Showing papers on "Measles published in 1987"
01 Jan 1987
TL;DR: Poliomyelitis immunization efforts have been so successful that the Pan American Health Organization is leading a drive to eradicate poliomyelinitis from the Americas by 1990.
Abstract: A general review of policy in World Health Organizations Expanded Program on Immunization is given. Particular attention is focussed on positions and topics that are new have changed or are considered controversial. Protection should be achieved before the infants are at high risk. Each country should adopt a schedule best suited to its own needs. In developing countries diseases covered by the program strike the very young and it is especially important to immunize children at the earliest possible age. For prevention of tuberculosis BCG antigen is required at birth. For prevention of poliomyelitis OPV in 4 doses is to be given at birth and with each DPT (diptheria pertussis and tetanus). The DPT is to be administered in 3 doses at ages 6 10 and 14 weeks. Measles antigen is required at 1st contact after 9 months. Resources should not be provided to administer booster doses until coverage levels for fully immunized infants are above 80%. Multiple antigens such as BCG DPT and measles vaccines can be given simultaneously. In developing countries the risk of measles and poliomyelitis in unimmunized infants is high and the risk from these vaccines even in the presence of symptomatic human immunodeficiency virus infection seems low. Immunization programs have to insure that a sterile syringe and needle are used with each injection.
342 citations
TL;DR: Mortality was several times higher in marasmic than in better nourished children, regardless of study allocation, and this difference in mortality was most obvious for children aged under 2 years.
Abstract: One hundred and eighty children admitted with measles were randomly allocated to receive routine treatment alone or with additional large doses of vitamin A (200,000 IU orally immediately and again the next day). Baseline characteristics of the two groups were virtually identical for age, severity of measles, and vitamin A and general nutritional states. In 91% of the children serum vitamin A concentrations were less than 0.56 mumol/l. Of the 88 subjects given vitamin A supplements, six (7%) died; of the 92 controls, 12 (13%) died (p = 0.13). This difference in mortality was most obvious for children aged under 2 years (one death out of 46 children receiving supplements versus seven deaths out of 42 controls; p less than 0.05) and for cases complicated by croup or laryngotracheobronchitis. Mortality was several times higher in marasmic than in better nourished children, regardless of study allocation (p less than 0.01).
264 citations
TL;DR: Serum samples from 1806 students at two secondary schools in Corpus Christi, Texas, obtained eight days after the onset of the first case of measles showed that the number of doses of vaccine received was the most important predictor of antibody response.
Abstract: An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced. Serum samples from 1806 students at two secondary schools were obtained eight days after the onset of the first case. Only 4.1 percent of these students (74 of 1806) lacked detectable antibody to measles according to enzyme-linked immunosorbent assay, and more than 99 percent had records of vaccination with live measles vaccine. Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been vaccinated, contracted measles. In addition, three seronegative students seroconverted without experiencing any symptoms. We conclude that outbreaks of measles can occur in secondary schools, even when more than 99 percent of the students have been vaccinated and more than 95 percent are immune.
189 citations
TL;DR: The rapidly escalating prevalence of this pneumonitis is due in great part to the epidemic of acquired immunodeficiency syndrome (AIDS) and because of advances in medical practice, the population of the United States is increasing.
Abstract: During the past year, the number of deaths from Pneumocystis carinii pneumonitis in the United States exceeded the combined number of deaths from meningococcal infections, all types of viral hepatitis and encephalitis, gonorrhea, syphilis, varicella, measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, amebiasis, shigellosis, salmonellosis, typhoid fever, typhus fevers, cholera, rabies, brucellosis, anthrax, tularemia, botulism, and malaria. More patients died of P. carinii pneumonitis than of all types of tuberculosis. The rapidly escalating prevalence of this pneumonitis is due in great part to the epidemic of acquired immunodeficiency syndrome (AIDS). Also, because of advances in medical practice, the population of . . .
181 citations
TL;DR: A prospective study of purified protein derivative skin test reactivity in children with natural measles virus infections who had received Bacillus Calmette-Guerin as infants to determine whether there was a difference in the altered cellular immune responses of children with and without complications.
Abstract: The suppression of cellular immune responses during measles is thought to contribute to the development of secondary infections which often complicate this disease. To determine whether there was a difference in the altered cellular immune responses of children with and without complications we performed a prospective study of purified protein derivative skin test reactivity in children with natural measles virus infections who had received Bacillus Calmette-Guerin as infants. Twenty-five tuberculin-positive children who developed measles (13 uncomplicated and 12 complicated) were skin-tested weekly beginning 1 to 2 weeks before and ending 2 to 7 weeks after the onset of the rash. All children became anergic during the acute phase of measles. Children with complications remained unreactive for a significantly longer period of time after the rash (mean, 4 weeks) than did children without complications (mean, 2.3 weeks, P less than 0.001).
136 citations
TL;DR: Persistence of part of the measles virus genome in AICAH may have important implications in the pathogenesis of the liver disease, and possibly in other disorders such as systemic lupus erythematosus, multiple sclerosis, and Paget's disease where an abnormal immune response to measles has been observed.
121 citations
TL;DR: A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986 and an outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.
Abstract: In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were immunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested by the haemolysis in gel method. After a neutralisation test against measles as well all children showed immunity to the disease. A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986. An outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.
103 citations
TL;DR: The various mechanisms by which measles causes corneal ulceration are discussed, and the priorities in prevention and management of corNEal ulcers in African children are discussed.
Abstract: One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. Herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin A deficiency was the major cause of bilateral ulceration, subsequent blindness, and mortality in this series. Other significant causes of childhood corneal ulceration were the use of traditional eye medicines, confluent measles keratitis, and ophthalmia neonatorum. We discuss the various mechanisms by which measles causes corneal ulceration, and the priorities in prevention and management of corneal ulceration in African children.
102 citations
TL;DR: The outbreak subsided spontaneously after four generations of illness in the school and demonstrates that when measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but that such transmission is not usually sustained.
Abstract: An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures. Persons who were unimmunized or immunized at less than 12 months of age had substantially higher attack rates compared to those immunized on or after 12 months of age. Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak. There was no evidence to suggest that waning immunity was a contributing factor among the vaccine failures. Close contact with cases of measles in the high school, source or provider of vaccine, sharing common activities or classes with cases, and verification of the vaccination history were not significant risk factors in the outbreak. The outbreak subsided spontaneously after four generations of illness in the school and demonstrates that when measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but that such transmission is not usually sustained.
101 citations
TL;DR: This review finds general support for recommendations on immunisation of HIV-infected children that have been developed by the World Health Organisation.
87 citations
TL;DR: The data suggest that the different diseases of the two rat strains are related to the immunogenetic background rather than to the replication of measles virus in the central nervous system.
Abstract: SUMMARY Lewis and Brown Norway (BN) rats which are susceptible or resistant to autoimmune reactions against brain antigen, respectively, were inoculated intracerebrally with a neurotropic measles virus. Suckling rats died from a rapidly fatal acute encephalopathy (AE). With increasing age Lewis rats developed a subacute measles encephalomyelitis (SAME) whereas BN rats showed a clinically silent encephalitis (CSE). Infectious virus could occasionally be recovered from SAME animals using cocultivation techniques but not from BN rats with CSE. With monoclonal antibodies against measles virus, viral proteins were localized in brain tissue. Nucleocapsid and phosphoprotein were detected in infected brain cells of all animals with AE, SAME and CSE, whereas measles virus haemagglutinin, fusion and matrix proteins were either reduced or absent, suggesting a restricted synthesis of measles virus envelope proteins. These data suggest that the different diseases of the two rat strains are related to the immunogenetic background rather than to the replication of measles virus in the central nervous system. This animal model provides the opportunity to investigate further the events occurring during establishment of measles virus persistence in the brain, and the genetic control of associated immunological and immunopathological reactions.
TL;DR: This outbreak suggests that measles transmission may persist in some settings despite appropriate implementation of the current measles elimination strategy.
Abstract: From January 4 to May 13, 1985, an outbreak of 137 cases of measles occurred in Montana and persisted for 12 generations of spread. A total of 114 cases occurred on the Blackfeet Indian reservation in northwest Montana. Of the 137 cases, 82 (59.9%) were in school-aged children (aged 5-19 years). Of the 114 cases on the reservation, 108 (94.7%) were classified as programmatically nonpreventable. A total of 64 (82.1%) of the 78 patients on the reservation who were born after 1956 and were above the recommended age at vaccination had a history of adequate measles vaccination. Additionally, an audit of immunization records at the schools in Browning, Montana, where most of the cases occurred, showed that 98.7% of students were appropriately vaccinated. A retrospective cohort study in the Browning schools failed to identify age at vaccination or time since vaccination as significant risk factors for vaccine failure. Overall vaccine efficacy was 96.9% (95% confidence interval = 89.5-98.2%). None of 80 Browning students who were vaccinated at less than 12 months of age and revaccinated at 15 months of age or older became infected. A case-control study showed a significant association between attendance at Browning basketball games and infection early in the outbreak. This outbreak suggests that measles transmission may persist in some settings despite appropriate implementation of the current measles elimination strategy.
TL;DR: Edmonston-Zagreb strain appears more effective than Schwarz vaccine in this population and further studies are indicated in other populations where early measles immunisation is desirable.
TL;DR: The severity of measles in the immunocompromised patient reinforces the need to improve the poor uptake of measles immunisation in Britain.
Abstract: Measles is a major cause of mortality and morbidity in children receiving treatment for leukaemia. A review was made of all the documented cases of measles in children in first remission from acute lymphoblastic leukaemia at four major treatment centres in 1974-84. Over the 11 years reviewed 1043 children with acute lymphoblastic leukaemia were referred to these centres. Fifty one (4.9%) died while in first remission and 15 (29.4%) of these deaths were due to measles or its complications: 12 cases of pneumonia, 10 of them fatal; and six cases of encephalitis, five of them fatal and the sixth child left severely handicapped. These children would have had at least a 50% chance of long term survival. The severity of measles in the immunocompromised patient reinforces the need to improve the poor uptake of measles immunisation in Britain.
TL;DR: The comparatively low mortality in this series may have been due to the extensive use of the fluorescent antibody technique in Newcastle during the study period and therefore detection of less severe cases as compared with other reports.
Abstract: A review study examined the clinical course of measles diagnosed in children being treated for malignant disease in Newcastle upon Tyne during 1973-86 Of the 17 cases diagnosed, five were fatal Factors associated with a favourable outcome were a typical rash and Koplik's spots, which were accompanied by a detectable serum antibody response and the disappearance of measles giant cells from nasopharyngeal secretions Pneumonitis severe enough to require assisted ventilation was invariably fatal Pneumonitis and encephalitis were the main complications Treatment included immunoglobulin, interferon, and ribavirin, but none could clearly be shown to be effective The comparatively low mortality in this series may have been due to the extensive use of the fluorescent antibody technique in Newcastle during the study period and therefore detection of less severe cases as compared with other reports
TL;DR: Serum antibody titres to Adenovirus, Chlamydia Group B, Coxiella burnettii, Cytomegalov virus, Herpes simplex virus, influenza A, Influenza B, Measles and Mycoplasma pneumoniae were measured and it was concluded that these agents play no role in the aetiology of Alzheimer's disease.
Abstract: Serum antibody titres to Adenovirus, Chlamydia Group B, Coxiella burnettii, Cytomegalovirus, Herpes simplex virus, Influenza A, Influenza B, Measles and Mycoplasma pneumoniae were measured in 33 patients with a clinical diagnosis of Alzheimer's disease, and in 28 non-demented controls suffering from functional psychiatric disorders. No statistically significant differences were found between the patients and controls, and it is concluded that these agents play no role in the aetiology of Alzheimer's disease.
TL;DR: Case type, sex, mother's education and household economic condition were found to have statistically significant impact on case fatality.
TL;DR: The continuing risk of infection to hospital staff is drawn to the continuing risk presented by hepatitis B and pulmonary tuberculosis, which are more common than diseases such as typhoid fever, brucellosis, histoplasmosis, whooping cough, infectious gastroenteritis, measles, and parotiditis.
Abstract: In this review of the risk of infection to hospital staff, attention is drawn to the continuing risk presented by hepatitis B and pulmonary tuberculosis, which are more common than diseases such as typhoid fever, brucellosis, histoplasmosis, whooping cough, infectious gastroenteritis, measles, and parotiditis. Other items considered include the susceptibility of female hospital staff to rubella and the importance of their undergoing screening and vaccination; the risks currently presented by epidemic keratoconjunctivitis and by herpes viruses (herpes simplex, varicella zoster, and cytomegalovirus); and the risk of contracting the new infectious diseases (Legionnaires' disease, Marburg disease, Lassa fever, and the acquired immune deficiency syndrome).
TL;DR: Antibody response in the sera of patients to type C influenza virus was equally good after every infection, although it was not efficient to prevent the succeeding infection.
Abstract: A follow-up study of type C influenza in a children's home was made where the first outbreak of type C influenza occurred in March, 1981. During the survey period of 2 years, 2 additional outbreaks occurred in April and October, 1982 and 4 cases of the secondary and 2 cases of the tertiary infections were serologically confirmed. All of the children exposed to the outbreaks, except 2 particular cases who were suffering from German measles, showed similar mild respiratory symptoms characterized by fever and long-lasting nasal discharge, irrespective of primary, secondary, and tertiary infections. No case of inapparent infection was observed. Incubation period was estimated to be not longer than 5 days and the period of virus shedding, to be longer than 22 days. Antibody response in the sera of patients to type C influenza virus was equally good after every infection, although it was not efficient to prevent the succeeding infection. Factors involved in the repeated infections of type C influenza were discussed.
TL;DR: The medical waiting room is a location where a reservoir of susceptible individuals may congregate, allowing for potential exposures to measles and other infectious diseases, and other measures to decrease exposures in this setting may be necessary to achieve the goal of measles elimination in the United States.
Abstract: During the period September 1981 to August 1985, we investigated every reported case of measles in Oklahoma to confirm the diagnosis, to determine the source, and to identify contacts to prevent spread of the disease. During this time, 33 serologically and/or epidemiologically confirmed cases were investigated. Nine (27%) persons acquired measles in a medical office or clinic waiting area. Eight of these recalled direct face-to-face contact with a source. An additional six (18%) cases were associated with exposure to these medically acquired cases, for a total of 45% that were the direct or indirect result of exposures in medical waiting rooms. The medical waiting room is a location where a reservoir of susceptible individuals may congregate, allowing for potential exposures to measles and other infectious diseases. Because many persons in these settings are too young to have received routine measles vaccination, other measures to decrease exposures in this setting may be necessary to achieve the goal of measles elimination in the United States.
TL;DR: Immunity induced by the vaccine seems to survive the challenge of close contact with measles in young children, even after 21 years.
Abstract: 21 years after receiving Schwartz strain live measles vaccine 4500 trial participants showed a continuing high level of protection compared with those who were unvaccinated. Over the last seven years of the follow up no cases of measles were reported in vaccinated participants who had had close contact with the disease. Immunity induced by the vaccine seems to survive the challenge of close contact with measles in young children, even after 21 years.
TL;DR: Sera from patients who within a period of 21/2 years had had a rubella form rash and/or symptoms of arthritis and arthralgia were investigated for evidence of rubella, human parvovirus B19 (HPV), and measles infection with methods to detect specific IgM and IgG antibodies.
Abstract: We investigated 627 patients who within a period of 21/2 years had had a rubella form rash and/or symptoms of arthritis and arthralgia. Sera from these patients were investigated for evidence of rubella, human parvovirus B19 (HPV), and measles infection with methods to detect specific IgM and IgG antibodies. Complement fixation tests were used to screen for a wide range of other infectious agents.
We detected 229 cases of rubella, 43 cases of HPV infection, 7 cases of measles, and 9 cases of infection by various other aetiological agents. This left a large proportion of rubelliform rashes, 54% (339 cases), whose aetiology was unknown. This study confirmed that the diagnosis of rubella on clinical grounds alone is unreliable.
Many (6.8%) of the rashes in the study were due to HPV infection, and the seasonal incidence was the same as for rubella. There was considerable overlap between the features of rubella and HPV infections, although in adults arthralgia occurred more frequently in HPV infections than in rubella. In all cases HPV infection was self-limiting, although, as in rubella, symptoms can be prolonged and one adult's disease lasted almost 9 months. Purpura was noted in only one patient with HPV infection.
In this study three patients had HPV infection during pregnancy. Two patients spontaneously aborted one month later. The third patient progressed to full term and delivered a healthy baby.
TL;DR: The data show that indapamide may cause skin reactions, and the Dutch experience suggests that cross sensitivity to other thiazides is probably rare, but whether these are relatively frequent can be confirmed or disproved only by further study.
Abstract: voluntary reporting, and no conclusions can be drawn about the comparative incidence of adverse effects to different drugs. Our data show that indapamide may cause skin reactions, and the Dutch experience suggests that cross sensitivity to other thiazides is probably rare. Rashes with indapamide were frequently reported, but whether these are relatively frequent can be confirmed or disproved only by further study.
TL;DR: In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan and eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions.
Abstract: In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan. Eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions. Medical students and a medical resident were involved in the outbreak's propagation. Health care providers need to be immune to measles. Measles should be suspected in young adults with compatible illnesses; persons suspected to have measles should be placed in stringent respiratory isolation to preclude airborne transmission.
TL;DR: All hospital employees born after 1950 who have significant patient contact should have documented immunity against measles, because of the high transmissibility of this disease and its potentially serious consequences in hospitalized patients.
TL;DR: Comparisons of any trends during the survey period in blood level concentrations in the exposed and control groups, together with results from the monitoring of sources of environmental lead should enable a broad assessment to be made of the effect of the reduction in petrol lead.
Abstract: The Department of the Environment (DOE) has undertaken an extensive programme to monitor blood lead concentrations annually over the period 1984 to 1987 in the context of the reduction in the maximum permissible lead content of petrol from 0.4 to 0.15 g/l from 1st January 1986. The study includes adults living in heavily trafficked urban areas and in occupational groups particularly exposed to petrol lead; children aged 6-7 years attending schools in heavily trafficked urban areas; and control groups of adults and children in rural areas. The surveys are planned to cover about 1500 adults and 1000 children in total each year. Cohorts of adults are being followed, with replacement where necessary owing to moving, etc. For ethical reasons, no child will be sampled more than once, although the schools concerned will be revisited each year; children's blood is also being examined for antibodies to measles and poliomyelitis. Blood samples are being analysed for lead by atomic absorption spectrophotometry (AAS); considerable efforts are being made to ensure the validity of the analytical results during the period of the study. Results for 1984 indicated that average blood lead concentrations in both adults and children were generally low and were in line with levels expected on the basis of earlier surveys; only a very small proportion of individuals had raised levels. A detailed statistical analysis has confirmed the results of the EEC Blood Lead Surveys (carried out in 1979-1981) that blood lead concentrations were related to a range of personal, social and environmental factors including age, sex and smoking and drinking habits. Comparisons of any trends during the survey period in blood level concentrations in the exposed and control groups, together with results from the monitoring of sources of environmental lead should enable a broad assessment to be made of the effect of the reduction in petrol lead.
TL;DR: It is concluded that at least 95% of children with common forms of systemic allergy can be vaccinated safely with MMR and, in general, that allergic diseases should not interfere with execution of the vaccination programs.
Abstract: • A series of 135 subjects (134 children and one adult) with documented or suspected systemic allergy were pricktested before a measles, mumps, and rubella (MMR) vaccination. Atopic eczema was documented in 68, asthma in 47, and cow's-milk allergy in 11 examinees; eight children were evaluated because of severe systemic reactions following diphtheria-pertussis-tetanus, measles, or inactivated polio (Salk) vaccinations. In one child, there was only a suspicion of general allergy. The undiluted MMR prick test gave negative reactions in 126 cases (93%). The highest rate of nonreactivity was observed in those with atopic eczema (96%) and in children with asthma (91%) or cow's-milk allergy (82%). All examinees with systemic reactions after other vaccinations also had negative prick-test reactions. A total of 122 (95%) of the 129 examinees were eventually vaccinated with MMR. No untoward reactions developed, except mild generalized urticaria or fever in two vaccinees. We conclude that at least 95% of children with common forms of systemic allergy can be vaccinated safely with MMR and, in general, that allergic diseases should not interfere with execution of the vaccination programs. ( AJDC 1987;141:1103-1105)
01 Jan 1987
TL;DR: Molecular biological studies will be described which are beginning to elucidate their evolutionary relationships and to provide a basis for understanding the role of individual virus genes in pathogenesis.
Abstract: The morbilliviruses are a closely related group of important human and animal pathogens. The best known members of the group are measles virus in man and canine distemper virus in dogs. The group also includes two other serious animal diseases, rinderpest or cattle plague and peste des petits ruminants in sheep and goats. The latter viruses are of great economic importance in Africa, Asia and the Middle East. Persistence of these viruses in some form is a possible mechanism whereby life-long immunity is conferred on an infected individual. In addition to the severe, often fatal, acute disease these viruses can, in rare cases, lead to a fatal chronic disease of the CNS. Molecular biological studies will be described which are beginning to elucidate their evolutionary relationships and to provide a basis for understanding the role of individual virus genes in pathogenesis.
TL;DR: The localization of measles virus proteins was analyzed by immunoperoxidase method using both monospecific and monoclonal antibodies and the presence of haemagglutinin on the surface of giant cells at the luminal side was noticed.
Abstract: The localization of measles virus proteins was analyzed by immunoperoxidase method using both monospecific and monoclonal antibodies. In Vero cells infected with the Edmonston or EB-L strain, the former being a laboratory strain and the latter a fresh isolate from a measles patient, nucleocapsid protein was located in the nuclei, and matrix protein, phosphoprotein, haemagglutinin and fusion protein were located in the cytoplasm. In the lung tissues of eight cases with measles giant cell pneumonia, the similar findings were obtained. The presence of haemagglutinin on the surface of giant cells at the luminal side was also noticed. Histopathologically, measles giant cells had nuclear and cytoplasmic eosinophilic inclusion bodies with some differences in appearance. The significance of localization of viral proteins is discussed in comparison with histopathological findings in measles giant cells.
TL;DR: Recently studies conducted in several countries using Edmonston-Zagreb vaccine administered subcutaneously to infants younger than 9 months of age have shown high seroconversion rates, approaching or equaling those routinely achieved at 9 month of age with the more widely used Schwarz vaccine.
Abstract: Recently studies conducted in several countries using Edmonston-Zagreb vaccine administered subcutaneously to infants younger than 9 months of age have shown high seroconversion rates, approaching or equaling those routinely achieved at 9 months of age with the more widely used Schwarz vaccine. These results have raised expectations that the Edmonston-Zagreb vaccine can play an important role in helping to prevent measles in young infants in highly endemic areas. Because of the implications of changing the measles vaccine recommendations, vaccine advisory groups and vaccine manufacturers will require additional studies to confirm the preliminary findings and to answer new questions which have been raised. The needed data will probably be collected over the next year or two in studies already under way or being planned in the hope that a more effective vaccine for young infants can be introduced before the end of this decade.