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Washam MC, Leber AL, Oyeniran SJ, Everhart K, Wang H. Shedding of measles vaccine RNA in children after receiving measles, mumps and rubella vaccination. J Clin Virol 2024; 173:105696. [PMID: 38823291 DOI: 10.1016/j.jcv.2024.105696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Measles, mumps, and rubella(MMR) vaccination is critical to measles outbreak responses. However, vaccine reactions and detection of measles vaccine RNA in recently immunized persons may complicate case classification especially in those presenting with another respiratory viral illness. We aim to characterize cases of measles vaccine shedding in recently vaccinated children presenting with respiratory viral symptoms. METHODS Children who were tested with a multiplex respiratory panel <30 days after receiving MMR were identified. Remnant nasopharyngeal(NP) samples were tested for measles vaccine by PCR. Medical records were reviewed for demographics, presenting symptoms, and test results. RESULTS From January 2022 to March 2023, 127 NP from children who received MMR were tested. Ninety-six NP were collected after the first dose, of which 33(34.4 %) were positive for vaccine RNA. The median interval between MMR and detection was 11.0 days. Thirty-one NP were collected after the second MMR and 1(3.2 %) was positive; time between the vaccination and detection was 18.9 days. Median cycle threshold(Ct) value of the measles PCR for vaccine shedding was significantly higher than median Ct in children with wild-type infection. CONCLUSION Shedding of measles vaccine RNA is not uncommon and vaccine RNA can be detected up to 29 days post MMR; the amount of vaccine RNA shedding is low indicated by high Ct values. Clinicians and public health officials should consider performing measles vaccine testing on those testing positive for measles within one month of MMR vaccination, especially if the Ct value is high and definitive epidemiological links are absent.
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Affiliation(s)
- Matthew C Washam
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
| | - Amy L Leber
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA; Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Sophonie J Oyeniran
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Kathy Everhart
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Huanyu Wang
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pathology, The Ohio State University, Columbus, Ohio, USA.
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Kurata T, Kaida Y, Kanbayashi D, Motomura K. Achieving measles elimination and emerging modified measles: Longitudinal measles epidemiology from 1982 to 2021 in Osaka Prefecture, Japan. Vaccine 2024; 42:271-286. [PMID: 38097458 DOI: 10.1016/j.vaccine.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND Measles is a contagious viral disease causing infant mortality in developing countries without vaccination programs. In Japan, measles vaccination was launched in 1978, surveillance commenced in 1981, and elimination was achieved in 2015. This was due to improved, legally required surveillance methods and vaccine programs. METHODS The data sets of sentinel (1982-2007) and notifiable (2008-2021) disease surveillance, as well as the vaccination coverage, detected genotypes, and seroepidemiology during the study period in Osaka Prefecture, were analyzed. Additionally, the trend under the current notifiable surveillance was compared before (2008-2014) and after (2015-2021) measles elimination. RESULTS Under sentinel surveillance, 51,107 cases were reported, predominantly infants aged 1-4 years (63.6 %). Under notifiable disease surveillance, the 781 patients were predominantly in their 20s-30s (43.7 %). From 2000, the age of the major susceptible group increased due to the rise in vaccination coverage, which exceeded 95% for the first dose in 1998 and 90% for the second dose in 2009. Consistent with these data, seroprevalence exceeded 95% in 2011. However, the geometric mean of the antibody titer showed a decreasing trend with a falling number of patients. Compared with before and after measles elimination, the number of modified measles cases increased from 10.1% to 48.2%. During the study period, 398 strains comprising eight genotypes were identified, and the dominant type changed over time. After measles elimination, genotypes B3 and D8, derived from imported cases, became predominant. CONCLUSIONS Improved vaccination coverage and surveillance reduced measles cases and increased herd immunity. However, the lack of a booster effect due to the low incidence of measles caused waning antibody titers despite high seroprevalence, which may contribute to the rising rate of vaccine failures causing modified measles. Careful monitoring of measles incidence and herd immunity are necessary for measles eradication.
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Affiliation(s)
- Takako Kurata
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Yuko Kaida
- Fujiidera Public Health Center, Inspection Division, Fujiidera 1-8-36, Fujiidera-shi, Osaka 583-0024, Japan.
| | - Daiki Kanbayashi
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Kazushi Motomura
- Osaka Institute of Public Health, Division of Public Health, Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
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de Oliveira MI, Aciole MR, Neves PAF, Silva VPOE, Silva MPOE, de Lorena VMB, de Araújo PSR. A stronger antibody response in increased disease severity of SARS-CoV-2. BMC Infect Dis 2024; 24:17. [PMID: 38166763 PMCID: PMC10762998 DOI: 10.1186/s12879-023-08923-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND An assessment of the factors that interfere with serum levels and the persistence of anti-SARs-CoV-2 IgG antibodies is essential in order to estimate the risk of reinfection and to plan vaccination. We analyzed the impact of the severity of coronavirus disease 2019 (COVID-19) and the clinical and biological factors regarding the persistence of SARs-CoV-2 anti-spike protein (IgG-S) antibodies at 12 months. METHODS This was an observational, longitudinal study with individuals who had recovered from COVID-19 between August 2020 and June 2021. Peripheral blood samples were collected from volunteers who were hospitalized (SERIOUS COVID-19) and those who required no hospitalization (COVID-19 LIGHT). Samples were grouped according to days after symptom onset: up to 90, between 91 and 180, ≥ 180 days after symptom onset. A semiquantitative test for IgG anti-spike protein S1(IgG-S1) was used. RESULTS We analyzed 238 individuals who had recovered from COVID-19, of whom 87 had been hospitalized and 151 had not. They provided 148 and 220 samples, respectively. Among those hospitalized, males (65.5%), volunteers aged over 60 years (41.1%), comorbidities such as arterial hypertension (67.8%) and diabetes mellitus (37.9%) were most frequent. We observed higher median serum IgG-S1 titers among those who had recovered from COVID-19 and had been hospitalized, at all collection time intervals (p < 0.001). We observed a weak correlation of increasing age with humoral IgG-S1 response (Spearman correlation = 0.298). There was a greater probability of IgG-S1 antibody persistence over time among samples from hospitalized individuals compared to samples from non-hospitalized participants (p = 0.001). CONCLUSION This study has revealed higher titers and a higher probability of the persistence of IgG-S1 in severe cases after SARs-CoV-2 primary infection in unvaccinated recovered patients. Thus, in this study, the severe clinical presentation of COVID-19 was the main factor influencing serum levels and the persistence of IgG-S1 antibodies in COVID-19.
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Affiliation(s)
- Marta Iglis de Oliveira
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Infectious Diseases, Hospital das Clínicas, Brazilian Company of Hospital Services (EBSERH), Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Melayne Rocha Aciole
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Patrícia Areias Feitosa Neves
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | - Virginia Maria Barros de Lorena
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Fiocruz-PE, Recife, Pernambuco, Brazil
| | - Paulo Sérgio Ramos de Araújo
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
- Department of Parasitology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Fiocruz-PE, Recife, Pernambuco, Brazil.
- Department of Infectious Diseases, Hospital das Clínicas, Brazilian Company of Hospital Services (EBSERH), Federal University of Pernambuco, Recife, Pernambuco, Brazil.
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Charlton CL, Bailey ANM, Thompson LA, Kanji JN, Marshall NC. What's in a number? The value of titers as routine proof of immunity for medical students. Vaccine 2023; 41:2734-2738. [PMID: 36948982 DOI: 10.1016/j.vaccine.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/24/2023] [Accepted: 03/05/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES To assess the guideline concordance of medical school requirements for students' proof-of-immunity in the United States (US) and Canada. METHODS National guidelines for healthcare worker proof-of-immunity to measles, mumps, rubella, and varicella were compared to admission requirements for 62 US and 17 Canadian medical schools. RESULTS All surveyed schools accepted at least one recommended form of proof-of-immunity, however, contrary to national guidelines, 16% of surveyed US schools asked for a serologic titer, and only 73-79% US schools accepted vaccination as the sole proof-of-immunity. CONCLUSIONS The requirement of numerical, non-standardized serologic testing highlights an oversight in medical school admissions documentation. The requirement for quantitative values to demonstrate immunity is not practical from a laboratory standpoint, and is not needed to show individual immunity to these vaccine-preventable diseases. Until a more standardized process is adopted, laboratories will need to provide clear documentation and direction for quantitative titer requests.
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Affiliation(s)
- Carmen L Charlton
- Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Precision Laboratories - Public Health, AB, Canada; Li Ka Shing Institute of Virology, Edmonton, AB, Canada; Women and Children's Health Research Institute, Edmonton, AB, Canada.
| | - Ashley-Nicole M Bailey
- Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada
| | - L Alexa Thompson
- Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada; Women and Children's Health Research Institute, Edmonton, AB, Canada
| | - Jamil N Kanji
- Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Precision Laboratories - Public Health, AB, Canada; Division of Infectious Diseases, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Section of Medical Microbiology, Department of Pathology & Laboratory Medicine, Cumming School of Medicine, Calgary, AB, Canada
| | - Natalie C Marshall
- Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Precision Laboratories - Public Health, AB, Canada
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González-Praetorius A, Fernández-García A, Pérez-Olmeda M, García-Rivera MV, Caballero-López B, Gilaberte-Reyzabal S, Román-Marcos E, Ory-Machón FD, Echevarría-Mayo JE. Measles outbreak in the sanitary area of Guadalajara (Spain): difficulty in microbiological diagnosis in the era of its elimination. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:532-538. [PMID: 35811250 DOI: 10.1016/j.eimce.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION In Spain, like in other countries where endemic measles has been eliminated, there is a need for available diagnostic tolos for confirming any cases in order to prevent and control its transmission. We describe the different microbiological tests used for the diagnosis of measles during an outbreak that occurred in 2019 in the province of Guadalajara (Spain). METHODS Serological and molecular tests were performed at the Microbiology laboratory of the Guadalajara University Hospital and at the National Center for Microbiology of the Carlos III Health Institute (Majadahonda, Spain). Patient data were obtained from the surveillance system. RESULTS A total of 43 patients had a laboratory diagnosis of measles: 29 cases by PCR (pharyngeal exudate or urine) and positive specific IgM, 11 cases by PCR, and 3 cases only by a positive IgM. Genotype D8 was identified in 35 confirmed cases and genotype A in two that were discarded as post-vaccination cases. PCR was positive in the acute sera of 11 out of 14 patients with a negative IgM. Eleven confirmed cases had recieved one or two vaccine doses. Twelve adult patients were hospitalizated, all of them with a diagnostic of hepatitis. CONCLUSIONS The combination of molecular tests and the presence of specific IgM is necessary for a correct diagnosis of measles and also to classify patients with a breakthrough infection or vaccine failures (primary or secondary). Genotyping is essential for the correct classification of the patients in the context of a measles elimination program.
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Affiliation(s)
| | - Aurora Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; Centro de Investigación, Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mayte Pérez-Olmeda
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - M Victoria García-Rivera
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, Spain
| | | | | | - Elena Román-Marcos
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, Spain
| | - Fernando de Ory-Machón
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; Centro de Investigación, Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Emilio Echevarría-Mayo
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; Centro de Investigación, Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Popović Dragonjić L, Jovanović M, Vrbić M, Nastić A, Djordjević M, Veljković M. The Occurrence of Acute Pancreatitis in Adult Patients during a Measles Outbreak from November 2017 to May 2018 in Southeastern Serbia. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111650. [PMID: 36422189 PMCID: PMC9692428 DOI: 10.3390/medicina58111650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Although it is believed that measles infections are under control, there is a global reappearance, and their treatment has become more complex as the disease is followed by a relatively high incidence of complications. This study, conducted on patients during a measles outbreak from November 2017 to May 2018, aims to evaluate a rarely reported complication of measles, acute morbilous pancreatitis (AMP), which has been reported in several cases to date. Materials and Methods: A total of 207 patients admitted and treated at the Clinic for Infectious Diseases, Clinical Center Nis, for measles infection were included in the analysis. The data collected from the patient's medical records included the demographic characteristics, disease duration, full blood, serum, and urine biochemical analysis, general measles-associated symptoms, and disease outcome. Results: According to the serum and urine amylase activity, and some clinical symptoms AMP were diagnosed in 14% (29/207) of the studied patients. These patients had significantly higher levels of ALT and vomited more frequently than the patients without AMP. Only slight differences in measles duration, changes in RBC count, and CRP levels were found between the males and females with AMP. Conclusions: Acute morbillous pancreatitis should not be underestimated as a complication, even though according to the results of our survey, it was not associated with a fatal outcome or disease severity as the course of it can be frequently rapid and fatal.
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Affiliation(s)
- Lidija Popović Dragonjić
- Department of Infectious Diseases and Epidemiology, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
- Clinic for Infectology, University Clinical Center Niš, 18000 Nis, Serbia
- Correspondence:
| | - Maja Jovanović
- Department of Infectious Diseases and Epidemiology, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
- Clinic for Infectology, University Clinical Center Niš, 18000 Nis, Serbia
| | - Miodrag Vrbić
- Department of Infectious Diseases and Epidemiology, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
- Clinic for Infectology, University Clinical Center Niš, 18000 Nis, Serbia
| | - Aleksandar Nastić
- Department of Mathematics, Faculty of Sciences and Mathematics, University of Niš, 18000 Nis, Serbia
| | - Miodrag Djordjević
- Department of Mathematics, Faculty of Sciences and Mathematics, University of Niš, 18000 Nis, Serbia
| | - Milica Veljković
- Department Physiology, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
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Hu S, Logan N, Coleman S, Evans C, Willett BJ, Hosie MJ. Correlating IgG Levels with Neutralising Antibody Levels to Indicate Clinical Protection in Healthcare Workers at Risk during a Measles Outbreak. Viruses 2022; 14:v14081716. [PMID: 36016338 PMCID: PMC9415042 DOI: 10.3390/v14081716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 02/01/2023] Open
Abstract
The rapid transmission of measles poses a great challenge for measles elimination. Thus, rapid testing is required to screen the health status in the population during measles outbreaks. A pseudotype-based virus neutralisation assay was used to measure neutralising antibody titres in serum samples collected from healthcare workers in Sheffield during the measles outbreak in 2016. Vesicular stomatitis virus (VSV) pseudotypes bearing the haemagglutinin and fusion glycoproteins of measles virus (MeV) and carrying a luciferase marker gene were prepared; the neutralising antibody titre was defined as the dilution resulting in 90% reduction in luciferase activity. Spearman’s correlation coefficients between IgG titres and neutralising antibody levels ranged from 0.40 to 0.55 (p < 0.05) or from 0.71 to 0.79 (p < 0.0001) when the IgG titres were obtained using different testing kits. In addition, the currently used vaccine was observed to cross-neutralise most circulating MeV genotypes. However, the percentage of individuals being “well-protected” was lower than 95%, the target rate of vaccination coverage to eliminate measles. These results demonstrate that the level of clinical protection against measles in individuals could be inferred by IgG titre, as long as a precise correlation has been established between IgG testing and neutralisation assay; moreover, maintaining a high vaccination coverage rate is still necessary for measles elimination.
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Affiliation(s)
- Siyuan Hu
- MRC-University of Glasgow Centre for Virus Research, Bearsden Road, Glasgow G61 1QH, UK
- Correspondence: (S.H.); (M.J.H.)
| | - Nicola Logan
- MRC-University of Glasgow Centre for Virus Research, Bearsden Road, Glasgow G61 1QH, UK
| | - Sarah Coleman
- Virology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | - Cariad Evans
- Virology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | - Brian J. Willett
- MRC-University of Glasgow Centre for Virus Research, Bearsden Road, Glasgow G61 1QH, UK
| | - Margaret J. Hosie
- MRC-University of Glasgow Centre for Virus Research, Bearsden Road, Glasgow G61 1QH, UK
- Correspondence: (S.H.); (M.J.H.)
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Sanz JC, Ramos B, Pérez-Olmeda M, Fernández-García A. Reply to "Modified measles outbreak in vaccinated healthcare workers exposed to primary measles case". ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:344-345. [PMID: 35491354 DOI: 10.1016/j.eimce.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Madrid, Spain; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Belén Ramos
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Madrid, Spain
| | - Mayte Pérez-Olmeda
- Laboratorio de Referencia e Investigación en Enfermedades Víricas Inmunoprevenibles, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Fernández-García
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain; Laboratorio de Referencia e Investigación en Enfermedades Víricas Inmunoprevenibles, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
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Sanz JC, Ramos B, Pérez-Olmeda M, Fernández-García A. Réplica a «Brote de sarampión-modificado en personal sanitario tras exposición a un caso de sarampión clásico». Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Naveed M, Yaseen AR, Khalid H, Ali U, Rabaan AA, Garout M, Halwani MA, Al Mutair A, Alhumaid S, Al Alawi Z, Alhashem YN, Ahmed N, Yean CY. Execution and Design of an Anti HPIV-1 Vaccine with Multiple Epitopes Triggering Innate and Adaptive Immune Responses: An Immunoinformatic Approach. Vaccines (Basel) 2022; 10:vaccines10060869. [PMID: 35746477 PMCID: PMC9228812 DOI: 10.3390/vaccines10060869] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022] Open
Abstract
Human Parainfluenza Virus (HPIV) Type-1, which is an anti-sense ribonucleic acid (RNA) virus belonging to the paramyxoviridae family, induces upper and lower respiratory tract infections. The infections caused by the HPIV Type-1 virus are usually confined to northwestern regions of America. HPIV-1 causes infections through the virulence of the hemagglutinin-neuraminidase (HN) protein, which plays a key role in the attachment of the viral particle with the host’s receptor cells. To the best of our knowledge, there is no effective antiviral drugs or vaccines being developed to combat the infection caused by HPIV-1. In the current study, a multiple epitope-based vaccine was designed against HPIV-1 by taking the viral HN protein as a probable vaccine candidate. The multiple epitopes were selected in accordance with their allergenicity, antigenicity and toxicity scoring. The determined epitopes of the HN protein were connected simultaneously using specific conjugates along with an adjuvant to construct the subunit vaccine, with an antigenicity score of 0.6406. The constructed vaccine model was docked with various Toll-like Receptors (TLRs) and was computationally cloned in a pET28a (+) vector to analyze the expression of vaccine sequence in the biological system. Immune stimulations carried out by the C-ImmSim Server showed an excellent result of the body’s defense system against the constructed vaccine model. The AllerTop tool predicted that the construct was non-allergen with and without the adjuvant sequence, and the VaxiJen 2.0 with 0.4 threshold predicted that the construct was antigenic, while the Toxinpred predicted that the construct was non-toxic. Protparam results showed that the selected protein was stable with 36.48 instability index (II) scores. The Grand average of Hydropathicity or GRAVY score indicated that the constructed protein was hydrophilic in nature. Aliphatic index values (93.53) confirmed that the construct was thermostable. This integrated computational approach shows that the constructed vaccine model has a potential to combat laryngotracheobronchitis infections caused by HPIV-I.
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Affiliation(s)
- Muhammad Naveed
- Department of Biotechnology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan; (A.R.Y.); (U.A.)
- Correspondence: (M.N.); (A.A.R.); (C.Y.Y.)
| | - Allah Rakha Yaseen
- Department of Biotechnology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan; (A.R.Y.); (U.A.)
| | - Hira Khalid
- Department of Medical Education, King Edward Medical University, Lahore 54000, Pakistan;
| | - Urooj Ali
- Department of Biotechnology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan; (A.R.Y.); (U.A.)
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
- Correspondence: (M.N.); (A.A.R.); (C.Y.Y.)
| | - Mohamed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia;
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Zainab Al Alawi
- Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Yousef N. Alhashem
- Department of Clinical Laboratory Sciences, Mohammed AlMana College of Health Sciences, Dammam 34222, Saudi Arabia;
| | - Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
- Correspondence: (M.N.); (A.A.R.); (C.Y.Y.)
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Rabaan AA, Mutair AA, Alhumaid S, Garout M, Alsubki RA, Alshahrani FS, Alfouzan WA, Alestad JH, Alsaleh AE, Al-Mozaini MA, Koritala T, Alotaibi S, Temsah MH, Akbar A, Ahmad R, Khalid Z, Muhammad J, Ahmed N. Updates on Measles Incidence and Eradication: Emphasis on the Immunological Aspects of Measles Infection. Medicina (B Aires) 2022; 58:medicina58050680. [PMID: 35630096 PMCID: PMC9147347 DOI: 10.3390/medicina58050680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/31/2022] Open
Abstract
Measles is an RNA virus infectious disease mainly seen in children. Despite the availability of an effective vaccine against measles, it remains a health issue in children. Although it is a self-limiting disease, it becomes severe in undernourished and immune-compromised individuals. Measles infection is associated with secondary infections by opportunistic bacteria due to the immunosuppressive effects of the measles virus. Recent reports highlight that measles infection erases the already existing immune memory of various pathogens. This review covers the incidence, pathogenesis, measles variants, clinical presentations, secondary infections, elimination of measles virus on a global scale, and especially the immune responses related to measles infection.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
- Correspondence: (A.A.R.); (N.A.)
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Roua A. Alsubki
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Fatimah S. Alshahrani
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia;
- Department of Internal Medicine, Division of Infectious Diseases, College of Medicine, King Saud University Medical City, Riyadh 11451, Saudi Arabia
| | - Wadha A. Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Jeehan H. Alestad
- Immunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UK;
- Microbiology Department, College of Medicine, Jabriya 46300, Kuwait
| | - Abdullah E. Alsaleh
- Core Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
| | - Maha A. Al-Mozaini
- Immunocompromised Host Research Section, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia;
| | - Thoyaja Koritala
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN 56001, USA;
| | - Sultan Alotaibi
- Molecular Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ali Akbar
- Department of Microbiology, University of Balochistan, Quetta 87300, Pakistan;
| | - Rafiq Ahmad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Zainab Khalid
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Javed Muhammad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Naveed Ahmed
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, University Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
- Correspondence: (A.A.R.); (N.A.)
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12
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Song K, Lee JM, Lee EJ, Lee BR, Choi JY, Yun J, Lee SN, Jang MY, Kim HW, Kim HS, Moon SM, Kim YK. Control of a nosocomial measles outbreak among previously vaccinated adults in a population with high vaccine coverage: Korea, 2019. Eur J Clin Microbiol Infect Dis 2022; 41:455-466. [PMID: 34999974 DOI: 10.1007/s10096-021-04390-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/30/2021] [Indexed: 01/26/2023]
Abstract
We describe a measles outbreak among previously vaccinated healthcare workers (HCWs) and inpatients and the control measures implemented at a tertiary care hospital in 2019. Case-patients were laboratory-confirmed measles with throat swabs tested by quantitative polymerase chain reactions (PCR), during April-May 2019. Medical histories and documented immunization records were obtained. We compared attack rates (ARs) among HCWs by occupational subgroup and age and examined the outbreak-associated costs. The index case was not ascertained. Among 26 measles case-patients (22 HCWs, four inpatients) aged 18-28 years, 25 had previously received measles-mumps-rubella (MMR) vaccine (12/26, 46% (two doses); 13/26, 50% (one dose)), and 16 (62%) had positive results of measles IgG prior to measles diagnosis. ARs were higher among HCWs aged < 30 years (1.88%), especially in the subgroup under 25 years of age (2.22%). Control measures included work restrictions for seronegative HCWs (218/2320, 9.4%) in immunity verification, administration of the MMR vaccine (207 HCWs) or intravenous immunoglobulin (2 HCWs and 11 inpatients), enhanced health surveillance of HCWs, and mandatory assessment of patients with measles-like symptoms at the infectious diseases screening units. The hospital spent 90,417,132 Korean won (US $79,733) in response to the outbreak. Measles outbreaks can occur in healthcare settings despite high population immunity, highlighting the importance of stronger vaccination policies, particularly among young HCWs. Moreover, an effective outbreak response comprising immunization activities and enhanced surveillance of HCWs and patients to rapidly detect measles-like symptoms at a prodromal phase is essential to control nosocomial measles outbreaks.
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Affiliation(s)
- Kyunghyun Song
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ju Mi Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Ju Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Bo Ram Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ji Young Choi
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jihee Yun
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Se Na Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Mi Young Jang
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Han Wool Kim
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Han-Sung Kim
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Song Mi Moon
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.,Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yong Kyun Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. .,Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea. .,Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
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13
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González-Praetorius A, Fernández-García A, Pérez-Olmeda M, García-Rivera MV, Caballero-López B, Gilaberte-Reyzabal S, Román-Marcos E, de Ory-Machón F, Echevarría-Mayo JE. Measles outbreak in the sanitary area of Guadalajara (Spain): Difficulty in microbiological diagnosis in the era of its elimination. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00232-9. [PMID: 34429225 DOI: 10.1016/j.eimc.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 01/30/2023]
Abstract
INTRODUCTION In Spain, like in other countries where endemic measles has been eliminated, there is a need for available diagnostic tools for confirming any cases in order to prevent and control its transmission. We describe the different microbiological tests used for the diagnosis of measles during an outbreak that occurred in 2019 in the province of Guadalajara (Spain). METHODS Serological and molecular tests were performed at the Microbiology laboratory of the Guadalajara University Hospital and at the National Center for Microbiology of the Carlos III Health Institute (Majadahonda, Spain). Patient data were obtained from the surveillance system. RESULTS A total of 43 patients had a laboratory diagnosis of measles: 29 cases by PCR (pharyngeal exudate or urine) and positive specific IgM, 11 cases by PCR, and 3 cases only by a positive IgM. Genotype D8 was identified in 35 confirmed cases and genotype A in 2 that were discarded as post-vaccination cases. PCR was positive in the acute sera of 11 out of 14 patients with a negative IgM. Eleven confirmed cases had recieved one or 2 vaccine doses. Twelve adult patients were hospitalizated, all of them with a diagnostic of hepatitis. CONCLUSIONS The combination of molecular tests and the presence of specific IgG and IgM are necessary for a correct diagnosis of measles and also to classify patients with a breakthrough infection or vaccine failures (primary or secondary). Genotyping is essential for the correct classification of the patients in the context of a measles elimination program.
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Affiliation(s)
| | - Aurora Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Mayte Pérez-Olmeda
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España
| | - M Victoria García-Rivera
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, España
| | | | | | - Elena Román-Marcos
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, España
| | - Fernando de Ory-Machón
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Juan Emilio Echevarría-Mayo
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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14
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Chang SY, Bisht A, Faysman K, Schiller GJ, Uslan DZ, Multani A. Vaccine-Associated Measles in a Hematopoietic Cell Transplant Recipient: Case Report and Comprehensive Review of the Literature. Open Forum Infect Dis 2021; 8:ofab326. [PMID: 34377725 PMCID: PMC8339276 DOI: 10.1093/ofid/ofab326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/18/2021] [Indexed: 01/04/2023] Open
Abstract
Measles is a worldwide viral disease that can cause fatal complications in immunocompromised hosts such as hematopoietic cell transplant (HCT) recipients. The live attenuated measles, mumps, and rubella (MMR) vaccine is generally contraindicated post-HCT due to the risk for vaccine-associated measles. This, combined with decreasing vaccination rates due to vaccine hesitancy and the coronavirus disease 2019 pandemic, raises significant concerns for a measles resurgence that could portend devastating consequences for immunocompromised hosts. Multiple guidelines have included criteria to determine which HCT recipients can safely receive the MMR vaccine. Here, we report a case of vaccine-associated measles in a HCT recipient who met guideline-recommended criteria for MMR vaccination. The objective of this article is to query these criteria, highlight the importance of MMR vaccination, and comprehensively review the literature.
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Affiliation(s)
- Sandy Y Chang
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Anjali Bisht
- Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, California, USA
| | - Karolina Faysman
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Gary J Schiller
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel Z Uslan
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, California, USA
| | - Ashrit Multani
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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15
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The Brief Case: Secondary Measles and the Pitfalls of Diagnostic Testing. J Clin Microbiol 2020; 58:58/9/e01938-19. [DOI: 10.1128/jcm.01938-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Laure B, Jacques F, Mathilde P, Anne-Marie R, Maïder C, Jean S, Alexandre B, Didier N, Astrid V, Julia D, Marie-Edith L, Cazanave C. A Major Regional Measles Outbreak: Description of Hospitalized Cases in 2017-2018 at Bordeaux University Hospital, France. Open Forum Infect Dis 2020; 7:ofaa332. [PMID: 33732748 PMCID: PMC7958733 DOI: 10.1093/ofid/ofaa332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background Measles remains endemic worldwide, despite current vaccination recommendations, and is associated with high morbidity and mortality rates. We describe all cases hospitalized in Bordeaux University Hospital (BUH), the starting point of a national significant measles outbreak in 2017–2018. Methods In this retrospective study, we included all patients hospitalized in BUH from September 1, 2017, to May 31, 2018. Inclusion criteria were age >1 year, clinical symptoms, and biological confirmation by measles immunoglobulin M or measles reverse transcription polymerase chain reaction positivity. Results We included 171 patients. Most patients were immunocompetent; only 19% had preexisting medical histories. Most patients had rash and fever (97%), but some cases were atypical and difficult to diagnose. Köplik’s spots were reported in 66 cases (38%). The most frequent biological markers were blood inflammation markers (96%) and lymphopenia (81%). Unexpectedly, we found hyponatremia (<135 mmol/L) in 40% of patients. We identified peaks in January and March, corresponding to 76 D8 genotypes and 28 B3 strains. The following complications were reported in 65 patients (38%): pneumonia, hepatitis, and keratitis; 10 had neurological symptoms. One patient had Guillain-Barré syndrome, and a young immunocompromised patient died from measles inclusion-body encephalitis. Most of the patients (80%) had not been correctly vaccinated, including 28 health care workers. Some patients (n = 43, 25%) developed measles despite having plasma IgG. These included 12 possible vaccination failure cases. Conclusions During the BUH outbreak, measles was often complicated and sometimes atypical. Vaccination coverage was dramatically insufficient. We also describe vaccination failure cases that must be better investigated.
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Affiliation(s)
- Barthod Laure
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, Bordeaux, France
| | - Fourgeaud Jacques
- Virology Department, CHU Bordeaux, CNRS UMR 5234, University of Bordeaux, Bordeaux, France
| | - Puges Mathilde
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, Bordeaux, France
| | - Rogues Anne-Marie
- Hygiène Hospitalière, CHU Bordeaux, University of Bordeaux, Bordeaux, France.,University of Medicine, Bordeaux, France
| | - Coppry Maïder
- Hygiène Hospitalière, CHU Bordeaux, University of Bordeaux, Bordeaux, France.,University of Medicine, Bordeaux, France
| | - Sarlangue Jean
- Pediatric Department, Bordeaux University Hospital, Bordeaux France
| | - Boyer Alexandre
- University of Medicine, Bordeaux, France.,Medical Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France
| | - Neau Didier
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, Bordeaux, France.,University of Medicine, Bordeaux, France
| | - Vabret Astrid
- Virology Department, UNICAEN, GRAM EA2656, CHU de Caen, Normandie University, Caen, France
| | - Dina Julia
- Virology Department, UNICAEN, GRAM EA2656, CHU de Caen, Normandie University, Caen, France
| | - Lafon Marie-Edith
- Virology Department, CHU Bordeaux, CNRS UMR 5234, University of Bordeaux, Bordeaux, France.,University of Medicine, Bordeaux, France
| | - Charles Cazanave
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, Bordeaux, France.,University of Medicine, Bordeaux, France
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17
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Williamson KM, Merritt T, Durrheim DN. Australia: an island in a sea of measles. Med J Aust 2020; 213:101-103.e1. [DOI: 10.5694/mja2.50650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kirsten M Williamson
- Hunter New England Local Health District Newcastle NSW
- Australian National University Canberra ACT
| | - Tony Merritt
- Hunter New England Local Health District Newcastle NSW
| | - David N Durrheim
- Hunter New England Local Health District Newcastle NSW
- University of Newcastle Newcastle NSW
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18
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Lee YC, Lee YH, Lu CW, Cheng SY, Yang KC, Huang KC. Measles immunity gaps in an era of high vaccination coverage: A serology study from Taiwan. Travel Med Infect Dis 2020; 36:101804. [PMID: 32569810 DOI: 10.1016/j.tmaid.2020.101804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/19/2020] [Accepted: 06/17/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Routine vaccination for children drastically reduces measles cases. Nonetheless, the global resurgence of measles since 2018 highlights the need for evaluating vaccine-induced immunity in an era of high vaccination coverage, especially in international travelers. This study aims to identify high-risk persons via analyzing the impact of age and different vaccination schedules on seroprevalence of measles in a country with high vaccination coverage, attempting to provide suggestions regarding pre-travel measles vaccination in highly immunized countries. METHOD We retrospectively collected serological results of measles from Taiwanese travelers during 2008-2017 and middle-aged subjects from community during 2007-2009. Participants were classified by age groups and cohort based on the national immunization program: cohort I (pre-mass vaccination), cohort II (suboptimal measles vaccination), and cohort III (2-dose MMR in childhood). The effects of age group on seropositivity was shown by odds ratio (OR) with 95% confidence interval (CI) in a logistic regression model. RESULTS The overall measles seroprevalence was 74.5% (N = 1096, mean age = 31.7 ± 12.3 years), with adolescents having the lowest seropositivity (65.9%) and participants ≥50 years having the highest (89.4%). Seropositivity was significantly higher in cohort I (pre-mass vaccination) compared with the other 2 cohorts (P < 0.0001). The effect of aging on seropositivity was only significant in cohort II (OR = 1.84, 95% CI = 1.13-2.99, P = 0.014 for 30-39 years vs. 20-29 years). CONCLUSIONS Waning immunity to measles in adolescents and young adults is a dominant issue in highly vaccinated cohorts. Enhancing pre-travel vaccination against measles can effectively fill the immunity gaps in highly immunized countries.
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Affiliation(s)
- Yi-Chen Lee
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Training Center for Travel Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Training Center for Travel Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; Training Center for Travel Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shao-Yi Cheng
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; Training Center for Travel Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuen-Cheh Yang
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; Training Center for Travel Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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19
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Qualitative Variation among Commercial Immunoassays for Detection of Measles-Specific IgG. J Clin Microbiol 2020; 58:JCM.00265-20. [PMID: 32238434 DOI: 10.1128/jcm.00265-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/26/2020] [Indexed: 11/20/2022] Open
Abstract
Measurement of measles virus-specific IgG is used to assess presumptive evidence of immunity among immunocompetent individuals with uncertain immune or vaccination status. False-negative test results may lead to unnecessary quarantine and exclusion from activities such as employment, education, and travel or result in unnecessary revaccination. In contrast, false-positive results may fail to identify susceptible individuals and promote spread of disease by those who are exposed and unprotected. To better understand the performance characteristics of tests to detect measles IgG, we compared five widely used, commercially available measles IgG test platforms using a set of 223 well-characterized serum samples. Measles virus neutralizing antibodies were also measured by in vitro plaque reduction neutralization, the gold standard method, and compared to IgG test results. Discrepant results were observed for samples in the low-positive ranges of the most sensitive tests, but there was good agreement across platforms for IgG-negative sera and for samples with intermediate to high levels of IgG. False-negative test results occurred in approximately 11% of sera, which had low levels of neutralizing antibody.
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20
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Lord H, Kok J, Fletcher S, Alexander K. Is it or is it not? Lessons learned from a case of suspected vaccine strain measles. Aust N Z J Public Health 2020; 44:160-162. [PMID: 32190947 DOI: 10.1111/1753-6405.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/01/2019] [Accepted: 12/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Measles continues to be a threat to Australia. While post-eradication risks are low, imported measles cases from overseas travellers who are non-immune can cause small outbreaks. This case report discusses the challenge of identifying wild-type measles in an individual who was recently vaccinated with measles-containing vaccine (MCV). METHODS A positive polymerase chain reaction (PCR) result for measles for an adult who had recently received a measles-containing vaccine was notified. Investigation revealed no known epidemiological link, recent overseas travel or contact with recent measles cases during the incubation period. RESULTS The results of the initial sequencing to distinguish between wild-type and vaccine-strain measles were inconclusive. A decision was made to re-run the genotyping, collect additional specimens and quarantine the case until a definitive result was obtained. Sequencing and genotyping revealed that this indeed was a wild-type measles strain. CONCLUSIONS Changing epidemiology of measles means distinguishing between wild-type and vaccine-strain measles has become a new challenge. Implications for public health: The reflection of the public health management of this case has provided a valuable teaching tool for public health professionals globally, particularly in low incidence measles countries.
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Affiliation(s)
- Heidi Lord
- Centre for Research in Nursing and Health, South Eastern Sydney Local Health District, New South Wales
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology-Institute of Clinical Pathology and Medical Research, New South Wales
| | - Stephanie Fletcher
- Public Health Unit, South Western Sydney Local Health District, New South Wales
| | - Kate Alexander
- Public Health Unit, South Western Sydney Local Health District, New South Wales
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21
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Böröcz K, Csizmadia Z, Markovics Á, Farkas N, Najbauer J, Berki T, Németh P. Application of a fast and cost-effective 'three-in-one' MMR ELISA as a tool for surveying anti-MMR humoral immunity: the Hungarian experience. Epidemiol Infect 2020; 148:e17. [PMID: 32014073 PMCID: PMC7019553 DOI: 10.1017/s0950268819002280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/30/2019] [Accepted: 12/18/2019] [Indexed: 12/27/2022] Open
Abstract
In Hungary, between February 2017 and July 2019, 70 confirmed measles cases were reported, raising questions about the adequacy of population-level immunity. Although the assumed vaccination coverage is ≥99%, in a recent study, we detected potential gaps in the anti-measles humoral immunity. In Hungary, according to a decree by the Ministry of Public Welfare, beginning from 2021, the healthcare provider should conduct a serosurvey of anti-measles protection levels of healthcare professionals. To facilitate the compliance with this requirement, we developed a quick 'three-in-one' or 'triple' MMR (measles, mumps and rubella) indirect ELISA (IgG); an assay format that is currently not available commercially. High throughput applicability of the 'three-in-one' ELISA was verified using 1736 sera from routine laboratory residual samples, using an automated platform (Siemens BEP 2000 Advance). Assay verification was performed by comparing the full antigen repertoire-based 'target' assay with in-house 'control' assays using recombinant viral antigen coatings, and by validated commercially available kits. Indirect immunofluorescence was used as an independent reference method. Data were analysed using OriginLab, IBM SPSS, RStudio and MedCalc. In case of measles, we combined our current results with previously published data (Ntotal measles = 3523). Evaluation of anti-mumps and anti-rubella humoral antibody levels was based on the measurement of 1736 samples. The lowest anti-measles seropositivity (79.3%) was detected in sera of individuals vaccinated between 1978 and 1987. Considering the antigen-specific seropositivity ratios of all samples measured, anti-measles, -mumps and -rubella IgG antibody titres were adequate in 89.84%, 91.82% and 92.28%, respectively. Based on the virus-specific herd immunity threshold (HIT) values (HITMeasles = 92-95%, HITMumps = 75-86%, HITRubella = 83-86), it can be stated that regarding anti-measles immunity, certain age clusters of the population may have inadequate levels of humoral immunity. Despite the potential gaps in herd immunity, the use of MMR vaccine remains an effective and low-cost approach for the prevention of measles, mumps and rubella infections.
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Affiliation(s)
- K. Böröcz
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs Medical School, Pécs, Hungary
| | - Z. Csizmadia
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs Medical School, Pécs, Hungary
| | - Á. Markovics
- Department of General and Physical Chemistry, Faculty of Natural Sciences, University of Pécs, Pécs, Hungary
| | - N. Farkas
- Department of Bioanalysis, University of Pécs Medical School, Pécs, Hungary
| | - J. Najbauer
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs Medical School, Pécs, Hungary
| | - T. Berki
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs Medical School, Pécs, Hungary
| | - P. Németh
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs Medical School, Pécs, Hungary
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Pacenti M, Maione N, Lavezzo E, Franchin E, Dal Bello F, Gottardello L, Barzon L. Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting. Vaccines (Basel) 2019; 7:vaccines7040199. [PMID: 31795157 PMCID: PMC6963570 DOI: 10.3390/vaccines7040199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 11/24/2022] Open
Abstract
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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Affiliation(s)
- Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
| | - Nataskya Maione
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Enrico Lavezzo
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Elisa Franchin
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Federico Dal Bello
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Lorena Gottardello
- Department of Hygiene and Public Health, Azienda ULSS 6 Euganea, 35131 Padova, Italy;
| | - Luisa Barzon
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
- Correspondence: ; Tel.: +39-049-821-8946
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