Subclinical measles infection in vaccinated seropositive individuals in arctic Greenland

Pedersen, Ib Rode; Mordhorst, C.H.; Glikmann, Graciela; Magnus, H. Von

doi:10.1016/0264-410x(89)90199-0

Cited by 48 publications

(34 citation statements)

References 4 publications

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“…These results are in agreement with previous observations (15,19,37) showing that vaccination-induced MV antibodies decline with time in the absence of natural booster infections or a second dose of vaccine. This indicates that a single-dose strategy at an early age results in IgG levels that vanish in adolescence, making this group at high risk of acquiring a milder or subclinical form of the infection (36,45). Although revaccination is advisable for all of those individuals, it should be taken into account that priming of T-cell immunity may have resulted because of vaccination, but very little neutralizing antibody could have been made (21).…”

Section: Discussionmentioning

confidence: 99%

Measles Virus-Specific Antibody Levels in Individuals in Argentina Who Received a One-Dose Vaccine

et al. 2006

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In spite of active measles virus (MV) vaccination strategies, reemergence continues to occur, impairing global eradication programs. The immune status against measles was evaluated in 350 vaccinated healthy Argentine children and teenagers who received a single dose of the MV Schwarz strain Lirugen vaccine (Aventis Pasteur). Sera were assessed for immunoglobulin G (IgG) antibodies by a commercial enzyme immunoassay (EIA) (Enzygnost; Behring), an in-house EIA, and neutralization EIA. Results obtained with these methods showed a marked decline in IgG level with increasing age. At 1 to 4 years of age, 84% of children had IgG antibodies above 200 mIU/ml, conventionally accepted as protective levels, whereas only 32% of older children and teenagers had antibody levels exceeding 200 mIU/ml. Moreover, the MV IgG content in the teenage group was significantly lower than the IgG antibody level of the group of younger children (P < 0.0001). In contrast, screening for IgG antibody levels to inactivated tetanus vaccine showed that, on average, 80% of this population was fully protected and that this high level of protection remained through the teenage years. This study suggests that within this population a considerable proportion of individuals had low measles antibody levels that may be insufficient to protect against reinfections or clinical disease.In the early 1960s, the advent of a live attenuated measles virus (MV) vaccine dramatically reduced the incidence of measles in many parts of the world, including developed (12,16,20,29,30,35,49,52) and developing (28, 58) countries. In some developing countries, fatality rates for measles can still be as high as 15%, causing about 770,000 annual deaths among infants and children, and this is probably due to lack of vaccination of many individuals in the population.Elimination of MV requires the continued commitment to increase vaccination coverage levels, the genetic analysis of circulating strains, and serosurveys of vaccinated individuals to establish the population at risk of contracting the infection. In this context, it is very important that reliable and sensitive laboratory methods are used to accurately determine the antibody level and protection achieved after vaccination and the level of antibodies that persists in those who were previously vaccinated.Despite active vaccination strategies, reemergence or resurgence of MV continues to occur, impairing elimination programs. The occurrence of several measles outbreaks in highly immunized populations (5, 34, 40, 51) has focused attention on vaccine efficacy and the durability of vaccine-induced immunity. It is likely that many factors contribute to the presence of susceptible individuals among highly vaccinated populations. These include failure to seroconvert and decline of immunity with time after vaccination (19, 37). Other important factors that might influence the immune response comprise the age at the time of vaccination (27, 33), the number of doses, and the strain included in the vaccine (18,23,28).High vacci...

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Section: Discussionmentioning

confidence: 99%

Measles Virus-Specific Antibody Levels in Individuals in Argentina Who Received a One-Dose Vaccine

et al. 2006

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“…However, one study from the USA suggests that many vaccinees with antibody levels below 200 mIU/ml are likely to experience a subclinical boost in antibody titre on exposure to measles [10]. Furthermore, serological evidence from Greenland suggests that persons infected subclinically may transmit measles virus [16].…”

Section: Discussionmentioning

confidence: 99%

Measles immunity and response to revaccination among secondary school children in Cumbria

Calvert¹,

Cutts

Irving³

et al. 1996

Epidemiol. Infect.

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SUMMARYThe prevalence of antibody to measles virus in 759 children aged 11-18 years attending a secondary school in Cumbria was measured using a salivary IgG antibody capture assay. Serum IgG antibody levels were measured using a plaque reduction neutralization assay in subjects whose saliva was antibody negative. Vaccination histories were obtained from the child health computer and general practice records. A total of 662 pupils (87 % of those tested) had detectable measles-specific IgG in saliva. Of the remaining 97, 82 provided blood samples and 29 had serum neutralizing antibody levels above 200 mIU/ml. After adjusting for non-participation rates, the proportion considered non-immune (no IgG in saliva and < 200 mIU/ml in serum) was 9 % overall, ranging from 6% in vaccinated children to 20% in unvaccinated children. Measles-mumps-rubella vaccine was given to 50 children of whom 38 provided post-vaccination serum and 32 saliva samples. Thirty (79 %) had a fourfold or greater rise in serum neutralizing antibody and 28 (88 %) developed IgG antibody in saliva. Half of the children considered non-immune by antibody testing would have been overlooked in a selective vaccination programme targeted at those without a history of prior vaccination. A programme targeted at all school children should substantially reduce the proportion nonimmune since a primary or booster response was achieved in three quarters of previously vaccinated children with low antibody levels and in all unvaccinated children. While it is feasible to screen a school-sized population for immunity to measles relatively quickly using a salivary IgG assay, a simple inexpensive field assay would need to be developed before salivary screening and selective vaccination could substitute for universal vaccination of populations at risk of measles outbreaks. The salivary IgG assay provided a sensitive measure of a booster response to vaccination.

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“…The worldwide emergence of large-scale measles epidemics in many developed countries during 1988-91 is alarming. New findings have changed our understandings of measles, including the occurrence of subclinical infection [14,38,39] at immunized individuals may transmit the virus [38][39][40], the lack of life-long immunity in certain individuals [41][42], the genetic variability of the virus [43] and the significance of air-borne transmission [44][45][46]. Future measles control, in Taiwan and globally, should include: (1) increasing the timeliness and completeness of surveillance, (2) prospective immunological evaluation of vaccinees, (3) reassessment of the roles of immunized and asymptomatic individuals in the dynamics of transmission, and (4) utilization of local seroepidemiological data as well as residual maternal antibody levels for optimizing age and doses of immunization programmes.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

et al. 1995

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SUMMARYWe analysed nation-wide reported measles cases during the 1988-9 epidemic and found that longer duration and wider spread were two major characteristics of the outbreak. All the 22 county/city index cases were reported with a delay of > 4 days and 64% were aged 5-14 years. This epidemic occurred mainly among 5-14-year-old school-children (59 % ), infants under 1 year (19%), and pre-school children ( 18 %). The overall attack rate was 0-63 cases per 10000 population, with the highest attack rate (7 4 cases per 10000 population) occurring in infants. Among 280 confirmed cases < 15 months of age, 9-month-old infants (42 cases) had a higher risk of measles and peaked at 10 months (49 cases). This epidemic started in March 1988 among 5-9-year-old children in the northern suburban area, then spread to Taipei City and neighbouring counties or cities. It continued to spread from the northern to southern and western areas during the summer vacation and New Year holidays. Multiple logistic regression analysis showed that the delay of measles reporting was strongly associated with the cases infected early in the epidemic (OR = 6-9, P < 0.001) and reported from teaching hospitals (OR = 2 6, P < 0-001). The reappearance of high attack rates among 5-9-year-old children in the 1985 and 1988-9 measles epidemics in Taiwan indicated the persistence of pockets of susceptible individuals even after mass immunization.

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Subclinical measles infection in vaccinated seropositive individuals in arctic Greenland

Cited by 48 publications

References 4 publications

Measles Virus-Specific Antibody Levels in Individuals in Argentina Who Received a One-Dose Vaccine

Measles Virus-Specific Antibody Levels in Individuals in Argentina Who Received a One-Dose Vaccine

Measles immunity and response to revaccination among secondary school children in Cumbria

Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

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