Measles: is a new vaccine approach needed?

Melenotte, Cléa; Zandotti, Christine; Parola, Philippe; Raoult, Didier

doi:10.1016/s1473-3099(18)30543-7

Cited by 17 publications

(21 citation statements)

References 12 publications

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“…Combined with a decrease of the natural immunity of the population and waning antibody titers in vaccinated people, a low vaccination coverage generates immunity gaps in specific age groups, who remain susceptible to infection and can sustain transmission during outbreaks, as recently predicted by a modelling analysis [6]. Another factor that has been hypothesized to account for the current resurge of measles is the emergence of new viral strains characterized by increased transmissibility and escape from vaccine-induced immunity [7]. Actually, the recent and ongoing measles outbreaks have been mainly caused by two MeV genotypes, i.e., genotype D8, which has been circulating in Europe during the last decade, and a genotype B3 strain, which has been introduced in Europe more recently [8].…”

Section: Introductionmentioning

confidence: 99%

Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting

et al. 2019

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Despite efforts to improve surveillance and vaccination coverage, measles virus (MeV) continues to cause outbreaks also in high-income countries. As the reference laboratory of the Veneto Region, Italy, we analyzed changes in population immunity, described measles outbreaks, investigated MeV genetic diversity, and evaluated cross-protection of measles vaccination against MeV epidemic strains. Like most European areas, the Veneto Region has suboptimal measles vaccination coverage and is facing a growing public mistrust of vaccination. A progressive decline of measles vaccine uptake was observed during the last decade in the Veneto Region, leading to immunity gaps in children and young adults. Measles outbreaks were caused by the same MeV genotype B3, D4, and D8 strains that were circulating in other European countries. Eleven cases of measles were observed in immunized subjects. These cases were not associated with particular MeV genotypes nor with mutations in epitopes recognized by neutralizing antibodies. Accordingly, sera from fully vaccinated subjects cross-neutralized epidemic MeV strains, including the genotypes B3, D4, and D8, with the same high efficiency demonstrated against the vaccine strain. In fully vaccinated subjects, high MeV IgG antibody titers persisted up to 30 years following vaccination. These results support the use of the current measles-containing vaccines and strategies to strengthen vaccination.

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Section: Introductionmentioning

confidence: 99%

Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting

et al. 2019

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“…MeV eradication by vaccination is complicated by several biological and societal factors, including incomplete protection in the presence of maternal antibodies (4) and decreasing vaccination rates, often related to parental concerns over safety (5). These factors contribute to the recent resurgence of MeV infection in Europe and the United States (6).…”

mentioning

confidence: 99%

Measles Virus Bearing Measles Inclusion Body Encephalitis-Derived Fusion Protein Is Pathogenic after Infection via the Respiratory Route

Mathieu

Ferren

Jurgens

et al. 2019

J Virol

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A clinical isolate of measles virus (MeV) bearing a single amino acid alteration in the viral fusion protein (F; L454W) was previously identified in two patients with lethal sequelae of MeV central nervous system (CNS) infection. The mutation dysregulated the viral fusion machinery so that the mutated F protein mediated cell fusion in the absence of known MeV cellular receptors. While this virus could feasibly have arisen via intrahost evolution of the wild-type (wt) virus, it was recently shown that the same mutation emerged under the selective pressure of small-molecule antiviral treatment. Under these conditions, a potentially neuropathogenic variant emerged outside the CNS. While CNS adaptation of MeV was thought to generate viruses that are less fit for interhost spread, we show that two animal models can be readily infected with CNS-adapted MeV via the respiratory route. Despite bearing a fusion protein that is less stable at 37°C than the wt MeV F, this virus infects and replicates in cotton rat lung tissue more efficiently than the wt virus and is lethal in a suckling mouse model of MeV encephalitis even with a lower inoculum. Thus, either during lethal MeV CNS infection or during antiviral treatment in vitro, neuropathogenic MeV can emerge, can infect new hosts via the respiratory route, and is more pathogenic (at least in these animal models) than wt MeV. IMPORTANCE Measles virus (MeV) infection can be severe in immunocompromised individuals and lead to complications, including measles inclusion body encephalitis (MIBE). In some cases, MeV persistence and subacute sclerosing panencephalitis (SSPE) occur even in the face of an intact immune response. While they are relatively rare complications of MeV infection, MIBE and SSPE are lethal. This work addresses the hypothesis that despite a dysregulated viral fusion complex, central nervous system (CNS)-adapted measles virus can spread outside the CNS within an infected host.

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“…More to the point, the surveillance system must also improve in tracking vaccination through encouraging families to hold onto home-based records [15]. This is to be bolstered by routine re-vaccination of high-risk individuals including health-care workers and contacts of measles cases in a strategy similar to the ring vaccination adopted in eradicating other viruses like the Pox virus; this would help limit the dissemination of the virus and lead to eventual elimination [19].…”

Section: Recommendations For Measles Preventionmentioning

confidence: 99%

Measles and Mumps Outbreaks in Lebanon : Trends and Links

Kassir

Bizri

Kassir

et al. 2020

Preprint

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Background: Lebanon has experienced several measles and mumps outbreaks in the past twenty years. In this article, a case-based surveillance of both measles and mumps outbreaks in Lebanon was carried out in an attempt to outline factors contributing to the failure of elimination plans and to provide potential solutions. The relationship between the outbreaks of both diseases was described and explored. Methods: A retrospective descriptive study of confirmed cases of measles and mumps in Lebanon between 2003 and 2018 collected from the Lebanese Ministry of Public Health Epidemiological Surveillance Unit public database was carried out. The information collected was graphically represented taking into consideration dates of reported cases, age groups affected, and vaccination status. Results: The mean number of measles cases was 150.25 cases/year in the 1-4 years age group, 87 cases/year in individuals aging between 5 and 14, and 63.68 cases/year in those > 14 years old. In the latter group, only 18.05% were unvaccinated. The mean number of mumps cases was 30.4 cases/year in the <4 year age group and 53.8 cases/year in the 10-19 years age group. During the study period, every spike in measles cases was followed by a similar spike in mumps. 9.66% of measles cases occurred in individuals who received at least 2 doses of the vaccine, 52.26% in the unvaccinated, and 38% in those whose vaccination status was undetermined. Conclusions: Measles in Lebanon is a disease of the pediatric population, but adults remain at risk. Outbreaks of mumps followed those of measles and were mainly among adolescents. Presence of a large number of Syrian refugees in the country may further complicate the situation. Vaccination activities need to be intensified.

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Measles: is a new vaccine approach needed?

Cited by 17 publications

References 12 publications

Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting

Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting

Measles Virus Bearing Measles Inclusion Body Encephalitis-Derived Fusion Protein Is Pathogenic after Infection via the Respiratory Route

Measles and Mumps Outbreaks in Lebanon : Trends and Links

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