Severe Measles in Immunocompromised Patients

Kaplan, Leonard J.

doi:10.1001/jama.1992.03480090085032

Cited by 285 publications

(110 citation statements)

References 46 publications

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“…Such studies should be conducted in children from measles-endemic areas who are at high risk of developing severe measles, 28 and could be extended to include other groups of immunocompromized children. 29 In conclusion, our study supports the vaccination of children irrespective of nutritional or HIV-infection status. However, further studies are recommended to investigate HIV-infected children and those with undetectable or low levels of measles antibody in order to assess clinical protection and the need for re-vaccination.…”

Section: Discussionsupporting

confidence: 74%

Serum levels of measles IgG antibody activity in children under 5 years in Dar-es-Salaam, Tanzania

Lyamuya

Matee

Aaby

et al. 1999

Annals of Tropical Paediatrics

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Measles IgG antibody levels were estimated in sera from 685 Tanzanian children, 374 (54.6%) boys and 311 (45.4%) girls aged 18 months to 5 years, using an enzyme-linked immunosorbent assay (ELISA). The children were screened for HIV-1 and 2 antibodies using ELISA, and reactive sera were confirmed by Western blot. Nutritional status was assessed by anthropometry. Overall measles vaccination coverage was 98.8%. Measles antibody activity was not detected in 41 (6.0%) children, and ten (1.5%) had antibody levels below 200 mIU/ml, the cut-off level considered to be protective. The non-reactive samples were from one unvaccinated child, one child with unknown vaccination status and 39 vaccinated children. Measles IgG antibody levels were higher in girls (3452.1 mIU/ml) than in boys (2928.2 mIU/ml) (p = 0.02). Higher mean levels were found in children with a history of low birthweight (< 2.5 kg) (p = 0.03). There were no significant differences in measles antibody levels with regard to variations in nutritional status. No correlation (r2 = 0.002) was found between antibody levels and time elapsed since vaccination. In a multivariable logistic regression analysis, children who were HIV-seropositive (n = 9) were more likely to have non-protective antibody levels < 200 mIU/ml (OR = 5.85; 95% CI: 1.37-24.93).

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Section: Discussionsupporting

confidence: 74%

Serum levels of measles IgG antibody activity in children under 5 years in Dar-es-Salaam, Tanzania

Lyamuya

Matee

Aaby

et al. 1999

Annals of Tropical Paediatrics

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“…Because the infection was proved to be from the vaccine virus, measles vaccine is no longer recommended for HIV-infected children who have developed AIDS or evidence of severe immunosuppression [404]. Immunocompromised children with underlying malignant diseases who have not been immunized are also at risk for developing severe and fatal measles [433][434][435].…”

Section: Complications and Mortalitymentioning

confidence: 99%

Chickenpox, Measles, and Mumps

Gershon¹

2011

Infectious Diseases of the Fetus and Newborn

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“…Le virus n'est retrouvé qu'au niveau du cerveau. Chez les patients fortement immunodéprimés, la rougeole peut également induire une maladie très grave, associant une pneumonie et une encéphalite aiguë progressive ; l'éruption manque dans 25 à 40 % des cas [14]. Dans cette épidémie actuelle, existe-t-il d'autres formes cliniques de rougeole ?…”

Section: Rougeole Dans L'épidémie Actuelleunclassified

Une maladie qui revient: la rougeole

Freymuth¹,

Dina²,

Mourez³

et al. 2011

Réanimation

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Après la diminution spectaculaire de la rougeole grâce à la vaccination, celle-ci est réapparue en 2008, où 604 cas ont été déclarés à l'Institut de veille sanitaire (InVS), puis 1 482 cas en 2009 et plus de 4 500 cas en 2010 (données provisoires au 5 janvier 2011). Le nombre de virus identifiés au Centre national de référence (CNR) a suivi une évolution parallèle. Cette épidémie est caractérisée par une atteinte plus spécifique des petits nourrissons : 4 % en 2008 et 9 % en 2010, et des sujets âgés de 20 ans ou plus : 17 % en 2008 et 38 % en 2010. La majorité des cas (82 %) survient évidemment chez des sujets non vaccinés contre la rougeole. Le nombre de cas hospitalisés a augmenté, passant de 18 % en 2008 à 34 % en 2010. Le virus de l'épidémie est de génotype D4. Il apparaît en 2008, puis s'étend en 2009 et représente 98,8 % des souches en 2010. La souche épidémique est identique au virus détecté dans un petit foyer de rougeole en Vendée au dernier trimestre 2008 : MVs/Montaigu.FRA/43.08 (D4). Le diagnostic moléculaire à partir d'un prélèvement nasopharyngé ou salivaire constitue l'approche la plus pré-coce, sensible et spécifique pour identifier une rougeole. Il permet aussi de connaître le génotype du virus. Pour citer cette revue : Réanimation 20 (2011). Mots clés Rougeole · Épidémie · Génotype D4Abstract After the tremendous decrease of measles due to vaccination, it reappeared in 2008, with 604 cases reported at the Institut de veille sanitaire (InVS), 1,482 cases reported in 2009, and more than 4,500 cases reported in 2010 (provisional data). The measles virus (MeV) was detected in parallel at the Centre national de référence (CNR). This outbreak was characterized by a specific attack among infants (4% in 2008 versus 9% in 2010) and young adults (17% in 2008 versus 38% in 2010). Most of the cases (82%) occurred in nonvaccinated persons. The number of hospitalized cases increased from 18% in 2008 to 34% in 2010. MeV genotype during this outbreak was D4. It appeared in 2008, spread in 2009, and represented 98.8% of the strains in 2010. The epidemiological MeV strain is identical to the one called MVs/Montaigu.FRA/43.08(D4) that caused a small outbreak of measles in the Vendee region during the last trimester of 2008. Molecular diagnosis from a nasopharyngeal or salivary sample is an early, sensitive, and specific way to prove measles in patients, allowing the identification of MeV genotypes as well. To cite this journal: Réanimation 20 (2011).

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Severe Measles in Immunocompromised Patients

Abstract: Measles is a severe illness in immunocompromised patients, and the absence of rash is frequent. While treatment is supportive, ribavirin requires further study. Measles vaccine may be efficacious in HIV-infected patients. Vaccination of oncology patients should be reassessed.

Cited by 285 publications

References 46 publications

Serum levels of measles IgG antibody activity in children under 5 years in Dar-es-Salaam, Tanzania

Serum levels of measles IgG antibody activity in children under 5 years in Dar-es-Salaam, Tanzania

Chickenpox, Measles, and Mumps

Une maladie qui revient: la rougeole

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