Vaccinated Children Get Milder Measles Infection: A Community Study from Guinea-Bissau

Aaby, Péter; Bukh, Jette; Leerhøy, Jørgen; Lisse, Ida Maria; Mordhorst, Carl H.; Pedersen, Ib Rode

doi:10.1093/infdis/154.5.858

Cited by 87 publications

(51 citation statements)

References 17 publications

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“…Therefore, interpretation of our data should take into account these limitations which are consequences of the passive surveillance system. However, we believe that the information obtained by the MOIF were reasonably reliable because our results agreed well with previous findings in terms of age distribution, the negative association of vaccination history with symptoms, and seasonal trend [14][15][16].…”

Section: Epidemiologysupporting

confidence: 90%

“…Our figure of 68n6 % for the 12-23 months age group would suggest the necessity for further investigations such as a cohort or case-control study to confirm the low measles VE in Malawi. Table 2 shows that vaccinated measles cases were less likely to develop cough, diarrhoea or pneumonia, which is consistent with the evidence that vaccinated children experience milder measles infections [15].…”

Section: Misdiagnosissupporting

confidence: 82%

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Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

et al. 2002

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SUMMARYMeasles surveillance data in Blantyre, Malawi were reviewed for 1996-8 to describe the epidemiology of infection and to estimate vaccine efficacy (VE) by the screening method. A total of 674 measles cases were reported to the Blantyre District Health Office during this period. Age distribution showed that 108 (16n1 %) of the cases were aged less than 1 year. The median age was 5 years. Eighty percent of the cases between 1 and 19 years had been previously vaccinated. VE was 68n6 % (95 % CI, 52n7-79n2) for children 12-23 months of age and 67n3 % (95 % CI, 48n3-79n3) for infants 9-11 months of age. Reasons for this low vaccine efficacy are discussed. Previous vaccination history was negatively associated with the risk for developing cough during measles infection (odds ratio (OR), 0n30 ; 95 % CI, 0n09-0n91), diarrhoea (OR, 0n64 ; CI, 0n44-0n95) and pneumonia (OR, 0n40 ; CI, 0n25-0n62). Logistic regression analysis showed that pneumonia in adults was negatively associated with vaccination history. The passive surveillance system for measles in Malawi was useful to describe the epidemiology of measles.

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Section: Epidemiologysupporting

confidence: 90%

Section: Misdiagnosissupporting

confidence: 82%

Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

et al. 2002

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“…Aaby et al [1986] demonstrated that previously vaccinated persons who develop classic measles infection are less contagious than unvaccinated persons with classic measles. It is possible that measles-infected persons with mild or no symptoms are even less likely to transmit measles; these persons may have better immunity prior to infection and a shorter duration of infection than previously vaccinated persons who develop classic measles.…”

Section: Discussionmentioning

confidence: 99%

Nonclassic measles infections in an immune population exposed to measles during a college bus trip

et al. 1998

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This study investigated the frequency of mild or asymptomatic measles infections among 44 persons exposed to a student with measles during a 3-day bus trip using two buses. Questionnaires and serum samples were obtained 26-37 days after the trip. All participants had detectable measles-neutralizing antibodies, and none developed classic measles symptoms. Ten persons (23%) were IgM positive for measles, indicating recent infection. Among previously vaccinated IgM-negative persons, those who rode on bus A with the index case-patient had significantly higher microneutralization titers than those on bus B (P= .001), suggesting that some persons on bus A were infected but were IgM negative at the time of the study. Mild or asymptomatic measles infections are probably very common among measles-immune persons exposed to measles cases and may be the most common manifestation of measles during outbreaks in highly immune populations.

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“…It has been recognized that clinical criteria cannot be used alone to rule out measles infection 6 . However, if measles virus transmission had been occurring, unvaccinated individuals and a small proportion of vaccinated individuals would have been expected to develop classical measles symptoms 21,23 . While individuals with asymptomatic or vaccine-modified measles may be less likely to infect others 24,25 , their role in sustaining low levels of measles virus transmission is unclear 21,26,27 .…”

Section: Discussionmentioning

confidence: 99%

Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004

Ciccone

Carvalhanas

Afonso

et al. 2010

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: To review measles IgM-positive cases of febrile rash illnesses in the State of São Paulo, Brazil, over the five-year period following interruption of measles virus transmission. METHODS: We reviewed 463 measles IgM-positive cases of febrile rash illness in the State of São Paulo, from 2000 to 2004. Individuals vaccinated against measles < 56 days prior to specimen collection were considered to be exposed to the vaccine. Serum from the acute and convalescent phases was tested for evidence of measles, rubella, parvovirus B19 and human herpes virus-6 infection. In the absence of seroconversion to measles immunoglobulin-G, measles IgM-positive cases were considered false positives in individuals with evidence of other viral infections. RESULTS: Among the 463 individuals with febrile rash illness who tested positive for measles IgM antibodies during the period, 297 (64%) were classified as exposed to the vaccine. Among the 166 cases that were not exposed to the vaccine, 109 (66%) were considered false positives based on the absence of seroconversion, among which 21 (13%) had evidence of rubella virus infection, 49 (30%) parvovirus B19 and 28 (17%) human herpes virus-6 infection. CONCLUSIONS: Following the interruption of measles virus transmission, thorough investigation of measles IgM-positive cases is required, especially among cases not exposed to the vaccine. Laboratory testing for etiologies of febrile rash illness aids interpretation of these cases.

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Vaccinated Children Get Milder Measles Infection: A Community Study from Guinea-Bissau

Cited by 87 publications

References 17 publications

Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

Nonclassic measles infections in an immune population exposed to measles during a college bus trip

Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004

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