In 1994, countries of the Region of the Americas set a goal of interrupting indigenous measles transmission, and the regional plan of action for achieving this goal was begun in 1996. As of March 16, 2003, the Region of the Americas has been free for 17 weeks from known circulation of the d9 measles virus, the strain responsible for the only large outbreak of measles in the region during 2002 (Figure).
Karolinska Institutet, Institute of Environmental Medicine, Department of Environmental Epidemiology, Box 210, SE-171 77 Stockholm, Sweden. helen.rosenlund@ki.se
OBJECTIVE: Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization. METHODS: A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy-Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study, conducted in 5 European countries (Austria, Germany, the Netherlands, Sweden, and Switzerland). The children were between 5 and 13 years of age and represented farm children, Steiner-school children, and 2 reference groups. Children attending Steiner schools often have an anthroposophic (holistic) lifestyle in which some immunizations are avoided or postponed. Parental questionnaires provided information on exposure and lifestyle factors as well as symptoms and diagnoses in the children. A sample of the children was invited for additional tests, and 4049 children provided a blood sample for immunoglobulin E analyses. Only children with complete information on measles vaccination and infection were included in the analyses (84%). RESULTS: In the whole group of children, atopic sensitization was inversely associated with measles infection, and a similar tendency was seen for measles vaccination. To reduce risks of disease-related modification of exposure, children who reported symptoms of wheezing and/or eczema debuting during first year of life were excluded from some analyses. After this exclusion, inverse associations were observed between measles infection and "any allergic symptom" and "any diagnosis of allergy by a physician." However, no associations were found between measles vaccination and allergic disease. CONCLUSION: Our data suggest that measles infection may protect against allergic disease in children.
Genetic and environmental factors have important roles in multiple sclerosis (MS) susceptibility. Several studies have attempted to correlate exposure to viral illness with the subsequent development of MS. Here in a population-based Canadian cohort, we investigate the relationship between prior clinical infection or vaccination and the risk of MS.
Using the longitudinal Canadian database, 14,362 MS index cases and 7,671 spouse controls were asked about history of measles, mumps, rubella, varicella and infectious mononucleosis as well as details about vaccination with measles, mumps, rubella, hepatitis B and influenza vaccines. Comparisons were made between cases and spouse controls.
Spouse controls and stratification by sex appear to correct for ascertainment bias because with a single exception we found no significant differences between cases and controls for all viral exposures and vaccinations. However, 699 cases and 165 controls reported a history of infectious mononucleosis (p
In 1992, because of the limitations of the one-dose measles immunization program, the National Advisory Committee on Immunization (NACI) recommended a two-dose measles immunization program to eliminate measles. More recently, NACI recommended also a special catch-up program to prevent predicted measles outbreaks and to achieve an earlier elimination of measles. The objective of this study was to complete a benefit-cost analysis of a two-dose immunization program with and without a mass catch-up compaign compared with the current one-dose program. The resulting benefit: cost ratios vary between 2.61:1 and 4.31:1 depending on the strategy used and the age of the children targeted. Given the parameters established for this analysis, the benefits of a second-dose vaccination program against measles far outweight the costs of such a program under all scenarios.
Mumps is a highly contagious viral infection prevented by immunization with live attenuated vaccines. Mumps vaccines have proven to be safe and effective; however, rare cases of aseptic meningitis (AM) can occur after vaccination. The range of meningitis occurrence varies by different factors (strain, vaccine producer, and so on). Monovaccines or divaccines (mumps-measles vaccine), prepared from the strain Leningrad-3 (L-3), are used in Russia. Meningitis occurrence after vaccination has been established previously as very low. Nevertheless, with the number of children being vaccinated every year, vaccine-associated AM cases still occur. There is no official statistics on AM incidence after mumps vaccines, and information on AM features as an adverse event of mumps vaccination is limited and mostly devoted to vaccines, prepared from strains other than L-3.
The study included patients with AM who were vaccinated against mumps in the previous 30 days before the present disease onset during 2009-2019.
Patients admitted to Infectious Clinical Hospital No. 1, Moscow, Russia, with AM were observed by a pediatrician and were screened for etiological agents of meningitis.
Seven patients were enrolled, and clinical features and the course of infection are presented.
Detection of only 7 cases of AM associated with mumps vaccination during the 10-year period supports very low occurrence of this adverse event after immunization with the L-3 strain-based mumps vaccines. Nevertheless, the annual number of AM cases that occur after mumps vaccination remains unknown and poorly diagnosed in practice because of the low awareness of physicians of this adverse reaction. Detection and objective coverage of such cases can lead to a weakening of 'antivaccination' moods in a society and to restoration of confidence in the healthcare system.
H:S Rigshospitalet, klinisk mikrobiologisk afdeling, Statens Serum Institut, epidemiologisk afdeling og virologisk afdeling, og Københavns Universitet, Institut for Medicinsk Mikrobiologi og Immunologi. siig@biobase.dk
Measles vaccination was implemented in the child vaccination programme in Denmark in 1987 and produced a rapid decline in the incidence. Few cases were recorded annually until 1999. The measles virus isolated in Denmark during 1997-1998 was compared by partial sequencing of the haemagglutinin-coding region with Danish strains from the prevaccination era collected in 1965-1983, as well as with representatives of globally circulating strains of today. The dissimilarity of the prevaccination era strains identified in Denmark in 1997-1998 along with the similarity of these five strains with globally circulating strains at present, substantiate the conclusion that there is no persistent circulation of the measles virus in Denmark.
The threat of measles will be eliminated for 72% of Canadian schoolchildren this spring as seven provinces/territories establish routine two-dose schedules for measles-mumps-rubella vaccination, including five jurisdictions that are undertaking universal catch-up immunization programs. The initiatives move the country closer to its commitment to eradicate measles by the year 2000.
