediated immunity to VZV which is commercially available in Japan. The biphasic viremia during incubation period of varicella and airborne spread of VZV from varicella patients and from herpes zoster patients with localized lesions were shown by the virus isolation or by detection of the virus DNA.     

Seroprevalence of mumps among children and adolescents in Thailand, 2020

Thailand has implemented single-dose mumps-containing vaccines since 1997 and two doses since 2010. This study aimed to describe the seroprevalence of mumps among children who received one- or two-dose mumps vaccines. A cross-sectional study of 145 children (aged 3–9 years) and 422 adolescents (10–18 years) was conducted. Mumps IgG seropositivity was defined as ≥ 22 RU/mL by EUROIMMUN ELISA method. The mumps seroprevalence was higher in children (82.1%, 95% CI 74.8–87.9) compared to adolescents (41.7%, 95% CI 37.0–46.6) who had received at least one dose of the mumps vaccine. Among those receiving 2 doses of mumps vaccine at ≥ 5 years after their last mumps vaccination, only 51.3% had maintained IgG ≥ 22 RU/ml. There was a reverse correlation between mumps IgG titer and the time interval from the second dose of mumps vaccine (R = -0.44, p < 0.001). A booster dose of MMR vaccine in young adults may be needed.     

Body composition,albumin levels,and delayed cutaneous cell-mediated immunity

In fifty-one adults with clinical suspicion of protein-energy malnutrition, body composition was assessed using total body potassium obtained by whole body counting. Serum albumin concentration was measured by immunochemical methods. Cell-mediated immunity was assessed by delayed cutaneous hypersensitivity reactions using up to seven microbial antigens. The proportion of responders and the cumulative induration score correlated with serum albumin levels. In those with positive skin responses, the extent of induration correlated significantly with lean body mass. Anergic subjects with lean body mass less than 82 percent of control were generally anergic. Delayed cutaneous hypersensitivity responses are useful functional indices of altered visceral protein synthesis and of reduced lean body mass.     

Natural immunity to measles, rubella and mumps among Spanish children in the pre-vaccination era

Prior to the start of mass vaccination campaigns against measles, rubella and mumps, a prevalence study of natural immunity to these diseases was undertaken in a sample of 1700 unvaccinated Spanish children. They were representative of the 3-7 year-old population in terms of age, regional distribution and urban or rural environment. Measles infection prevalence was significantly higher than that for rubella and mumps from 3 (48.3%, 14.2%, 25.5%, respectively) through 7 years of age, (64%, 40.9%, 39%). As a function of age, naturally-acquired immunity increased according to parabolic progressions. In the 3-5 year-old group, rural environment, low socioeconomic status, no school attendance and lack of brothers were associated with statistically lower levels of measles, rubella, or mumps infection. In the 6-7 year-old group, only 12% of the children showed antibodies against the three diseases and 18.7% exhibited triple susceptibility.     

Immunity against infectious diseases: predictive value of self-reported history of vaccination and disease.

OBJECTIVE: To determine whether self-reported history of disease and/or vaccination is predictive of immunity against hepatitis B, varicella, rubella, mumps, and measles. DESIGN: The seroprevalence of viral antibodies and the predictive value of a self-report questionnaire were determined for 616 paramedical students who matriculated into Padua Medical School (Padua, Italy) during 2003-2005. RESULTS: The majority of subjects (86.9%) remembered being vaccinated against hepatitis B but had no recollection of disease. Among vaccinees, 1.5% showed markers of previous infection, 6.7% tested negative for anti-hepatitis B virus surface antigen (anti-HBsAg) antibodies, and 91.8% tested positive for anti-HBsAg. Self-reported vaccination history had a positive predictive value of 93.2% for test results positive for immunity against hepatitis B. Immunity against varicella (93.7% of subjects) and rubella (95.5%) was high, compared with immunity against mumps (79.9%) and measles (83.1%). In addition, results of tests for detection of immunity against mumps and measles were equivocal for more than 7% of subjects, probably because their vaccination regimen was not completed. Self-reported histories of varicella disease and rubella disease and vaccination had high positive predictive values (greater than 98% each) for testing positive for antiviral antibodies, compared with self-reported histories of mumps disease and vaccination and measles disease and vaccination; however, high positive predictive values were observed for self-reported histories of mumps only (92.0%) and measles only (94.7%). CONCLUSIONS: The self-report questionnaire used in this study did not accurately predict immunity against 5 transmittable but vaccine-preventable diseases. A complete serological evaluation of healthcare workers, followed by vaccination of those with negative or equivocal results of serological tests, is an appropriate measure to decrease the risk of infection in this population.     

Seroprevalence of parvovirus B19 in the German population

Acute parvovirus B19 infection is a risk for pregnant women. After vertical transmission the infected fetus may develop hydrops fetalis. Since B19 infection occurs mainly during childhood, children represent a main source for virus transmission. In order to determine whether certain groups in the German population show increased risks for B19 infection we analysed the seroprevalence using 6583 sera collected from adults in former Eastern and Western Germany during the German National Health Survey and 649 sera from healthy Thuringian children and adolescents. In adults the overall seroprevalence was 72.1%, rising from 20.4% in children (1-3 years) and 66.9% in adolescents (18-19 years) to 79.1% in the elderly (65-69 years). Significant differences were observed between females (73.3%) and males (70.9%) and between inhabitants of small (74.8%) and big cities (69.0%) but not between people of the former Eastern (72.8%) and Western states (72.0%) of Germany. For women during childbearing age (18-49 years) highest values were observed in those living together with two or more children (81.6%) and in women with occupational contact with children aged <6 years (88.9%). In contrast seroprevalence was significantly lower in age-matched female singles (64.8%) and in women with occupational contact with children aged >6 years and adolescents (63.8%).     

Seroepidemiological study of the transmission of the mumps virus in St. Lucia, West Indies

A seroepidemiological study of the prevalence of mumps virus specific antibodies reveals a pattern of endemic persistence on the island of St Lucia in the West Indies. In the unvaccinated population the proportion seropositive rose rapidly in the child age classes to attain a stable plateau close to unity in value in the teenage and adult age groups. The average age at infection was estimated to be between 3 and 4 years of age and the average duration of detectable levels of maternally derived antibodies was approximately 3 months. Analyses based on mathematical models of the transmission dynamics of the virus suggest that in excess of 75% of each cohort of 1- to 2-year-old children must be effectively immunized to eliminate mumps virus transmission. A mumps radial haemolysis test, developed for quantitative measurements of antibody, is discussed.     

Epidemiology of mumps in the Netherlands.

In a Dutch population group neutralizing antibodies against mumps virus were determined by a plaque reduction technique, which proved reproducible, sensitive and specific. The results with sera of about 800 suburban children show that mumps is acquired at an early age with peak acquisition rates between the ages of four and six years. Over 90% have acquired mumps before the age of 14 years. More than 95% of about 1000 adults (18--65 years) have neutralizing antibodies. The relatively constant median titre suggests that antibodies persist during life. During a family study 77 clinical and 18 subclinical cases were observed. In families with index cases the attack rate was 26/37 = 0.71. Eleven children (excluding six babies) escaped infection. The mean attack rate during the epidemic was 0.30. The mean titre of mumps neutralizing antibody is maximal during the first year after the disease but declines during childhood. Mothers exposed to mumps in the family occasionally showed a significant rise in titre. Some seronegative mothers remained seronegative after exposure.     

超声在流行性腮腺炎临床诊断中的研究进展

腮腺炎病毒传染会导致流行性腮腺炎爆发,属于一种急性的呼吸道疾病。临床症状主要表现为腮腺肿大、疼痛以及发烧,该病传染性极强,多见于儿童中流行爆发,而且该病一年四季都可以发病。本病在传播过程中,主要通过飞沫进行传播,在未经治疗的情况下该病在一周左右会自行消退,由于流行性腮腺炎是由病毒引起,目前并没有治疗该病的特效药物,只能依靠患者自身的免疫力。而儿童和青少年免疫系统正处在发育的过程中,如果不及时进行治疗,将会引发严重的并发症,只有尽早诊断和治疗,才能避免不良预后和大范围流行。     

Changes of the immunological patterns against measles, mumps and rubella. A vaccination programme studied 3 to 7 years after the introduction of a two-dose schedule

A two-dose vaccination programme using a combined measles, mumps and rubella vaccine (MMR) and administration at the ages of 18 months and 12 years was introduced in 1982. The 12-year-old schoolchildren were tested yearly from 1985 to 1989 on serum samples obtained prior to and after vaccination. Each year between 420 and 756 children were tested. The method used for antibody testing was the haemolysis-in-gel (HIG) assay. For measles also the enzyme-linked immunosorbent assay (ELISA) and the neutralization titre (NT) were applied. Only minor variations of the prevaccination immunity to measles were seen during the period 3-7 years after introduction of the programme. The age groups studied had partly been vaccinated against measles earlier. Between 12 and 16% lacked prevaccination immunity. In contrast the immunity to mumps and rubella of the 12-year-old children decreased considerably during the study period. No general vaccination against these diseases had been performed. Thus the susceptibility to mumps increased from 14% in 1985 to 39% in 1989 and to rubella from 41 to 57%. The seroconversion rate of children seronegative for measles was high, i.e. 100% in 1985 and later varied between 96 and 97%. For mumps, the seroconversion rate was lower and varied between 72 and 88%. All sera converted to rubella. During the follow-up period there was a declining incidence of measles, mumps and rubella. The relationship between the vaccination and reduction of disease and natural immunity strongly suggests that the association is causal and that this vaccination policy reduced the transmission of infection.     

Incidence of mumps and immunity to measles, mumps and rubella among US military recruits, 2000-2004

Recent mumps outbreaks have evoked concerns of decreasing mumps immunity among adolescents and adults, including US military recruits subject to differing mumps immunization policies. To compare mumps incidence and to assess initial measles, mumps and rubella seropositivity, we conducted a cohort study among recruits from 2000 to 2004. Mumps incidence in the targeted MMR and universal MMR cohorts was 4.1 and 3.5 per 100,000 person-years, respectively, giving an incidence rate ratio of 1.16 (P=0.67). Measles, mumps, and rubella seropositivity was 84.6%, 89.5%, and 93.2%, respectively. Among recruits with measles and rubella immunity, 92.8% were mumps immune. These findings support the policy of targeting MMR immunization based upon measles and rubella serology alone.     

Seroepidemiology of hepatitis A and hepatitis B virus in Luxembourg

A prospective seroepidemiological survey was carried out in Luxembourg in 2000-2001 to determine the antibody status of the Luxembourg population against hepatitis A virus (HAV) and hepatitis B virus (HBV). One of the objectives of this survey was to assess the impact of the hepatitis B vaccination programme, which started in May 1996 and included a catch-up campaign for all adolescents aged 12-15 years. Venous blood from 2679 individuals was screened for the presence of antibodies to HAV antigen and antibodies to hepatitis B surface antigen (anti-HBs) using an enzyme immunoassay. Samples positive for anti-HBs were tested for antibody to hepatitis B core antigen (anti-HBc) using a chemiluminiscent microparticle immunoassay to distinguish between individuals with past exposure to vaccine or natural infection. The estimated age-standardized anti-HAV seroprevalence was 42.0% [95% confidence interval (CI) 39.8-44.1] in the population >4 years of age. Seroprevalence was age-dependent and highest in adult immigrants from Portugal and the former Yugoslavia. The age-standardized prevalence of anti-HBs and anti-HBc was estimated at 19.7% (95% CI 18.1-21.3) and 3.16% (95% CI 2.2-4.1) respectively. Anti-HBs seroprevalence exceeding 50% was found in the cohorts targeted by the routine hepatitis B vaccination programme, which started in 1996. Our study illustrates that most young people in Luxembourg are susceptible to HAV infection and that the hepatitis B vaccination programme is having a substantial impact on population immunity in children and teenagers.     

Live varicella vaccine: the third act?

The story of live varicella vaccine is reaching a dénouement. The first act started in Japan, where in 1973 Dr Michiaki Takahashi developed and tested a varicella vaccine called OKA (from the strain of virus) in normal and immunosuppressed children. The vaccine was inoculated subcutaneously in varying doses between 300 and 1000 p.f.u., and elicited both antibody to varicella and delayed type hypersensitivity to a varicella skin test antigen. Normal children showed little or no reaction to the vaccine, whereas for the most part immunosuppressed children had only mild vesicular rashes. Some of these vaccine trials were done during institutional outbreaks of varicella in an effort to protect uninfected children and efficacy was convincingly demonstrated.     

Mass vaccination programme aimed at eradicating measles, mumps and rubella in Sweden: vaccination of schoolchildren

In 1982-83, a unique, two-dose programme of immunization with a combined vaccine against measles, mumps and rubella was initiated in Sweden. The first dose was administered at 18 months and the second at 12 years of age. A vaccination study was carried out on 247 12 year old schoolchildren from four schools situated in two urban and two rural areas. In urban areas, 30% of children were found to be susceptible to rubella and 18% to mumps, compared with 55% susceptible to rubella and 31% to mumps in rural areas. The reverse was found for measles, to which 20% of children lacked immunity in urban areas but only 6% in rural areas. Seroconversion was seen in 82% against measles, in 80% against mumps and in 100% against rubella. Follow-up studies of the timing and the virus dosage are also to be carried out.