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Takkinsatian P, Wannaphahoon K, Upapan P, Senawong S, Prommalikit O. Measles seroprevalence in Thailand: are adolescents and young adults at risk of measles? Singapore Med J 2024; 65:340-347. [PMID: 35651287 DOI: 10.11622/smedj.2022058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION During the last decade, measles has become an important re-emerging disease in Thailand. The objective of this study was to measure measles seroprevalence and its influencing factors so as to plan an improved vaccination programme. METHODS A total of 600 participants aged between 9 months and 50 years were divided into seven groups representing birth cohorts that experienced different measles vaccination policies. Participants' blood samples were obtained to measure measles immunoglobulin G (IgG) levels. RESULTS None of the participants in the age group of 9 months had measles IgG levels beyond a protective level. Participants in the age groups 2.5, 5-15, 16-29, 30-33, 34-40 and 41-50 years had 82% (95% confidence interval [CI] 73.3-90.7), 50% (95% CI 36.1-63.9), 52% (95% CI 42.3-62.7), 70% (95% CI 61.1-78.9), 88.8% (95% CI 84.1-93.5) and 98.8% (95% CI 96.4-100.0) measles seropositivity, respectively. The study did not find any significant factors affecting measles seropositivity. CONCLUSION Individuals aged 15-34 years are vulnerable to measles infections. Supplementary vaccination should be encouraged in special situations, including postexposure prophylaxis for young adults during an outbreak and for high-risk occupations such as healthcare personnel.
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Affiliation(s)
- Panit Takkinsatian
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kamolmart Wannaphahoon
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Prasit Upapan
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Sansnee Senawong
- Department of Immunology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Olarn Prommalikit
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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Gonwong S, Mason CJ, Chuenchitra T, Khanijou P, Islam D, Ruamsap N, Kana K, Tabprasit S, Vesely BA, Demons ST, Waters NC, Swierczewski BE, Crawford JM, Jones JW. Nationwide Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever in Young Thai Men. Am J Trop Med Hyg 2022; 106:tpmd201512. [PMID: 35378507 PMCID: PMC9128670 DOI: 10.4269/ajtmh.20-1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/18/2022] [Indexed: 11/07/2022] Open
Abstract
Scrub typhus group (STG), typhus group (TG), and spotted fever group (SFG) rickettsiae are pathogens distributed worldwide and are important causes of febrile illnesses in southeast Asia. The levels of rickettsioses burden and distribution in Thai communities are still unclear. Nonspecific symptoms, limit diagnostic capacity and underdiagnoses contribute to the absence of clarity. The objective of this study was to determine the nationwide IgG seroprevalence of STG, TG, and SFG by ELISA in repository sera from the Royal Thai Army recruits collected during 2007-2008 and 2012 to estimate rickettsiae exposure in young Thai men to better understand rickettsiae exposure distribution in the Thai population. IgG seroprevalence of STG, Orientia tsutsugamushi; TG, Rickettsia typhi; and SFG, R. rickettsii was 12.4%, 6.8%, and 3.3% in 2007-2008 and 31.8%, 4.2%, and 4.5% in 2012, respectively. The STG had the highest seroprevalence of Rickettsia assessed, with the highest regional seroprevalence found in southern Thailand. The STG seroprevalence changed significantly from 2007 to 2008 (P value < 0.05), which corresponds with morbidity rate of scrub typhus from the last decade in Thailand. We were unable to determine the causality for seroprevalence changes between the two periods due to the limitation in sample numbers for intervening years and limited information available for archived specimens. Additional research would be required to determine agency. However, study results do confirm Rickettsia endemicity in Thailand lends weight to reports of increasing STG seroprevalence. It also corroborates the need to raise rickettsial disease awareness and educate the general public in prevention measures.
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Affiliation(s)
- Siriphan Gonwong
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Carl J. Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Dilara Islam
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Nattaya Ruamsap
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Khunakorn Kana
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Brian A. Vesely
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Norman C. Waters
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - John M. Crawford
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - James W. Jones
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Vaccine serocoverage under the expanded program on immunization among hill tribe children in Thailand: A cross-sectional study. Vaccine 2021; 39:6477-6484. [PMID: 34607747 DOI: 10.1016/j.vaccine.2021.09.061] [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: 03/31/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Expanded programs on immunization (EPIs) are country-specific vaccine programs designed and implemented to prevent childhood diseases globally, including in Thailand. Hill tribe children in Thailand live in remote areas with underdeveloped education systems and low economic status. This study aimed to assess serocoverage under the EPI and access to vaccination clinics. METHODS A cross-sectional study was performed to assess serocoverage after childhood vaccination among hill tribe children who lived in 34 selected villages in Chiang Rai Province, Thailand. A validated questionnaire was administered, and 3-mL blood specimens were collected. Antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B core antigen (anti-HBc), measles, Japanese encephalitis virus (JEV), and tetanus were detected. Chi-square tests were performed to detect the different proportion of patients with antibodies with different characteristics. RESULTS Half of the hill tribe children aged 1-18 years did not have medical evidence (logbook) of immunization. More than 98.0% of the children who had medical evidence received the recommended immunizations. Only half of the children had anti-HBs (51.1%), and 22.3% had antibodies against JEV. The majority were found to be positive for antibodies against measles (83.3%) and tetanus (91.4%). Sex (p-value = 0.028), tribe (p-value < 0.001), age (p-value < 0.001), and parents' monthly income (p-value = 0.008) were associated with a lack of medical evidence. CONCLUSIONS Existing immunization programs for hill tribe children in Thailand should be urgently evaluated and monitored for effectiveness.
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Bohannon CD, Ende Z, Cao W, Mboko WP, Ranjan P, Kumar A, Mishina M, Amoah S, Gangappa S, Mittal SK, Lovell JF, García‐Sastre A, Pfeifer BA, Davidson BA, Knight P, Sambhara S. Influenza Virus Infects and Depletes Activated Adaptive Immune Responders. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2100693. [PMID: 34189857 PMCID: PMC8373117 DOI: 10.1002/advs.202100693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/18/2021] [Indexed: 05/14/2023]
Abstract
Influenza infections cause several million cases of severe respiratory illness, hospitalizations, and hundreds of thousands of deaths globally. Secondary infections are a leading cause of influenza's high morbidity and mortality, and significantly factored into the severity of the 1918, 1968, and 2009 pandemics. Furthermore, there is an increased incidence of other respiratory infections even in vaccinated individuals during influenza season. Putative mechanisms responsible for vaccine failures against influenza as well as other respiratory infections during influenza season are investigated. Peripheral blood mononuclear cells (PBMCs) are used from influenza vaccinated individuals to assess antigen-specific responses to influenza, measles, and varicella. The observations made in humans to a mouse model to unravel the mechanism is confirmed and extended. Infection with influenza virus suppresses an ongoing adaptive response to vaccination against influenza as well as other respiratory pathogens, i.e., Adenovirus and Streptococcus pneumoniae by preferentially infecting and killing activated lymphocytes which express elevated levels of sialic acid receptors. These findings propose a new mechanism for the high incidence of secondary respiratory infections due to bacteria and other viruses as well as vaccine failures to influenza and other respiratory pathogens even in immune individuals due to influenza viral infections.
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Affiliation(s)
- Caitlin D. Bohannon
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
- Oak Ridge Institute for Science and Education (ORISE)CDC Fellowship ProgramOak RidgeTN37831USA
| | - Zachary Ende
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
- Oak Ridge Institute for Science and Education (ORISE)CDC Fellowship ProgramOak RidgeTN37831USA
| | - Weiping Cao
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
| | - Wadzanai P. Mboko
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
- Department of Comparative Pathobiology and Purdue Institute for InflammationImmunologyand Infectious DiseasePurdue UniversityWest LafayetteIN47907USA
| | - Priya Ranjan
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
| | - Amrita Kumar
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
| | - Margarita Mishina
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
| | - Samuel Amoah
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGA30329USA
| | | | - Suresh K. Mittal
- Department of Comparative Pathobiology and Purdue Institute for InflammationImmunologyand Infectious DiseasePurdue UniversityWest LafayetteIN47907USA
| | - Jonathan F. Lovell
- Department of Biomedical EngineeringState University of New York at BuffaloBuffaloNY14260USA
| | - Adolfo García‐Sastre
- Global Health and Emerging Pathogens InstituteIcahn School of Medicine at Mount SinaiNew YorkNY10029USA
- Department of MicrobiologyIcahn School of Medicine at Mount SinaiNew YorkNY10029USA
- Department of MedicineDivision of Infectious DiseasesIcahn School of Medicine at Mount SinaiNew YorkNY10029USA
- The Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNY10029USA
| | - Blaine A. Pfeifer
- Department of Chemical and Biological EngineeringSchool of Engineering and Applied SciencesState University of New York at BuffaloBuffaloNY14260USA
| | - Bruce A. Davidson
- Department of AnesthesiologyJacobs School of Medicine and Biomedical SciencesState University of New York at BuffaloBuffaloNY14260USA
- Department of Pathology and Anatomical SciencesSchool of Medicine and Biomedical SciencesState University of New York at BuffaloBuffaloNY14260USA
- Research ServiceVeterans AdministrationWestern New York Healthcare SystemBuffaloNY14215USA
| | - Paul Knight
- Department of AnesthesiologyJacobs School of Medicine and Biomedical SciencesState University of New York at BuffaloBuffaloNY14260USA
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Arnold JN, Gundlach N, Böckelmann I, Sammito S. Vaccination coverage rates of military personnel worldwide: a systematic review of the literature. Int Arch Occup Environ Health 2020; 94:1-8. [PMID: 32561973 PMCID: PMC7826299 DOI: 10.1007/s00420-020-01559-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
Objectives Due to the professionally specific risk of infection in the armed forces, recommendations for vaccination are usually adapted for soldiers and are subject to special regulations. Little data is available on scientifically measured vaccination coverage of soldiers. Methods A systematic literature research was carried out in the PubMed database using the search terms “army” or “military” or “Bundeswehr” and “vaccination” or “vaccine”. Studies covering the period from 1990 to 2018 that contain statements on vaccination coverage rates of soldiers were identified. Twenty-two out of the initially found 1801 results were used. Results The studies found were conducted in nine different countries with eight out of the 22 studies originating from the USA. The size of study was between 180 and 32,502 subjects. On average, the vaccination rates determined in the studies were between 26.8 and 94.7%. Hepatitis A coverage was lowest (a minimum of 11.3%) and tetanus vaccination coverage was highest (with a maximum of 94.7%). Vaccination rates decreased with increasing age and coverage tended to be lower for men than for women. The term of service did not have a significant effect on vaccination rates. Conclusions On the whole, most studies referred to recruits. They showed high vaccination rates for standard vaccinations and lower vaccination rates for indication and seasonal vaccinations. However, there were also vaccination gaps of temporary-career volunteers. This leads to a considerable effort at the armed forces to complete vaccine protection in case of a short-term operational commitment.
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Affiliation(s)
- Jana Nele Arnold
- Bundeswehr Hospital Hamburg, Hamburg, Germany.,Occupational Medicine, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | | | - Irina Böckelmann
- Occupational Medicine, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | - Stefan Sammito
- Occupational Medicine, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany. .,Air Force Centre of Aerospace Medicine, Department I 3, Flughafenstraße 1, 51147, Cologne, Germany.
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Laundy NC, Greig JM, Raza M, Mitchell T. Delay in the diagnosis of measles complicated by pneumonitis and appendicitis in a returning traveller. BMJ Case Rep 2019; 12:e232652. [PMID: 31796443 PMCID: PMC7001684 DOI: 10.1136/bcr-2019-232652] [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] [Accepted: 11/11/2019] [Indexed: 11/04/2022] Open
Abstract
A 40-year-old British man presented to the emergency department for the second time in 10 days following a 2-week holiday in Thailand with malaise, bilateral conjunctivitis and a morbilliform rash. He had previously seen his general practitioner and ophthalmology and was diagnosed with conjunctivitis. We confirmed measles following RNA detection on a mouth swab. Four days after admission he developed abdominal pain and a CT abdomen demonstrated acute appendicitis with large appendicoliths. A perforated appendix was identified intraoperatively. Measles RNA was detected in the resected appendix. Preoperatively he developed hypoxia with right upper lobe changes seen on a CT pulmonary angiogram. Bronchoalveolar lavage performed in theatre isolated measles RNA at high level, consistent with measles pneumonitis. He required ventilatory support in the intensive care unit and was also treated with intravenous antibiotics. He made a complete recovery.
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Affiliation(s)
| | - Julia M Greig
- Infectious Diseases, Sheffield Teaching Hospitals, Sheffield, UK
| | - Mohammad Raza
- Virology, Sheffield Teaching Hospitals, The University of Sheffield, Sheffield, UK
| | - Tamara Mitchell
- Infectious Diseases, Sheffield Teaching Hospitals, Sheffield, UK
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Kraszewska-Głomba B, Matkowska-Kocjan A, Miśkiewicz K, Szymańska-Toczek Z, Wójcik M, Banyś D, Szenborn L. Mumps, measles and rubella vaccination in children with PFAPA syndrome. Vaccine 2016; 34:5903-5906. [PMID: 27997341 DOI: 10.1016/j.vaccine.2016.10.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 11/26/2022]
Abstract
There is no published data regarding immunologic response to vaccinations in children with PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis). The aim of this study was to evaluate mumps, measles and rubella immunity in children with PFAPA. 31 children with PFAPA syndrome and 22 healthy children (control group - CG) were recruited to the study. All children were previously vaccinated with one dose of MMR vaccine according to the Polish obligatory vaccination schedule. The patients from both groups were evaluated for anti-measles, anti-mumps and anti-rubella IgG antibodies concentrations (ELISA tests; the reference values for protective antibody levels were 150IU/L, 16RU/L and 11IU/ml respectively). The percentage of patients with protective antibodies levels was as follows: measles - 93.55% of PFAPA and 95.45% of CG patients (p=0.77); mumps - 74.19% of PFAPA and 95.45% of CG patients (p=0.02); rubella - 80.65% of PFAPA and 90.9% of CG patients (p=0.30). CONCLUSIONS Children with PFAPA syndrome present a good response to the measles and rubella component of the MMR vaccine, however immunity against mumps after one dose of MMR may not be sufficient. Further investigation concerning immunity against vaccine-preventable diseases and the safety of vaccinations in children with periodic fever syndromes is required.
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Affiliation(s)
- Barbara Kraszewska-Głomba
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Agnieszka Matkowska-Kocjan
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Katarzyna Miśkiewicz
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Zofia Szymańska-Toczek
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Marta Wójcik
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Dorota Banyś
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
| | - Leszek Szenborn
- Department and Clinic of Paediatric Infectious Diseases, Wrocław Medical University, 2-2A Chałubińskiego, 50-368 Wrocław, Poland.
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