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Lifelong measles (the disease) immunity

Dtsch Med Wochenschr 2001 Nov 16;126(46):1289-93 Related Articles, Help
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[Epidemiological analysis of immunity against vaccine-preventable diseases: rubella, measles, mumps and chickenpox]

[Article in German]

Buxbaum S, Doerr HW, Allwinn R.

Institut fur Medizinische Virologie der Universitatsklinik Frankfurt/Main, Germany.

BACKGROUND AND OBJECTIVE: Measles, mumps, rubella and varicella zoster virus (VZV) infections are regarded as typical diseases of childhood: They are normally clinically mild and result in lifelong immunity. Severe clinical disease is known in immunocompromised patients; rubella virus infections during pregnancy often result in congenital rubella syndrome. All these diseases are preventable by vaccination which is recommended in Germany, recently vaccination against VZV for teenager without immunity since July 2001. In the following study we screened for immunity against the four viruses. PATIENTS AND METHODS: Serum samples were obtained at the Institute of Medical Virology Frankfurt/Main from January 1999 until December 2000. We tested for specific antibodies against measles (n = 915), against mumps (n = 857), against rubella (n = 1886) and against VZV (n = 2291). Seroprevalences were determined in different age groups. RESULTS: Altogether the highest rate of seronegatives is detected in younger children. VZV-seronegativity rates decrease from 74 % to 32 % in younger children. Against rubella also in this age group rate of seronegatives is found in 40 % and less than 10 % by teenagers. From this age group also immunity against rubella is found approximately in 80 % of seropositives. CONCLUSIONS: The following study shows that high seronegative rates are detectable, and here specially against VZV-specific antibodies. For seronegative teenagers, vaccination against VZV is now recommended in Germany. Immunization rates of at least 95 % in childhood would be effective in avoiding severe courses of disease and giving protection in pregnancy.

PMID: 11709730 [PubMed - indexed for MEDLINE]

Arch Virol Suppl 1999;15:139-58 Related Articles, Help

Pathogenic aspects of measles virus infections.

Schneider-Schaulies S, ter Meulen V.

Institute of Virology and Immunobiology, University of Wurzburg, Germany.

Measles virus (MV) infections normally cause an acute self limiting disease which is resumed by a virus-specific immune response and leads to the establishment of a lifelong immunity. Complications associated with acute measles can, on rare occasions, involve the central nervous system (CNS). These are postinfectious measles encephalitis which develops soon after infection, and, months to years after the acute disease, measles inclusion body encephalitis (MIBE) and subacute sclerosing panencephalitis (SSPE) which are based on a persistent MV infection of brain cells. Before the advent of HIV, SSPE was the best studied slow viral infection of the CNS, and particular restrictions of MV gene expression as well as MV interactions with neural cells have revealed important insights into the pathogenesis of persistent viral CNS infections. MV CNS complication do, however, not large contribute to the high rate of mortality seen in association with acute measles worldwide. The latter is due to a virus-induced suppression of immune functions which favors the establishment of opportunistic infections. Mechanisms underlying MV-mediated immunosuppression are not well understood. Recent studies have indicated that MV-induced disruption of immune functions may be multifactorial including the interference with cytokine synthesis, the induction of soluble inhibitory factors or apoptosis and negative signalling to T cells by the viral glycoproteins expressed on the surface of infected cells, particularly dendritic cells.

Publication Types:
  • Review
  • Review, Tutorial

PMID: 10470275 [PubMed - indexed for MEDLINE]

MMW Fortschr Med 1999 Sep 16;141(37):30-2 Related Articles, Help

[Measles. A viral illness with risk of permanent damage]

[Article in German]

Butenandt O, Weiss M.

Kinderklinik im Dr. von Haunerschen Kinderspital, Universitat Munchen.

Measles is a highly contagious exanthematous disease. After an incubation period of almost two weeks, catarrhal prodromic, associated with initial attacks of fever appear. Typical manifestations are Koplik's spots. The exanthema appears together with the second rise in temperature. The illness confers lifelong immunity. In individual cases, an encephalitis resulting in permanent neurological deficits must be expected. Every effort should be made to prevent this condition from arising. To this end, immunization with a combination measles, mumps, rubella (MMR) vaccine is recommended.

PMID: 10897970 [PubMed - indexed for MEDLINE]

Virus Res 1993 Dec;30(3):271-80 Related Articles, Help

Analysis of antibody response to the measles virus using synthetic peptides of the fusion protein. Evidence of non-random pairing of T and B cell epitopes.

Muller CP, Handtmann D, Brons NH, Weinmann M, Wiesmuller KH, Spahn G, Wiesneth M, Schneider F, Jung G.

Laboratoire National de Sante, Luxembourg.

The measles virus induces a life-long immune response associated with antibodies specific for the fusion protein. To map the linear immunodominant recognition sites of the fusion (F) protein of the measles virus, we have reacted a complete set of 108 overlapping pentadecapeptides with purified IgG obtained from donor sera with elevated anti-measles titers. The antibodies recognized about 20% of the peptides and generated a characteristic binding pattern, defining about 6 or 7 distinctive regions (31-75; 111-145; 151-165; 191-215; 271-320; 421-440; 481-530) which include the major hydrophobic segment (111-145) of the intersubunit region and the C-terminal Cys-cluster region. The binding sites were located in close proximity of the few experimentally defined T cell epitopes. This pairing of T and B cell epitopes was corroborated by computer-assisted T cell prediction. The significance of a non-random association of T and B cell epitopes for processing and presentation is discussed. It is speculated that in long-term immunity against measles (F protein), B cells of the same sIg specificity play an important role both as antigen presenting cells and as antibody producing cells. In contrast to human sera from late convalescent donors, mouse and rabbit MV antisera with high neutralizing titers as well as neutralizing MV-F specific monoclonal antibodies did not react with the peptides.

PMID: 8109160 [PubMed - indexed for MEDLINE]

Cancer Immunol Immunother 1992;34(5):313-20 Related Articles, Help

Persistent measles virus infection enhances major histocompatibility complex class I expression and immunogenicity of murine neuroblastoma cells.

Gopas J, Itzhaky D, Segev Y, Salzberg S, Trink B, Isakov N, Rager-Zisman B.

Department of Microbiology and Immunology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

The effect of persistent measles virus infection on the expression of major histocompatibility complex (MHC) class I antigens was studied. Mouse neuroblastoma cells C1300, clone NS20Y, were persistently infected with the Edmonston strain of measles virus. The persistently infected cell line, NS20Y/MS, expressed augmented levels of both H-2Kk and H-2Dd MHC class I glycoproteins. Activation of two interferon(IFN)-induced enzymes, known to be part of the IFN system: (2'-5')oligoadenylate synthetase and double-stranded-RNA-activated protein kinase, was detected. Measles-virus-infected cells elicited cytotoxic T lymphocytes that recognized and lysed virus-infected and uninfected neuroblastoma cells in an H-2-restricted fashion. Furthermore, immunization of mice with persistently infected cells conferred resistance to tumor growth after challenge with the highly malignant NS20Y cells. The rationale for using measles virus for immunotherapy is that most patients develop lifelong immunity after recovery or vaccination from this infection. Patients developing cancer are likely to have memory cells. A secondary response induced by measles-virus-infected cells may therefore induce an efficient immune response against non-infected tumour cells.

PMID: 1347254 [PubMed - indexed for MEDLINE]

Pediatr Infect Dis J 1990 Feb;9(2):101-10 Related Articles, Help

Duration of live measles vaccine-induced immunity.

Markowitz LE, Preblud SR, Fine PE, Orenstein WA.

Division of Immunization, Centers for Disease Control, Atlanta, GA 30333.

Publication Types:
  • Review
  • Review, Tutorial

From the article Similar to immunity after natural measles infection, live measles vaccine-induced immunity has been thought to be lifelong.  Vaccinees who subsequently develop measles have been considered primary vaccine failures, defined as the failure of the initial vaccination to elicit an appropriate immune response.  Primary vaccine failures are believed to be caused by (1) interference by maternal antibody when vaccination occurs at a young age, (2) technical problems, such as improper vaccine storage or administration, or (2) other unknown reasons.  Transmission of measles among older children in the United States, most of whom have been appropriately vaccinated, has raised the question of whether waning vaccine-induced immunity may also be responsible for some vaccine failures.  Current vaccination policy as well as mathematical models assume that vaccine-induced immunity is life-long.  If waning vaccine-induced immunity does occur, changes in measles vaccination strategies might be necessary.  The purpose of this paper is to review information concerning the duration and quality of measles vaccine-induced immunity.

Discussion: Several types of studies have been applied to evaluate the duration and quality of measles vaccine-induced immunity.  The few reports of measles disease in persons who had seroconverted after vaccination document that secondary vaccine failure can occur.  In addition two studies provide data on the potential magnitude of the risk of secondary vaccine failure.  However, most data suggest that waning immunity is uncommon.

Many questions concerning the duration of vaccine-induced immunity remain to be answered, including what percentage of cases reported in previously vaccinated persons in the United States is caused by primary or secondary vaccine failure, whether different measles vaccine strains produce immunity which is more or less "durable", whether reexposure to wild measles virus is important for maintenance of vaccine-induced immunity and whether it is possible to identify individuals at risk for waning immunity.

The consequences of waning measles vaccine-induced immunity may be minor for individuals if secondary vaccine failure is associated with mild disease.  However, waning vaccine-induced immunity could be of greater consequence to a population.  Although persons with subclinical reinfection have not been shown to transmit virus, it is not known whether this is true for persons with secondary vaccine failure.  If these individuals are able to transmit disease to other susceptibles, waning immunity, even in a small percentage of persons, may impede realization of the goal of measles elimination.  Revaccination may be successful in decreasing the number of persons who become susceptible due to waning immunity.  However, it is not known whether revaccination of such persons will result in sustained immunity. 

Questions concerning duration of vaccine-induced immunity and secondary vaccine failure were raised at the time of vaccine licensure and discussed 10 to 15 years later when outbreaks occurred in vaccinated children.  Now, 26 years after licensure, many of the same issues remain unresolved.  Although waning immunity has been documented to occur in a small proportion of vaccinees, the epidemiologic significance of this is still unclear.


PMID: 2179836 [PubMed - indexed for MEDLINE]

: Prog Med Virol 1989;36:1-33 Related Articles, Help

Measles active and passive immunity in a worldwide perspective.

Black FL.

'The simplest of all virus disease is measles' said Kenneth Maxy 40 years ago in a chapter on epidemiology. I hope that the data set out here provide the reader with a sufficiently complete and clear picture of the factors that determine measles epidemiology, that he or she will agree with Maxy's prescient words. Measles is an antigenically complex virus, but few components of the immune response to this virus are epidemiologically relevant. The relevant components are durable for a lifetime. They can be conveniently measured by serological tests, and the results of these tests correlate well with measles immunity. The tests show that measles is an extremely infectious disease, and that very high antibody prevalence rates are needed for herd protection. The currently available measles vaccine is capable of yielding adequate antibody prevalence rates for herd immunity, but to achieve this, immunization procedural flaws and faulty records must be kept to very low levels. The greatest obstacle to worldwide control of measles is a failure of vaccination programs to produce adequate herd immunity levels in less-developed countries. There, vaccine must be given promptly after passive immunity wanes, because the level of endemicity is so high. It is difficult to determine just what age is optimal, because it varies from one country to another. Premature vaccination not only fails to immunize, but also interferes with subsequent re-immunization. Because we now know this, further direct tests of vaccine effectiveness in very young children are ethically undesirable, and methods that use determination of passively acquired antibody are to be preferred. The levels of antibody that mothers have to pass to their children vary considerably. These differences are important in comparisons of South Asian countries with others, but not elsewhere. Differences in efficiency of transport of antibody across the placenta also play a role, but usually a minor one. Most important seems to be variation in antibody durability in the infant. Where families are poor, the children acquire many infections at an early age, and passively acquired antibody is swept out. These children who are least able to withstand the effects of measles infection, are hit at the earliest age. To provide protection for them, the vaccine must be given at a carefully determined age, specific for each community. Only when this is done can we hope to reduce measles worldwide to a sufficiently low level that it will be removed as a threat to persons in the United States, or anywhere else.

Publication Types:
  • Review
  • Review, Academic

PMID: 2685909 [PubMed - indexed for MEDLINE]

: Biochem Soc Symp 1987;53:25-37 Related Articles, Help

The molecular biology of the morbillivirus (measles) group.

Barrett T.

Institute for Animal Disease Research, Pirbright Laboratory, Surrey, U.K.

The morbilliviruses are a closely related group of important human and animal pathogens. The best known members of the group are measles virus in man and canine distemper virus in dogs. The group also includes two other serious animal diseases, rinderpest or cattle plague and peste des petits ruminants in sheep and goats. The latter viruses are of great economic importance in Africa, Asia and the Middle East. Persistence of these viruses in some form is a possible mechanism whereby life-long immunity is conferred on an infected individual. In addition to the severe, often fatal, acute disease these viruses can, in rare cases, lead to a fatal chronic disease of the CNS. Molecular biological studies will be described which are beginning to elucidate their evolutionary relationships and to provide a basis for understanding the role of individual virus genes in pathogenesis.

Publication Types:
  • Review
  • Review, Tutorial

PMID: 3332767 [PubMed - indexed for MEDLINE]

J Pediatr 1965; 66: 471-88

        Studies on immunity to measles.

        Krugman S, Giles JP, Friedman H, Stone S.

Studies on immunity to measles have been in progress since 1960.  Primary infection with measles virus was followed by evidence of detectable antibody by the twelfth day; peak antibody titers were observed by the twenty-first to the twenty-eighth day.  Subsequently, in most instances antibody persisted for at least four years at levels capable of completely inhibiting measles infection.  However, when antibody declined to minimal or undetectable levels, exposure to measles virus was usually followed by an asymptomatic infection and a booster response; under these circumstances antibody was detectable by the seventh day and peak antibody levels were observed by the twelfth day.  These studies confirm the observation that one attack of measles is followed by lifelong immunity.  They also provide strong support for the prediction that one inoculation of live measles-virus vaccine will confer permanent immunity.

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