A serosurvey to identify the window of vulnerability to wild-type measles among infants in rural Mali.

As infants lose maternally derived antibody, they experience a period when antibody levels are insufficient to protect against measles yet may interfere with immunization. In Kangaba Mali, sera were collected from 89 2-8-month-old infants and 32 9-10-month-old infants without a history of measles or vaccination; post-vaccination sera were collected from 24 of the 9-10-month-old infants 3-5 weeks after receiving measles vaccine. Measles antibody was measured by plaque reduction neutralization (PRN) and enzyme linked immunosorbent assay. At two months of age, 30% had protective PRN titers; among six-month-old infants, none had protective titers. Prior to vaccination, 16% of 9-10-month-old infants exhibited protective titers; all demonstrated protective titers post-vaccination. The early onset of the window of vulnerability in Kangaba infants likely reflects the changing ecology of measles in Africa. Ways to protect these vulnerable infants against measles must be devised.