Showing papers on "Measles published in 2006"
01 Jan 2006
TL;DR: This chapter analyzes the costs and cost-effectiveness of scaling up the EPI and introducing selected new vaccines into the program and summarizes the epidemiology of diseases preventable through immunization and estimates the disease burden with and without immunization programs.
Abstract: This chapter analyzes the costs and cost-effectiveness of scaling up the EPI and introducing selected new vaccines into the program. It also summarizes the epidemiology of diseases preventable through immunization and estimates the disease burden with and without immunization programs. In addition the chapter discusses the organization delivery and financing of immunization programs and highlights future prospects and areas for further study. Several areas overlap with other chapters. For example the vaccines that prevent measles tuberculosis diphtheria pertussis Hib and Neisseria meningitis prevent respiratory diseases. Some vaccines such as those against measles and pertussis prevent diseases that cause or contribute to malnutrition. Chapter 16 provides an in-depth review of tuberculosis and a discussion of the potential impact of bacillus Calmette-Guerin (BCG) vaccines. This chapter also does not discuss some new vaccines including conjugate Streptococcus pneumoniae influenza typhoid fever and rotavirus because other chapters deal with those diseases and vaccines. Vaccines to prevent mumps and varicella that are routinely used in some developed countries are not included in most vaccination programs in developing countries. Other interventions that can reduce the burden of vaccine-preventable diseases and are not covered in this chapter include clean umbilical cord care to reduce the incidence of neonatal tetanus vitamin A therapy to reduce the case-fatality rate (CFR) from measles and intensive clinical care that can reduce the mortality associated with most of the vaccine-preventable diseases. (excerpt)
271 citations
TL;DR: In 2005, a 17-year-old unvaccinated girl who was incubating measles returned from Romania, creating the largest documented outbreak of measles in the United States since 1996 as discussed by the authors.
Abstract: Background Measles was declared eliminated from the United States in 2000 but remains endemic worldwide. In 2005, a 17-year-old unvaccinated girl who was incubating measles returned from Romania, creating the largest documented outbreak of measles in the United States since 1996. Methods We conducted a case-series investigation, molecular typing of viral isolates, surveys of rates of vaccination coverage, interviews regarding attitudes toward vaccination, and cost surveys. Results Approximately 500 persons attended a gathering with the index patient one day after her return home. Approximately 50 lacked evidence of measles immunity, of whom 16 (32 percent) acquired measles at the gathering. During the six weeks after the gathering, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 percent were home-schooled. Vaccine failure occurred in two persons. The virus strain was genotype D4, which is endemic in Romania. Although containment measures began after 20 persons were already infectious, measles remained confined mostly to children whose parents had refused to have them vaccinated, primarily out of concern for adverse events from the vaccine. Seventy-one percent of patients were from four households. Levels of measles-vaccination coverage in Indiana were 92 percent for preschoolers and 98 percent for sixth graders. Estimated costs of containing the disease were at least 167,685 dollars, including 113,647 dollars at a hospital with an infected employee. Conclusions This outbreak was caused by the importation of measles into a population of children whose parents had refused to have them vaccinated because of safety concerns about the vaccine. High vaccination levels in the surrounding community and low rates of vaccine failure averted an epidemic. Maintenance of high rates of vaccination coverage, including improved strategies of communication with persons who refuse vaccination, is necessary to prevent future outbreaks and sustain the elimination of measles in the United States.
250 citations
TL;DR: The pathogenesis of measles and the likelihood of the worldwide elimination of this disease are discussed and the pathogenesis is compared to previous studies.
Abstract: Safe and effective vaccines are available that could be used to eradicate measles, which is a primary cause of childhood vaccine-preventable deaths worldwide. This article reviews the pathogenesis of this deadly disease and the prospects for its elimination. Measles remains a leading vaccine-preventable cause of child mortality worldwide, particularly in sub-Saharan Africa where almost half of the estimated 454,000 measles deaths in 2004 occurred. However, great progress in measles control has been made in resource-poor countries through accelerated measles-control efforts. The global elimination of measles has been debated since measles vaccines were first licensed in the 1960's, and this debate is likely to be renewed if polio virus is eradicated. This review discusses the pathogenesis of measles and the likelihood of the worldwide elimination of this disease.
227 citations
TL;DR: Efforts to increase vaccination coverage should take reasons for non- vaccination into account, and paternal and maternal levels of education and immigration time of both parents to Istanbul were found to influence whether children were completely vaccinated or non-vaccinated.
Abstract: In order to control and eliminate the vaccine preventable diseases it is important to know the vaccination coverage and reasons for non-vaccination. The primary objective of this study was to determine the complete vaccination rate; the reasons for non-vaccination and the predictors that influence vaccination of children. The other objective was to determine coverage of measles vaccination of the Measles Immunization Days (MID) 2005 for children aged 9 month to 6 years in a region of Umraniye, Istanbul, Turkey. A '30 × 7' cluster sampling design was used as the sampling method. Thirty streets were selected at random from study area. Survey data were collected by a questionnaire which was applied face to face to parents of 221 children. A Chi-square test and logistic regression was used for the statistical analyses. Content analysis method was used to evaluate the open-ended questions. The complete vaccination rate for study population was 84.5% and 3.2% of all children were totally non-vaccinated. The siblings of non-vaccinated children were also non-vaccinated. Reasons for non-vaccination were as follows: being in the village and couldn't reach to health care services; having no knowledge about vaccination; the father of child didn't allow vaccination; intercurrent illness of child during vaccination time; missed opportunities like not to shave off a vial for only one child. In logistic regression analysis, paternal and maternal levels of education and immigration time of both parents to Istanbul were found to influence whether children were completely vaccinated or non-vaccinated. Measles vaccination coverage during MID was 79.3%. Efforts to increase vaccination coverage should take reasons for non-vaccination into account.
158 citations
TL;DR: A decision theory model of the decision to vaccinate fits the facts well and generates practical strategies for uptake of MMR and similar childhood vaccines.
130 citations
TL;DR: The effects of several viral infections during pregnancy where the effects on the developing embryo and fetus are infrequent, but they may sometimes cause severe neonatal disease are discussed.
123 citations
TL;DR: This retrospective study analyzes the response to primary MMR and varicella immunization in selected pediatric liver transplant recipients in the largest such study to date and finds live virus immunization with MMR and Varivax was safe and immunogenic in this selected population of Liver transplant recipients.
Abstract: Viral infection is a recognized and potentially serious complication in children following solid organ transplantation The risks of viral infection are particularly important for infants who may not have completed standard childhood immunizations at the time of transplantation and are therefore at risk for otherwise preventable infections The general practice of withholding live virus immunization from transplant recipients has been questioned and several small studies have looked at MMR and/or Varivax administration in children following transplantation This retrospective study analyzes the response to primary MMR and varicella immunization in selected pediatric liver transplant recipients in the largest such study to date Nineteen of 26 children (73%) developed serologic immunity for measles following MMR (although 18 required multiple doses) Similarly, varicella immunization resulted in seroconversion in 20 of 31 children (645%; seven required multiple doses) Only minor adverse effects reported in the general population were observed Live virus immunization with MMR and Varivax was safe and immunogenic in this selected population of liver transplant recipients
113 citations
TL;DR: Despite immune reconstitution, antibodies against live-attenuated vaccine and wild-type natural virus strains disappear over time in up to 40% of children with HIV-1 infection.
Abstract: OBJECTIVE. In the pre–highly active antiretroviral therapy era, a loss of specific antibodies was seen. Our objective with this study was to describe the loss of specific antibodies during treatment with highly active antiretroviral therapy. METHODS. In a prospective, single-center, cohort study of 59 children with HIV-1 infection, we investigated the long-term effect of highly active antiretroviral therapy on the titers and course of specific antibodies against measles, mumps, and rubella vaccine strains compared with wild-type varicella zoster virus, cytomegalovirus, and Epstein-Barr virus. RESULTS. During highly active antiretroviral therapy, age-adjusted CD4 + T cells and B cells increased, whereas total immunoglobulin levels declined. Although these children were preimmunized before the start of highly active antiretroviral therapy, only 24 (43%) had antibodies against all 3 measles, mumps, and rubella. Antibodies against measles, mumps, and rubella were lost in 14 (40%), 11 (38%), and 5 (11%) children who were seropositive at baseline. We also observed loss of varicella zoster virus immunoglobulin G in 7 (21%) of 34, cytomegalovirus immunoglobulin G in 3 (7%) of 45, but none of 53 Epstein-Barr virus–seropositive children. During highly active antiretroviral therapy, primary vaccination in 3 patients and 15 revaccinations in those with negative serology demonstrated incomplete seroconversion. CONCLUSIONS. Humoral reactivity in children with HIV-1 infection remains abnormal during highly active antiretroviral therapy. Despite immune reconstitution, antibodies against live-attenuated vaccine and wild-type natural virus strains disappear over time in up to 40% of children with HIV-1 infection.
105 citations
TL;DR: It can be concluded that cytostatic therapy for ALL in children results in a temporarily reduction of specific antibody levels, and memory is preserved but revaccination may be warranted.
Abstract: Intensified chemotherapy regimens resulting in improved survival of children with acute lymphocytic leukemia (ALL) lead to concerns about therapy-induced immune damage reflected by the loss of protection of previous immunizations and the efficacy of (re-)vaccination. The severity of secondary immunodeficiency, however, is not clear and knowledge is based on a limited number of studies. We performed a systematic review on literature concerning vaccination data of children with ALL published since 1980. Eight studies fulfilled the inclusion criteria. Regarding antibody titers after treatment, the number of children who had preserved the defined protection level for antibodies differed widely, ranging from 17 to 98% for diphtheria, 27 to 82% for Bordetella pertussis, 20 to 98% for tetanus, 62 to 100% for poliomyelitis, 35 to 100% for Haemophilus influenzae type B (HiB), 29 to 92% for mumps, 29 to 60% for measles and 72 to 92% for rubella. Most patients however responded to revaccination, demonstrating immunological recovery. Although the designs and results of the included studies varied widely, it can be concluded that cytostatic therapy for ALL in children results in a temporarily reduction of specific antibody levels. Memory is preserved but revaccination may be warranted. This is the first systematic review and the best possible current approximation of chemotherapy-induced immune damage in children after ALL treatment.
101 citations
TL;DR: Administration of 2 doses of the combined MMRV vaccine was as immunogenic and well-tolerated as separate injections of MMR and varicella vaccine, and did not induce an increased local or general reactogenicity compared with the separate administration.
Abstract: Background:Combination vaccines against common childhood diseases are widely used, provide an improved coverage, are more convenient and are more cost-effective than multiple injections. We conducted a study to evaluate the safety and immunogenicity of acombined measles-mumps-rubella-varicella (MMRV
100 citations
TL;DR: The present article summarizes the clinical syndrome of CRS, the process by which the vaccine was developed, and the history leading up to elimination, as well as the possible extension of elimination on a wider scale.
Abstract: Congenital rubella syndrome (CRS) was discovered in the 1940s, rubella virus was isolated in the early 1960s, and rubella vaccines became available by the end of the same decade. Systematic vaccination against rubella, usually in combination with measles, has eliminated both the congenital and acquired infection from some developed countries, most recently the United States, as is confirmed by the articles in this supplement. The present article summarizes the clinical syndrome of CRS, the process by which the vaccine was developed, and the history leading up to elimination, as well as the possible extension of elimination on a wider scale.
TL;DR: Two-dose vaccination was adequate to protect women from rubella infection at least during childbearing age and as a result of a more rapid decay of high-titre antibodies, many vaccinees may eventually become susceptible to vaccine-modified measles (VMM) and consequently complicate measles control strategies.
TL;DR: Measles vaccine effectiveness was high; thus, diminished effectiveness was not the main cause of the outbreak and very high population immunity is needed to prevent measles outbreaks and to protect infants below the age of vaccination.
Abstract: Background The Republic of the Marshall Islands (RMI) is a South Pacific nation freely associated with the United States. In 2003, the RMI experienced the largest measles outbreak within the United States or its associated areas for more than a decade, although the reported coverage of 1-dose measles-mumps-rubella (MMR) vaccine was 80%-93%. The outbreak ended only after vaccination of >35,000 persons among a population of 51,000. Of outbreak cases, 41% were reported to have been previously vaccinated. We studied measles attack rates in RMI households to assess vaccine effectiveness and patterns of disease transmission. Methods For the household secondary attack rate study, households were selected by convenience sampling of outbreak measles cases. The primary case was defined as the first person with measles in a household. Secondary cases were household members with measles onset 7-18 days after the primary case's rash onset. Vaccine effectiveness analysis was limited to children aged 6 months to 14 years, with vaccination status verified against written records. Results Seventy-two households were included in the study. The median household size was 11 persons, and the median number of persons per room was 5.5. Secondary cases were more likely than primary cases to be infants (46% vs. 13%; P=.03). MMR vaccine effectiveness was 92% (95% confidence interval [CI], 67%-98%) for 1 dose and 95% (95% CI, 82%-98%) for 2 doses. Conclusions Measles vaccine effectiveness was high; thus, diminished effectiveness was not the main cause of the outbreak. In communities with high population density and household crowding, very high population immunity is needed to prevent measles outbreaks and to protect infants below the age of vaccination. This may require excellent implementation of a routine 2-dose measles vaccination strategy.
TL;DR: Better characterization of human leukocyte antigen (HLA) haplotypes could inform and improve the design of novel epitope-rich vaccines and help to predict protective immune responses at the individual and population level.
Abstract: lotype was associated with high levels of IgG antibody to measles virus ( ) but low levels of IgG antibody P p .09 to rubella virus ( ), whereas DRB1*04-DQB1*03-DPB1*03 was associated with high lymphoproliferative P p .02
TL;DR: In this study of more than 2 million children, DTP and MMR vaccines were not associated with an increased risk of encephalopathy after vaccination.
Abstract: Background:Whole-cell pertussis (wP) and measles vaccines are effective in preventing disease but have also been suspected of increasing the risk of encephalopathy or encephalitis. Although many countries now use acellular pertussis vaccines, wP vaccine is still widely used in the developing world.
TL;DR: Investigation into the efficacy of two doses of a mumps containing vaccine should be a priority during the current epidemic as the degree to which these individuals are protected is unclear.
Abstract: SUMMARY A mixture modelling technique is applied to age-specific frequency distributions of quantitative results from serological surveys for measles, mumps and rubella using samples collected across the age range in England and Wales in 2000. In accordance with previous studies the analysis suggests that the antibody response to natural infection is stronger than that produced by vaccination, that vaccine-induced antibody levels wane with time and that levels of vaccineinduced antibody response vary for each virus infection being strongest for rubella and weakest for mumps. The current mumps epidemic in the United Kingdom is focused in cohorts born during 1982–1987 who were too old to have received routine MMR vaccination. In the cohort born in 1981–1985 the model estimates that 7 . 5 % have no evidence of mumps specific IgG and 24 . 9% have the lowest level of detectable antibody. The similar proportions of mumps antibody in these categories among cohorts with opportunity for 1 or 2 doses of vaccine is a concern, as the degree to which these individuals are protected is unclear. Investigations into the efficacy of two doses of a mumps containing vaccine should be a priority during the current epidemic.
TL;DR: New advances in the field are highlighted, emphasising the interaction between MV proteins and their cellular targets, in particular the cell membrane receptors, CD46, CD150, TLR2 and FcγRII in the induction of immunological abnormalities associated with measles.
Abstract: Measles virus (MV) causes transient but profound immunosuppression resulting in increased susceptibility to secondary bacterial and viral infections. Due to the development of these opportunistic infections, measles remains the leading vaccine-preventable cause of child death worldwide. Different immune abnormalities have been associated with measles, including disappearance of delayed-type hypersensitivity reactions, impaired lymphocyte and antigen-presenting cell functions, down-regulation of pro-inflammatory interleukin 12 production and altered interferon alpha/beta signalling pathways. Several MV proteins have been suggested to hinder immune functions: hemagglutinin, fusion protein, nucleoprotein and the non-structural V and C proteins. This review will focus on the novel functions attributed to MV proteins in the immunosuppression associated with measles. Here, we highlight new advances in the field, emphasising the interaction between MV proteins and their cellular targets, in particular the cell membrane receptors, CD46, CD150, TLR2 and FcgammaRII in the induction of immunological abnormalities associated with measles.
TL;DR: The U.S. Immunization Program has been one of the most successful efforts in preventive medicine since its beginning with passage of the Vaccination Assistance Act in 1962, polio, measles and rubella have been eliminated and many other vaccine-preventable diseases are at record or near record lows.
Abstract: The U.S. Immunization Program has been one of the most successful efforts in preventive medicine. Since its beginning with passage of the Vaccination Assistance Act in 1962, polio, measles and rubella have been eliminated and many other vaccine-preventable diseases are at record or near record lows. In 1966, 3 years after licensure of the first measles vaccines, the Centers for Disease Control and Prevention began an effort to eliminate measles within the United States, an on-and-off effort that was to last more than 30 years. With measles elimination as the primary driver, fundamental components of today's immunization program were built that affected not only measles, but all of the vaccines and vaccine-preventable diseases of childhood. Some of the major contributions were the enactment and enforcement of immunization requirements for school attendance in all 50 states, enactment of an entitlement program for vaccine purchase, the Vaccines for Children Program, support for health services research to determine reasons for nonimmunization and interventions to improve coverage, development of standards for immunization practices and the measurement system for immunization coverage in all 50 states and 28 major urban areas. Key lessons have been: (1) the program must rest on a sound base of vaccine science and health services science; (2) having a limited number of measurable goals allows program focus, but consider strategies that have crosscutting impact; (3) accountability is critical to program performance at all levels-state, local and individual practice; and (4) establishing and maintaining political support is essential.
TL;DR: Extensive experience with the most widely used mumps vaccine strains in many countries has shown that the risk-benefit ratio of live mumps vaccines is highly favourable for vaccination, despite the occasional occurence of aseptic meningitis.
TL;DR: The widespread establishment of immunisation programmes over the past 30 years has provided remarkable achievements but serious challenges remain and more efforts are needed to immunise the un-immunised and save lives.
TL;DR: The low prevalence of susceptible subjects has already led to the elimination of indigenous measles in Catalonia and should allow the eliminationof indigenous rubella by 2005, and the level of antibodies necessary to interrupt the transmission of mumps has still not been reached in all age groups.
Abstract: Determination of antibody levels against vaccine-preventable diseases is of great value to assess immunization programmes. The objective of this study was to determine the prevalence of measles, rubella, and mumps antibodies in representative samples of the child and adult population of Catalonia and compare the findings to those obtained in 1996. A representative sample of the child and adult (≥15 years) population of Catalonia was studied. Enzyme-linked immunosorbent assay techniques were used to determine the presence of antibodies. Equivocal results for antibodies against measles and rubella were tested using an immunofluorescence technique. To compare proportions, the chi-square test and the Fisher’s exact test were used. Statistical significance was set at 0.05. Adjusted odds ratios were calculated using multiple logistic regression analysis. Samples from 2,619 people were analyzed. The global prevalence of antibodies was 98.3% for measles, 91.1% for mumps, and 98.1% for rubella. The prevalence of rubella antibodies was higher in women than in men (98.8 vs. 97.2%, respectively). Compared with the results obtained in the 1996 seroprevalence study, only the prevalence of rubella antibodies showed a statistically significant increase in men (97.2 vs. 94.6%; p=0.002) and, in particular, in women (98.8 vs. 95.3%; p<0.001). The low prevalence of susceptible subjects has already led to the elimination of indigenous measles in Catalonia and should allow the elimination of indigenous rubella by 2005. The level of antibodies necessary to interrupt the transmission of mumps has still not been reached in all age groups.
TL;DR: Increased measles susceptibility in nursery children is concerning, particularly in the most vulnerable areas, and increased susceptibility levels can be expected in primary schools in the future, as levels of late uptake are insufficient to compensate for underlying declines.
Abstract: Aims: To determine the impact of adverse publicity on MMR uptake and measles susceptibility, including whether vaccination is delayed and the role of deprivation. Methods: A population database for all Scotland containing immunisation records for over one million children (n = 1 079 327) born 1987–2004 was analysed. MMR uptake was determined by birth cohort and deprivation category. “Final” uptake (at approx age 6 years) was predicted by linear regression by birth cohort. Measles susceptibility in 1998 and 2003 was determined by postcode sector and district for cohorts combined to construct nursery and primary school age groups. Results: There is evidence of a slight rise in late uptake, but insufficient to compensate for underlying declines. Late vaccination continues to be associated with deprivation, while the most affluent tend to be vaccinated promptly, or not at all. Predicted figures for “final” MMR1 uptake are over 90%, but under 95%. Measles susceptibility has increased significantly in nursery children, with an eightfold rise in the number of districts with greater than 20% susceptibility in this group (from 3 to 25). Conclusions: Increased measles susceptibility in nursery children is concerning, particularly in the most vulnerable areas. These figures are likely to increase in the future, as MMR uptake has not yet returned to the previous higher level. Increased susceptibility levels can also be expected in primary schools in the future, as levels of late uptake are insufficient to compensate. Predicted figures for “final” MMR1 uptake are under the herd immunity threshold and campaigns may be required to increase uptake among future primary school children.
TL;DR: Reducing measles mortality in Niger will require wide-age-range vaccination campaigns, improvement in routine immunization services, and periodic "follow-up" campaigns.
Abstract: Background. The World Health Organization (WHO) estimates that the case-fatality rate (CFR) for measles in West Africa is 4%–6%. In Niger, 50,138 measles cases and 201 deaths (CFR, 0.4%) were reported in 2003. We conducted an investigation to determine the epidemiology and the true CFR of measles in the Mirriah district in Niger. Methods. Twenty-two villages from the Mirriah district that reported measles cases in 2003 were included in the investigation. A comprehensive household search for measles cases and deaths was conducted, and serum samples from 12 villages were collected for laboratory confirmation. A measles case was defined as illness characterized by fever, rash, and either cough, coryza, or conjunctivitis, with rash onset during the period from 1 January 2003 to 15 April 2003. Deaths occurring within 30 days after rash onset were attributed to measles unless they were obviously due to other causes. Results. Measles was confirmed serologically in all villages from which samples were collected. Of 945 case patients identified, 900 (95.2%) were aged !15 years, 114 (12.3%) were vaccinated, and 789 (83.5%) sought treatment at a health care facility. A total of 92 deaths were attributed to measles (CFR, 9.7%; 95% confidence interval, 7.9%–11.5%). The CFR was highest in infants aged !1 year (15.6%). Households with 2 case patients had a higher CFR (10.8%) than that of households with only 1 case patient (6.0%). Households consisting of 8 members had a CFR of 12.8%, whereas the CFR of smaller households was 7.1%. Conclusions. This investigation suggests that the measles CFR in the Mirriah district may be 2-fold higher than the WHO regional estimate and 20-fold higher than the estimate derived from routine surveillance. Reducing measles mortality in Niger will require wide-age-range vaccination campaigns, improvement in routine immunization services, and periodic “follow-up” campaigns. Measles continues to cause high morbidity and mortality
TL;DR: The uptake of the combined measles, mumps, and rubella (MMR) vaccine in the United Kingdom and Europe is reviewed, and susceptible groups are identified.
Abstract: Measles has reappeared in the United Kingdom, with 449 confirmed cases to the end of May 2006 compared with 77 in 2005, and the first death since 1992.12 Cases are occurring in inadequately vaccinated children and in young adults, leading to concerns that endemic measles could re-emerge. But, as with smallpox, measles could be eradicated. It has been eliminated in the Americas since 2002. The World Health Organization has set 2010 as the target for elimination in the European region, where 29 000 cases were reported in 2004.3 Much ground will have to be regained in the United Kingdom if the 2010 target is to be met.
We review the uptake of the combined measles, mumps, and rubella (MMR) vaccine in the United Kingdom and Europe, and identify susceptible groups. As clinical experience of measles has declined, doctors in the United Kingdom may not consider the diagnosis nor recognise a case. We also therefore consider the diagnosis, management, and control of measles infection.
Measles is caused by a single stranded RNA virus of the genus Morbillivirus from the paramyxovirus family.4 It is among the most contagious of diseases,5 with a basic reproductive number (R) of 15-20 (box 1).6 The virus remains transmissible in the air or on infected surfaces for up to two hours, obviating the need for direct person to person contact.57 Although genetic drift of the viral RNA is documented,4 measles has only one serotype, and both infection with wild type virus and appropriate immunisation confer longstanding immunity.7 Despite this, measles remains a leading cause of vaccine preventable death worldwide. In 2004 an estimated 454 000 deaths were due to measles.5 Mortality from measles is highest in children aged less than 12 months8 and in …
TL;DR: The proportion of 9-month-old infants who developed cellular and/or humoral immunity to measles was lower in the aerosol group but measles antibody and T cell responses were comparable among those who developed measles immunity.
TL;DR: In this article, the immune status of health care workers against measles, rubella, mumps, and varicella zoster (MMRV) in Turkey and to define an appropriate vaccination program among HCWs were investigated.
TL;DR: A seasonally-forced mathematical model provides the threshold condition for disease control in terms of four major parameters: coverage of the primary vaccine; efficacy of the vaccine; waning rate; and the rate of booster administration, and shows that if the vaccine provides only temporary immunity, then the infection typically cannot be eradicated by a single vaccination episode.
Abstract: Despite the effectiveness of vaccines in dramatically decreasing the number of new infectious cases and severity of illnesses, imperfect vaccines may not completely prevent infection. This is because the immunity afforded by these vaccines is not complete and may wane with time, leading to resurgence and epidemic outbreaks notwithstanding high levels of primary vaccination. To prevent an endemic spread of disease, and achieve eradication, several countries have introduced booster vaccination programs. The question of whether this strategy could eventually provide the conditions for global eradication is addressed here by developing a seasonally-forced mathematical model. The analysis of the model provides the threshold condition for disease control in terms of four major parameters: coverage of the primary vaccine; efficacy of the vaccine; waning rate; and the rate of booster administration. The results show that if the vaccine provides only temporary immunity, then the infection typically cannot be eradicated by a single vaccination episode. Furthermore, having a booster program does not necessarily guarantee the control of a disease, though the level of epidemicity may be reduced. In addition, these findings strongly suggest that the high coverage of primary vaccination remains crucial to the success of a booster strategy. Simulations using estimated parameters for measles illustrate model predictions.
TL;DR: Both studies provided evidence that HTMV per se was associated with low mortality and the sequence or combination of vaccinations may have an effect on sex-specific mortality patterns in low-income countries.
TL;DR: This study failed to substantiate reports of the persistence of measles virus in autistic children with development regression.
Abstract: Leukocyte preparations from children with documented evidence of MMR vaccination and confirmed diagnosis of autism were examined by several assays designed to target multiple regions of the measles virus genome sequence. No sample was found positive by any method. The assays applied were highly sensitive, specific and robust in nature, and were based on the amplification of measles virus RNA transcripts by real-time quantitative RT-PCR (QRT-PCR) as well as by conventional RT-PCR-nested PCR. The assays applied were potentially able to detect measles virus RNA down to single figure copy numbers per reaction. The amount of total nucleic acid extract of leukocytes subjected to various measles virus-specific investigations was several fold higher than minimally required of a sample where measles virus persistence is well documented. This study failed to substantiate reports of the persistence of measles virus in autistic children with development regression.
TL;DR: The immunity to common childhood exanthematic diseases such as varicella, rubella, mumps and measles was evaluated in 1024 students of the degree courses of health professions at Padua University Medical School and males older than 25 years were significantly more immune than younger ones.