Measles Mumps Research Articles

Intralesional antigen immunotherapy for the treatment of plane warts: A comparative study.

Intralesional immunotherapy by different antigens has shown promising efficacy and safety in the treatment of warts. However, the use of these antigens for the treatment of plane warts has been investigated in two studies only. To evaluate the efficacy and safety of three antigens; Measles Mumps, Rubella vaccine (MMR), Candida antigen, and purified protein derivative (PPD) in the treatment of multiple plane warts. The study included 120 patients who were randomly assigned to three groups, 40 patients in each group. Each agent was injected intralesionally at a dose of 0.1 mL into the largest wart at 2-week intervals until complete clearance or for a maximum of five sessions. Complete clearance of warts was observed in 55% of the PPD group, in 70% of the Candida antigen group, and in 62.5% of the MMR group. No statistically significant difference in the therapeutic response was found between the three groups. Intralesional antigen immunotherapy seems to be a promising well-tolerated and effective therapeutic option for the treatment of multiple plane warts, with relatively higher efficacy of Candida antigen.

Reasonable Grounds? The Delayed Introduction of MMR Vaccine in Denmark and the Netherlands, 1977–87

It is commonly argued that the decision to introduce a new vaccine is properly based on objective and measurable criteria, including disease burden and efficacy of the vaccine. Moreover, new vaccines are to be introduced rapidly and globally: delay is difficult to justify. Historical studies of new vaccine introductions paint a rather different and more complex picture. The few studies comparing new vaccine introduction in different countries suggest that ‘evidence’ for the efficacy of a vaccine was commonly subjected to varying interpretations. This paper, based on analysis of the introduction of the measles–mumps–rubella (MMR) vaccine in Denmark and the Netherlands, takes this argument further. Though both countries are – and were – small welfare states with well-organised national immunisation programmes, both adopted MMR a full decade after its introduction in the USA. The paper suggests that the reasons for delaying, in each case, are a reasonable reflection of each country’s concerns, perceptions of the three diseases, and technological approaches already adopted. There were differences in each of these respects. The decision to adopt MMR, which each country eventually took, was significantly influenced by the political and ideological changes taking place in the 1980s, including a growing emphasis on costs and benefits, as well as the growing influence of the international context.

Is keeping my child from getting the MMR vaccine unethical? Bioethical arguments for informed decision-making

Abstract Measles is a viral illness that poses a potentially fatal threat to health all over the world, especially for children. Due to the increase in measles outbreaks in the last few years, and the ever-growing popularity of anti-vaccine groups, it needs to be determined whether or not vaccine refusal is ethical, as it is an important issue that can have an effect on parental decision-making. A brief review is presented on the Measles Mumps Rubella (MMR) vaccine and recent outbreaks, with special attention to the role of anti-vaccine movements. Diverse bioethical perspectives are discussed to answer this issue. Informed consent is advised for all settings and mandatory vaccination is suggested for high risk children and vulnerable groups, based on the bioethical analysis.

Antibodies to measles, mumps, and rubella virus in Thai children after two-dose vaccination at 9 months and 2.5 years: A longitudinal study

IntroductionThailand changed the schedule of childhood measles–mumps–rubella (MMR) vaccination in 2014, moving the second dose from the age of 6 years to 2.5 years. There are currently no data on antibody responses to the MMR vaccine since this recommendation. Material and methodsWe investigated antibody responses in a cohort of children who received two doses of MMR vaccine at the ages of 9 months and 2.5 years that was originally established to evaluate antibody levels to Bordetella pertussis antigens (ClinicalTrials.gov no. NCT02408926). Infants were born to mothers who previously received tetanus–diphtheria–acellular pertussis vaccine at 27–36 weeks of gestation. Anti-measles, -mumps, and -rubella virus IgG levels were measured at birth (cord blood) and the ages of 2 and 7 months (before the first MMR vaccination); 18 and 24 months (9 and 15 months, respectively, after the first dose); and 36 months (6 months after the second dose) using commercially available enzyme-linked immunosorbent assay kits. ResultsAt 7 months of age, 96.2%, 99.6%, and 98.8% of infants had no protection against measles, mumps, and rubella, respectively. Levels of antibody against all three antigens increased significantly after the first but not the second dose. At 6 months after two-dose vaccination, 97.4%, 84.8%, and 78.7% of children remained seroprotected against measles, mumps, and rubella, respectively. ConclusionsMaternally derived antibodies to measles, mumps, and rubella virus disappeared by the age of 7 months in Thai children. Two-dose MMR vaccination at 9 months and 2.5 years of age induced robust immune responses against these viruses.

Diphtheria-Tetanus-Polio, Measles-Mumps-Rubella, and Hepatitis B Vaccination Coverage and Associated Factors among Homeless Children in the Paris Region in 2013: Results from the ENFAMS Survey.

Background: The number of homeless families has increased considerably since the 1990s in France. We aimed to estimate the homeless children vaccination coverage (VC) for diphtheria, tetanus, polio, measles–mumps–rubella and hepatitis B and identify factors associated with insufficient VC according to birthplace. Methods: A cross-sectional survey was conducted among homeless shelter families in the greater Paris area. A nurse conducted face-to-face interviews and collected vaccination records. We analyzed factors associated with insufficient VC, stratified by birthplace and vaccine, using robust Poisson regression. Results: The study included 214 children born in France and 236 born outside France. VC in French-born homeless children was high (>90% at 24 months for most vaccinations) and similar to levels observed in the general population, whereas VC in those born outside France was low (<50% at 24 months for all vaccines). Factors significantly associated with insufficient VC among children born outside France were age, parents with French-language difficulties, and changing residence at least twice in the previous year. Children in contact with the healthcare system at least once in the previous year had significantly higher VC, irrespective of vaccine and birthplace. Conclusion: Special attention should be paid to homeless children born outside France, with recent European and French recommendations confirming the need for catch-up vaccination in children with undocumented VC.

Consequences of Undervaccination — Measles Outbreak, New York City, 2018–2019

BackgroundMeasles was declared eliminated in the United States in 2000, but the risk of outbreaks owing to international importations remains. An outbreak of measles in New York City began when one unvaccinated child returned home from Israel with measles; onset of rash occurred on September 30, 2018, 9 days after the child returned home.MethodsWe investigated suspected cases of measles by conducting interviews, reviewing medical and immunization records, identifying exposed persons, and performing diagnostic testing. Measles–mumps–rubella (MMR) vaccine (given as either MMR or measles–mumps–rubella–varicella vaccine and collectively referred to as MMR vaccine) uptake was monitored with the use of the Citywide Immunization Registry. The total direct cost to the New York City Department of Health and Mental Hygiene was calculated.ResultsA total of 649 cases of measles were confirmed, with onsets of rash occurring between September 30, 2018, and July 15, 2019. A majority of the patients (93.4%) were part of the Orthodox Jewish community, and 473 of the patients (72.9%) resided in the Williamsburg area of Brooklyn, New York. The median age was 3 years; 81.2% of the patients were 18 years of age or younger, and 85.8% of the patients with a known vaccination history were unvaccinated. Serious complications included pneumonia (in 37 patients [5.7%]) and hospitalization (in 49 patients [7.6%]); among the patients who were hospitalized, 20 (40.8%) were admitted to an intensive care unit. As a result of efforts to promote vaccination, the percentage of children in Williamsburg who received at least one dose of MMR vaccine increased from 79.5% to 91.1% among children 12 to 59 months of age. As of September 9, 2019, a total of 559 staff members at the Department of Health and Mental Hygiene (7% of the agency) had been involved in the measles response. The cost of the Department of Health and Mental Hygiene response was $8.4 million.ConclusionsImportation of measles and vaccination delays among young children led to an outbreak of measles in New York City. The outbreak response was resource intensive and caused serious illness, particularly among unvaccinated children.

Confirmatory bias in health decisions: Evidence from the MMR-autism controversy

Since Wakefield et al. (1998), the public was exposed to mixed information surrounding the claim that measles–mumps–rubella vaccine causes autism. A persistent trend to delay the vaccination during 1998–2011 in the US was driven by children of college-educated mothers, suggesting that these mothers held biases against the vaccine influenced by the early unfounded claim. Consistent with confirmatory bias, exposures to negative information about the vaccine strengthened their biases more than exposures to positive information attenuated them. Positive online information, however, had strong impacts on vaccination decisions, suggesting that online dissemination of vaccine-safety information may help tackle the sticky misinformation.

Intralesional measles–mumps–rubella is associated with a higher complete response in cutaneous warts: a systematic review and meta-analysis of randomized controlled trial including GRADE qualification

Introduction Warts can be difficult to treat and progressing to chronic and resistant disease. Several studies have reported the successful application of mumps–measles–rubella (MMR) vaccine resulting in clearance of warts via immunomodulation and induction of immune system. Methods We performed a comprehensive search on the role of intralesional MMR in warts from several electronic databases. Complete response is defined as complete clearance of warts lesion. Results There were a total of 425 subjects from five studies. Intralesional injection of MMR was associated with an increased complete response (OR 9.43 [5.78, 15.37], p < .001; I 2: 5%, p = .38). Subgroup analysis on patients receiving injection for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [6.40, 21.38], p < .001; I 2: 20%, p = .29. Patients receiving intralesional MMR were associated with a lower partial response (OR 0.54 [0.33, 0.88], p = .01; I 2: 0%, p = .66). Intralesional MMR was associated with a reduced no-response (OR 0.16 [0.06, 0.43], p < .001; I 2: 69%, p = .01). Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias. There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord’s test (p = .047). Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000. Conclusion Intralesional MMR injection was associated with a higher complete response and lower no-response with a high level of certainty.

P782 Immune status to viral infectious diseases and associated factors in Korean patients with inflammatory bowel diseases

Abstract Background Data on the protective immune status against measles, mumps, rubella, varicella zoster virus (VZV), hepatitis A virus (HAV) and Epstein–Barr virus (EBV) infection among inflammatory bowel disease (IBD) patients is still lacking. Therefore, we investigated seropositivity to viral infectious diseases and associated factors in Korean IBD patients. Methods In this retrospective cohort study, serum immunoglobulin G (IgG) antibody positivity against measles virus, mumps virus, rubella virus, VZV, HAV and EBV viral capsid antigen (VCA) were measured in consecutive patients with Crohn’s disease (CD) or ulcerative colitis (UC) who first visited the IBD clinic of Asan Medical Centre, Seoul, Korea. Seropositivities and their associated factors were analysed. Results Of 263 study subjects, one hundred sixty seven (67.3%) were males. Median age at diagnosis of IBD and median age at serologic tests were 28 years (interquartile range [IQR], 20–41) and 30 years (IQR, 22–46), respectively. UC patients were 50.9% (n = 134) and median disease duration at serologic tests were 6 months (IQR, 0–59). One hundred eighty two patients (69.2%) were not under any immunosuppressive therapy. Seropositivity rates were 84.0% for measles, 85.2% for mumps and 66.5% for rubella. IgG anti-VZV positivity rates were 87.4%, but only half (50.0%) were positive for IgG anti-HAV. IgG against EBV VCA was positive in 93.6%. Younger age at IBD diagnosis (&amp;lt;40 years) was independently associated with non-protection status against measles (odds ratio [OR], 8.76; 95% confidence interval [CI], 2.06–37.30). Younger age (&amp;lt;40 years) at serologic test was independently associated with non-protection status against rubella (OR, 2.08; 95% CI, 1.16–3.73) and HAV (OR, 9.07; 95% CI, 4.51–18.24). Among 182 patients who were not under any immunosuppressive therapy, seropositivity rates were 83.0% for measles, 85.2% for mumps, 67.6% for rubella, 88.9% for VZV, 52.5% for HAV and 92.0% for EBV VCA, respectively. Younger age at IBD diagnosis (&amp;lt;40 years) was independently associated with non-protection status against measles (OR, 14.41; 95% CI, 1.91–108.78) and HAV (OR, 14.52; 95% CI, 4.85–43.49). IBD type, UC was independently associated with seroprotection status against HAV (OR, 2.55; 95% CI, 1.28–5.09) among patients who were not under immunosuppressive therapy. Conclusion Seroprotection rates for common vaccine-preventable diseases and EBV among Korean IBD patients with or without immunosuppressive therapy were similar to those of the general Korean population. In the young age group under 40 years old, immunity to measles, rubella and HAV is needed to be checked together with proper vaccination as needed.

Cross-sectional Retrospective Study on Paracetamol Post Infants' Vaccination in Malaysia.

ABSTRACTIntroduction:Practice of dispensing paracetamol (PCM) in post infants’ vaccination remains debatable in Malaysia as the administration of PCM postvaccination in infants was found to cause the vaccine to be less effective, thus requiring appropriate regulation measures.Objective:This research aimed to investigate the prevalence of adverse events following immunization (AEFI) with/without PCM to be prescribed post infants’ vaccination in Malaysia (possible associated factors: age, types and stages of vaccination, concomitant vaccines and drugs, and/vitamins).Materials and Methods:A retrospective cross-sectional study was conducted from 2011 to 2017. The AEFI was extracted from Quests 2, 3, and 3+ System of National Pharmaceutical Regulatory Agency (NPRA). The population of vaccinated infants was obtained from the Ministry of Health (MOH) Malaysia official website. The AEFI data were further categorized into (i) AEFI with possibility for PCM to be prescribed, and (ii) AEFI with no possibility for PCM to be prescribed. The data were analyzed using Microsoft Excel 2013, Portland, USA simple and multiple logistic regression tests, Statistical Package for the Social Sciences (SPSS) software programme, version 22.0 (IBM), New York, USA.Result:Various AEFI cases (359 infants) were reported. DTaP/Hib/IPV and measles–mumps–rubella (MMR) showed higher prevalence of AEFI with/without PCM to be prescribed post infants’ vaccination cases per 100,000 population (2.07 and 2.21, respectively) than other types of vaccinations. DTaP/Hib/IPV (2 months) vaccination showed the highest value (3.00) among other age groups. Backward elimination presented DTaP/Hib/IPV (3–4 months) (95%CI; 0.231, 0.899%; P = 0.023) was the possible associated factor. Hepatitis B (1–5 months), DTaP/Hib/IPV (3–4 months), DTaP/Hib/IPV (5–12 months), concomitant vaccines as well as concomitant drugs and/ vitamins were the identified potential cofounders.Conclusion:Prescribing and dispensing of PCM post infants’ vaccination may be confined to DTaP/Hib/IPV (2–4 months) and 12 months MMR groups.

Evaluation of Immunity to Measles in a Cohort of Medical Students in Rome, Italy.

Background: Measles is a highly contagious viral disease with serious complications. Currently, in Italy, measles vaccination is not mandatory for health care workers (HCWs) and medical students, and the free offer of the Measles Mumps Rubella (MMR) vaccine is the only national prevention measure to increase the coverage rate among these subjects. Aims: The aim of our study was to evaluate the impact on vaccination rate of the National Plan of Vaccine Prevention (NPVP) implemented in 2017. Material and Methods: This is a retrospective observational study that evaluated the measles-specific IgG immunity status of medical students at the University Tor Vergata of Rome, which underwent occupational health surveillance from 1 January to 31 December 2018. Results: In 2018, 84 of 319 students (26.30%) were serologically non-immune to measles; among these, 16 (19%) had previously been vaccinated, and 35 of the remaining 68 students accepted the MMR vaccine. Therefore, 33 out of 319 students did not undergo vaccination in 2018. These data are similar to those obtained in the previous year. In the 2017 screening, 84/314 (26.75%) students tested negative at the serological screening, whereas 15/85 (17.8%) among them documented a previous vaccination with two doses of the MMR vaccine; 69 students tested as unprotected. Vaccine compliance was 51.44%. Conclusions: No change in vaccination coverage occurred after the introduction of the last NPVP. Further efforts are needed to sensitize target populations about the relevance of vaccination; providing pre-employment screening for measles and free vaccine might be useful for this purpose.

Measles mumps and rubella virus vaccine

Measles mumps and rubella virus vaccine

PIN141 SOCIAL MEDIA AND VACCINE HESITANCY: FOCUS ON MMR

Vaccine hesitancy was listed as the number seven threat to global health by the World Health Organization in 2019 – a point exemplified by ongoing, preventable measles outbreaks. Today, it is easier than ever for anti-vaccination groups to share ‘fake news’ due to global internet and social media access. We investigated the impact of social media on vaccine uptake/awareness – using the measles mumps and rubella (MMR) vaccine as an example. A structured literature search using Embase, Medline, PsycInfo and EBM reviews, utilising terms relating to MMR vaccination and social media/internet was conducted (limits: English language; 2009–2019). Supplementary online searches using no predefined search terms were conducted. Eighteen relevant studies were identified: the negative impact of social media was highlighted in eight whilst the remaining also highlighted a positive impact. Impact on vaccine uptake as a percentage was not identified – however, coverage was inversely correlated to internet search activity, Tweets and Facebook posts in one study and being influenced by the internet in another. Other negative factors included: inaccurate/false information being easier to access than accurate information when researching risks and anti-vaccination groups being more active than pro-vaccination – e.g. although a minority of social media posts/comments focused on anti-vaccination, they received more likes and were disproportionally represented on online forums. Websites with minimal user restriction (e.g. YouTube/Google versus Wikipedia/PubMed) correlated with a dominance of views linking MMR to autism. Positive impact was highlighted by: paediatrician bloggers accurately and frequently addressing vaccination myths; data accessed on social media often not being trusted and utilisation of social media in positive ways by pro-vaccination groups/governments. The potential positive and negative impact of social media on MMR uptake should not be underestimated. Efforts to reduce hesitancy and improve uptake should focus on leveraging social media to deliver scientifically accurate pro-vaccination messages.

ICTV Virus Taxonomy Profile: Paramyxoviridae.

The family Paramyxoviridae consists of large enveloped RNA viruses infecting mammals, birds, reptiles and fish. Many paramyxoviruses are host-specific and several, such as measles virus, mumps virus, Nipah virus, Hendra virus and several parainfluenza viruses, are pathogenic for humans. The transmission of paramyxoviruses is horizontal, mainly through airborne routes; no vectors are known. This is a summary of the current International Committee on Taxonomy of Viruses (ICTV) Report on the family Paramyxoviridae. which is available at ictv.global/report/paramyxoviridae.

Measles mumps and rubella virus vaccine

Measles mumps and rubella virus vaccine

Study on epidemic dynamics model with time delay to eliminate measles in China

Measles is an infectious illness and especially harmful to children. Although the national immunization program is implemented, measles remains to be an important public health issue in China. This paper is devoted to modelling the combined effects of the first dose of Measles rubella combination vaccines (MR1) and the second dose of Measles mumps rubella combination vaccines (MMR2) coverage rates on the controlling of measles. To do that, we propose and study a robust time delayed compartment measles epidemic model where MMR2 is followed after an interval time τ by MR1. Via simulation method, we find ℜ0 is a decreasing function on the coverage rates of MR1 η1 and the coverage rates of MMR2 η2, but an increasing function on the interval time τ . We also find ℜ0 > 1 based on the Chinese current situation of η1 = 0.95, η2 = 0.95 and τ = 1.25. In order to completely eliminate measles in China, η1 should be more than 0.9643, or η2 should be more than 0.9586, or τ should be within 8 month. By comparison, it is easier to shorten the interval time τ by revising the Chinese national immunization program.

Early childhood vaccination and subsequent mortality or morbidity: are observational studies hampered by residual confounding? A Danish register-based cohort study

ObjectivesTo estimate the association between childhood vaccination and subsequent morbidity and mortality by adjusting for environmental and host factors. Further, to examine the degree of residual confounding in such observational...

V protein, the virulence factor across the family Paramyxoviridae: a review

Paramyxoviridae is a family of viruses within the order Mononegavirales and comprises 14 genera; Metaavulavirus, Orthoavulavirus, Paraavulavirus, Synodonvirus, Ferlavirus, Aquaparamyxovirus, Henipavirus, Morbillivirus, Respirovirus, Jeilongvirus, Narmovirus, Salemvirus, Pararubulavirus and Orthorubulavirus. The members within this family are negative and single-stranded RNA viruses including human and animal pathogens such as measles virus (MeV), Nipah virus (NiV), mumps virus (MuV), Sendai virus (SeV) and Newcastle disease virus (NDV). The V protein is conserved within the family and plays an essential role in viral pathogenicity. Although V proteins of many paramyxoviruses are interferon-antagonists which counteract with the host’s innate immunity, there are still differences in the mode of action of the V protein between different genera or species within the same genera. The strategies to circumvent the host interferon (IFN) pathway can be divided into three general mechanisms; degradation of signal transducers and activators of transcription (STAT) protein, inhibition of phosphorylation of the transcription factor and, inhibition of translocation of STAT proteins into the nucleus. As a result, inhibition of IFN signalling and production promotes viral replication in the host cells. This review highlights the mechanism of the paramyxoviral V protein in evading the host IFN system.

Measles mumps and rubella virus vaccine

Measles mumps and rubella virus vaccine

Immunogenicity and safety of the new MMR vaccine containing measles AIK-C, rubella Takahashi, and mumps RIT4385 strains in Japanese children: a randomized phase I/II clinical trial

ABSTRACTDomestic measles, mumps, and rubella combined (MMR) vaccines were discontinued in 1993 in Japan because of the unexpected high incidence of aseptic meningitis. The introduction of an effective MMR vaccine with lower reactogenicity has been expected. A new MMR vaccine (JVC-001) was developed, using mumps RIT4385 strain in combination with Japanese measles AIK-C strain and rubella Takahashi strain (MR) vaccine. An open-label, randomized, phase I/II clinical study was conducted in 100 healthy Japanese children equally randomized to a JVC-001 group and an MR with monovalent mumps vaccine (Hoshino strain) group. Immunogenicity was assessed using a neutralization test (NT) for measles, hemagglutination inhibition (HI) test for rubella, and NT and enzyme-linked immune-sorbent assay (ELISA) for mumps strain with different genotypes (genotype A, B, D and G) on Day 0 and Day 42–56. Solicited and unsolicited adverse events (AEs) were recorded. Seroconversion rates of measles and rubella were both 100%. JVC-001 induced higher immunogenicity against mumps virus genotype G with seroconversion rate of 77.1% (95% confidence interval [CI]: 62.7–88.0%) compared to 65.3% (95% CI: 50.4–78.3%) in the control group. Geometric mean titer (GMT) was 12.5 (95% CI: 8.6–18.3) in the JVC-001 group and 7.1 (95% CI: 5.0–10.1) in the control group. JVC-001 also induced good immunogenicity against other genotypes (A, B and D). There was no apparent difference in the incidence of AEs between JVC-001 and the control groups. JVC-001 is safe and induces effective immunogenicity against measles, mumps, and rubella compared with the currently marketed vaccines in Japan.