Maternal antibodies protect against
measles in infancy
[Seroprevalence of IgG antibodies against
measles, mumps and rubella in Swiss children during the first 16 months of
life]
[Article in German]
Desgrandchamps D, Schaad UB, Glaus J, Tusch G, Heininger U.
Abteilung fur Infektiologie und Vakzinologie, Universitats-Kinderspital beider
Basel.
OBJECTIVE: To study the question of how long maternal IgG antibodies against
measles, mumps and rubella persist in infants. METHODS: Sera of children aged
0-16 months who had been hospitalised in our institution between 1994 and 1999
were identified from our routine serum collection. Exclusion criteria were:
preterm delivery; suspected measles, mumps or rubella illness or exanthema of
unknown aetiology; transfusion of blood products in the 6 months preceding
serum collection; foreign-born mother; previous MMR immunisation. IgG
antibodies were measured by use of commercially available ELISA kits. RESULTS:
254 serum specimens were analysed. Age distribution of patients was as follows:
0-3 months n = 58; > 3-6 months n = 48; > 6-9 months n = 52; > 9-12
months n = 42; > 12-16 months n = 54. The following seroprevalence rates for
IgG antibodies were found (measles/mumps/rubella): 0-3 months 97%/62%/91%; >
3-6 months 40%/2%/42%; > 6-9 months 4%/2%/10%; > 9-12 months 2%/0%/12%;
> 12-16 months 0%/7%/7%. CONCLUSIONS: Our results demonstrate high levels of passive immunity
against measles and rubella in Swiss infants during the first months of
life, whereas immunity against mumps appears to be considerably less reliable.
Beyond the first 3 months of life, IgG antibodies against all 3 illnesses are
lacking in the majority of patients; beyond 12 months of age they are only rarely
detectable. These results raise the question whether the first MMR
immunisation, currently recommended at the age of 15 months in Switzerland,
should be brought forward.
PMID: 11075412 [PubMed - indexed for MEDLINE]
Comment in:
·
Pediatr
Infect Dis J. 1998 Aug;17(8):763.
Loss maternally derived measles immunity in
Argentinian infants.
Nates SV, Giordano MO, Medeot SI, Martinez LC, Baudagna AM, Naretto E,
Garrido P, De Wolff CD.
Instituto de Virologia Dr. J. M. Vanella, Facultad de Ciencias Medicas,
Universidad Nacional de Cordoba, Ciudad Universitaria, Argentina.
snates@cmefcm.uncor.edu
BACKGROUND: Measles immunization of children at 1 year of age with a single
dose of the current vaccine has successfully reduced measles incidence in
Argentina. However, the optimal schedule of measles vaccination of young
infants would balance the risk of early loss of maternal antibody in the majority of infants with
the risk of primary vaccine failure because of passive measles immunity. This study is the first
to document a significant association between loss of passive measles antibody
and age among infants born in 1995 and 1996 in Cordoba City, Argentina.
METHODS: This is a seroprevalence study of 340 infants to investigate the
duration of transplacentally derived measles antibody, assayed by a
neutralization test, during the first 8 months of age in Cordoba City, Argentina.
RESULTS: The proportion with detectable neutralizing measles antibodies
decreased from 85% at 1 month of age to 8% at 8 months of age. The simple
logistic model with age (in weeks) as the only variable showed that the decline
in the proportion of infants with a positive antibody titer was sharpest during
the second and fifth months of age (6.6 and 6.8% per week during a 4-week
period, respectively). CONCLUSIONS: These findings suggest that 80% of infants
are susceptible to measles infection for at least 3 months before routine
immunization at 12 months of age.
PMID: 9576386 [PubMed - indexed for MEDLINE]
Maternal immunity to measles and infant
immunity at less than twelve months of age relative to maternal place of birth.
Bromberg K, Shah B, Clark-Golden M, Light H, Marcellino L, Rivera M, Li PW,
Erdman D, Heath J, Bellini WJ.
Children's Medical Center, Brooklyn, New York 11203.
Sera from infants aged 5 to 11 months and from their mothers were used to
investigate the level and
duration of transplacentally derived measles antibody. The infants of foreign-born,
inner-city mothers were more likely to have measles antibody and were less
likely to get measles. Infants of foreign-born mothers, because they are
less likely to respond to measles vaccine, may require different vaccine
strategies than infants of mothers born in the United States.
PMID: 7931876 [PubMed - indexed for MEDLINE]
Presumably,
the reason infants born in the U.S. are more likely to respond is that their U.S.
mothers are likely to have been vaccinated and therefore provide less and of
shorter duration passively acquired maternal antibodies. - SM
[Transplacental measles immunity in infants
in the 1st year of life]
[Article in Russian]
Bystriakova LV, Zaitseva RV, Kolobova LV, Pushkareva EA, Smorodinova IP.
A total of 187 parturients (66 with a history of measles and 121 immunized with
live measles vaccine, or LMV, in childhood) and their 187 newborn infants, as
well as 195 children aged up to 1 year, were examined. Antimeasles antibodies
in blood sera were detected in the hemagglutination inhibition test. In all mothers with a history of
measles and in their newborn infants antimeasles antibodies in different titers
were detected. In mothers, formerly immunized with LMV, antimeasles
antibodies were absent in 5.8% and in their newborn infants, in 6.6% of the
examinees. Among children aged up to 1 year, born of formerly immunized
mothers, more rapid disappearance of passive antimeasles immunity was observed.
In cases of contact with measles, the serological examinations of all children
born of mothers immunized with LMV should be carried out in order to protect
seronegative children by passive or active immunization.
PMID: 1839342 [PubMed - indexed for MEDLINE]
Loss of maternal measles antibody in black
South African infants in the first year of life--implications for age of
vaccination.
Kiepiela P, Coovadia HM, Loening WE, Coward P, Abdool Karim SS.
Department of Paediatrics and Child Health, University of Natal, Durban.
In order to investigate the feasibility of measles vaccination before the age
of 9 months the duration of passive
immunity against measles was estimated by conducting a longitudinal
study of measles antibody levels in 20 black neonates delivered at term.
Measles serum antibody (IgG) was measured by enzyme-linked immunosorbent assay
in the mother at childbirth and on consecutive samples taken from the infants
from birth until 9 months of age. Protective measles antibody level was defined
as greater than 200 mIU. Unprotective levels were found in 88% (95% confidence
interval (CI) 81-99%) of 6-month-old infants, while at 9 months all were
susceptible. The mean antibody level was 192 mIU (CI 104-348%) at 4 months; 34
mIU (CI 15-73%) at 6 months and 13 mIU (CI 6-24%) at 9 months of age. Our data
support the recent World Health Organisation recommendation to immunise
children in developing countries at 6 months with the 'high titre'
Edmonston-Zagreb measles vaccine, since most infants in our study had lost
passive immunity against measles by this age.
PMID: 1994484 [PubMed - indexed for MEDLINE]
Principles of measles control.
Cutts FT, Henderson RH, Clements CJ, Chen RT, Patriarca PA.
Immunization Division, Centers for Disease Control, Atlanta, GA 30333.
WHO's Expanded Programme on Immunization has significantly helped to reduce
global morbidity and mortality from measles. Recently, some African countries
with high vaccine coverage levels have reported measles outbreaks in children
above the current target age group for immunization. Outbreaks such as these
are to be expected, unless close to 100% of the population are immunized with a
vaccine which is 100% effective. Success of an immunization programme requires
identification of the distribution and ages of susceptible children and
reduction of their concentration throughout the community. Priority should be
given to urban and densely populated rural areas. In large urban areas, high coverage of infants must be
achieved soon after the age at which they lose their maternal antibodies and
become susceptible. This will be facilitated by the introduction of
high-dose measles vaccines which can be given at 6 months of age. Where measles
incidence is increasing among children aged over 2 years, immunization of older
children may be considered during contacts with the health care system, or at
primary school entry, if this does not divert resources from immunization of
younger children. Health workers should be informed of the predicted changes in
measles epidemiology following immunization. The collection, analysis and use
of data on measles (vaccine coverage, morbidity and mortality) should be
improved at all levels of the health care system in order to monitor the
immunization programme's overall impact, identify pockets of low coverage, and
allow early detection of and response to measles outbreaks.
Publication Types:
·
Review
·
Review, Tutorial
PMID: 2054914 [PubMed - indexed for MEDLINE]
Measles in developing countries. Part I.
Epidemiological parameters and patterns.
McLean AR, Anderson RM.
Department of Pure and Applied Biology, Imperial College, London University.
This paper presents a review of published data concerning the epidemiology of
measles in developing countries. Simple mathematical models provide a framework
for data analysis and interpretation. The analyses highlight differences and
similarities in the patterns of transmission of the measles virus in developed
and developing countries. Whilst the rate of loss of maternally derived immunity to measles is
broadly similar, the average age at infection is much lower, and case fatality
rates are much higher in developing countries. Data analysis also serves to
illustrate inter-relationships between different kinds of epidemiological data.
Thus, for example, in order to correctly interpret an age stratified
serological profile from a developing country it is necessary to have
information on the rate of decay of maternal antibodies and age specific case
fatality rates. To determine the probable impact of a given vaccination
programme, information on the birth rate in the community concerned is also
required. A discussion is given of the epidemiological data required in order
to effectively design a community based vaccination programme aimed at the
eradication of measles.
PMID: 3338500 [PubMed - indexed for MEDLINE]
High measles mortality in infancy related to
intensity of exposure.
Aaby P, Bukh J, Hoff G, Leerhoy J, Lisse IM, Mordhorst CH, Pedersen IR.
In a West African urban community, measles infection in infants was examined
over 5 years (1979-1983). In the age group 0 to 11 months, measles mortality
was higher among secondary cases (infected in the house) than among index cases
(infected outside the house), and the proportion of secondary cases was
significantly higher for this age group than for older children. Intensive
exposure related to the social pattern of disease transmission may be important
in explaining the high infant mortality observed with measles in developing
countries. Mortality
during the first 12 months of life increased with age, presumably because of
the decrease of maternally derived measles antibodies. In children
younger than 6 months of age, who are usually considered to be protected by
maternal antibody, intensive exposure may lead to infection, as demonstrated by
a high level of measles-specific antibodies in some children exposed to an
older sibling with measles. The aim of public health policies should be to
change conditions of exposure.
PMID: 3723239 [PubMed - indexed for MEDLINE]
Disappearance of measles antibody in Thai
infants after birth.
Vanprapar N, Chavalittamrong B, Chearskul S, Pimolpan V.
A seroepidemiology of measles hemagglutination inhibition antibody was studied
in infants at birth to 8 months of age. It was found that at birth the antibody
was greater than 1:8 in 56 of 64 newborns. At 2 and 4 months of age, 9 of 21
and 12 of 21 respectively had measles antibody titer less than 1:8, while at 8
months of age, only 1 of 6 had the antibody titer greater than 1:8. It shows that the maternal
measles antibody can protect the infant at young age and the decrease in
antibodies occur as the child grows. The measles vaccine should be given when
the maternal passive immunity of measles disappears. This study indicates that
the optimal age to recommend measles vaccination should be at the age of 9
months.
PMID: 6673124 [PubMed - indexed for MEDLINE]
-
Measles in the 1980s.
Christopher PJ, MacDonald PA, Murphy AM, Buckley PR.
We detail aspects of measles immunization programmes in several countries.
Live measles vaccine has been available in Australia for 16 years, yet, in
1981, there were outbreaks of measles in the State of New South Wales
(population 5 200 000) which led to 2200 admissions to hospital and five
deaths. In response to complaints of "vaccine failure", a survey
determined that 22.5% of children with measles seen by general practitioners
and 10.3% of those admitted to hospitals had been previously immunized.
There was no evidence of waning immunity, and noparticular batch of vaccine
was implicated. The vaccine failures are attributed in part to failure of
seroconversion in some recipients when immunized at 12 months of age as a
result of interference by transplacentally
acquired antibodies. As more of the susceptible population is
vaccinated, there will be fewer cases of measles, but among these cases will
be an increasing proportion of cases occurring in previously vaccinated
individuals. The equation to calculate this expected proportion of
"vaccine failures" is given. We support the measures to increase
immunization compliance.
PMID: 6633361 [PubMed - indexed for MEDLINE]
-
Selective primary health care: strategies for control
of disease in the developing world. IV. Measles.
Walsh JA.
Measles, a highly contagious viral disease, kills several hundred thousand
infants and young children yearly. Essentially all children will become
infected; at least 1% of those living in developing countries will die
unless protected by immunization. In urban areas, peak incidence occurs in
those younger than three years. The youngest and most undernourished
children suffer the most severe complications and the highest risk of
death. Diarrhea, malnutrition, pneumonia, and blindness associated with
vitamin A deficiency are the worst complications. The infection is
preventable by the timely administration of a potent vaccine. This
endeavor requires a well-managed technical and administrative network that
remains difficult to organize in many areas of the world. The vaccine is
efficacious and has few adverse effects but must be provided to children
during the short interval between loss of transplacentally
acquired antibodies and the acquisition of natural infection. The
improvements in heat stability of the vaccine increase the likelihood of
providing potent vaccine, but a well-managed cold chain remains a
prerequisite for any successful immunization program. Health education,
improved management skills, publicity, and community support are all
important factors for ultimately preventing the morbidity and mortality
from this disease.
PMID: 6844806 [PubMed - indexed for MEDLINE]
-
Measles immunity and immunization in developing countries
of Africa: a review.
Abdurrahman MB, Taqi AM.
Although an effective vaccine against measles has been available for several
years, the disease is still prevelant in Africa. The disease is
characterized by its occurrence in younger age groups and high morbidity and
mortality. The African child is born
with a high transplacentally acquired measles antibody level. However, the
antibody declines rapidly, so that it is virtually absent after the age of 6
months. The measles vaccine with which the African child is immunized
is of reduced potency because of poor storage and transportation facilities
and the adverse effect of tropical climate on the vaccine. The pattern of
measles immunity in Africa is different from that in developed countries.
Measles immunization schedule in Africa, as in any other part of the world,
must be based on sound epidemiological and serological data.
Publication Types:
PMID: 6287828 [PubMed - indexed for MEDLINE]
Books,