Modified Measles

Abstract

A 35-year-old man, who received a measles vaccination at 2 years of age, developed a 38.5 fever 2 days after displaying catarrhal symptoms, and milia-like papules of approximately 1-mm in size extending from the face to the trunk and extremities. However, no fused papules were found (Picture 1-3). Koplik's spot was not observed in the oral mucosa. The EIA method, revealed that the patient's measles-IgM antibody titer was 1:9.26, and his measles-IgG antibody titer was 1:128 or lower. A measles RT-PCR showed the presence of measles RNA in throat swab specimens, the further sequencing of the PCR products revealed the measles B3 genotype. We therefore diagnosed the patient with modified measles.Modified measles is difficult to diagnose because of the absence of typical symptoms during outbreaks (1); however, measles is highly infectious, and should be rapidly diagnosed. The authors state that they have no Conflict of Interest (COI). Reference1. Nakajima N, Ueda M, Yamazaki M, Takahashi T, Katayama Y.Optic neuritis following aseptic meningitis associated with modified measles: a case report. Jpn J Infect Dis 66: 320-322, 2013.

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

“…The latter usually occurs during outbreaks in intense contact settings, and these cases may be partially protected from disease, often have a milder presentation, and may be difficult to diagnose. 38 , 39 Their ability to transmit virus, however, is thought to be greatly diminished, as subsequent spread of measles from a person with prior immunity has rarely been documented. 38 , 40 , 41 Because primary versus secondary vaccine failure cases cannot be readily distinguished without specialized testing and cases with a past immunologic response to measles might be contagious, 38 any person with confirmed measles, regardless of vaccination status, is recommended to be isolated for the duration of the infectious period.…”