Abstract

Measles vaccines have been in use since the 1960s with excellent safety and effectiveness profiles. Limited data are available on detection of measles vaccine virus (MeVV) RNA in human subjects following vaccination. Available evidence suggests MeVV RNA can be identified up to 14 days after vaccination, with detection beyond this rare. In routine diagnostic testing, we used two real-time reverse transcription-polymerase chain reaction (RT-rPCR) assays targeting M and F genes to identify measles virus (MeV) and MeVV RNA. Confirmatory testing was performed with an N gene RT-rPCR, followed by sequence confirmation of RT-rPCR positives by semi-nested conventional RT-PCR assays targeting portions of the N, H, and L genes. We report detection and confirmation of MeVV RNA from the respiratory tract of 11 children between 100 and 800 days after most recent receipt of measles-containing vaccine. These novel findings emphasize the importance of genotyping all MeV detections and highlight the need for further work to assess whether persistent MeVV RNA represents viable virus and if transmission to close contacts can occur.

Highlights

  • Measles virus (MeV) is one of the most infectious pathogens of humans

  • In 2014, a local public health unit initiated a follow-up process for a patient who was measles virus (MeV) reverse transcription-polymerase chain reaction (RT-rPCR)

  • measles vaccine virus (MeVV) RNA was present in this sample, collected 548 days after most recent measles vaccination (Table 1, case 4)

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Summary

Introduction

Measles virus (MeV) is one of the most infectious pathogens of humans. It is highly transmissible with 90% of non-immune contacts exposed becoming infected; a high level of population immunity is required to interrupt transmission [1,2]. In March 2014, Australia was certified by the World Health Organization (WHO) as having eliminated measles [8]. Information about the detection of measles vaccine virus (MeVV) and MeVV RNA in human clinical samples is limited. We report a series of extremely delayed MeVV RNA detections, identified by testing specimens submitted for diagnostic measles PCR, more than 100 days following vaccination in Queensland, Australia

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