Katherine B Gibney1,2, Lucy O Attwood3, Suellen Nicholson4, Thomas Tran4, Julian Druce4, Julia Healy1, Janet Strachan1, Lucinda Franklin1, Robert Hall5, Gail B Cross6,7. 1. Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Victoria, Australia. 2. The Peter Doherty Institute for Infection and Immunity, the University of Melbourne and the Royal Melbourne Hospital, Melbourne, Victoria, Australia. 3. Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia. 4. Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. 5. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore. 7. Department of Infectious Diseases, National University Hospital, Singapore.
Abstract
BACKGROUND: Waning measles immunity among vaccinated individuals may result in an attenuated illness. This study compares the epidemiological, clinical, and laboratory profile of measles cases with waning immunity with other measles cases. METHODS: Polymerase chain reaction-positive (+) measles cases notified to Victoria's Department of Health and Human Services from 2008 to 2017 with immunoglobulin (Ig) M and IgG tested at diagnosis were classified according to serology at diagnosis: IgG negative (-) (nonimmune), IgM+/IgG+ (indeterminate), or IgM-/IgG+ (waning immunity). RESULTS: Between 2008 and 2017, 297 measles cases were notified, of whom 190 (64%) were included; 151 of 190 (79%) were nonimmune at diagnosis, 26 (14%) were indeterminate, and 13 (7%) had waning immunity. Between 2008-2013 and 2014-2017, the proportion of cases with waning immunity increased from 0 of 87 (0%) to 13 of 103 (13%) (P < .001) and the diagnostic sensitivity of initial IgM fell from 93% to 81% (P = .012), respectively. Seven (54%) waning immunity cases reported receiving measles-containing vaccines; 1 case had 2 documented doses. Compared with nonimmune and indeterminate cases, waning immunity cases were more likely to be male; less likely to report fever, coryza, and cough; and had lower burden of virus (higher cycle threshold values). Waning immunity cases had higher IgG titers than indeterminate cases (mean optical density values, 1.96 vs 0.71; P = .004). Onward transmission from 1 waning immunity case was documented. CONCLUSIONS: Waning immunity among measles cases, associated with secondary vaccine failure and modified clinical illness, is emerging in Victoria with transmission potential.
BACKGROUND: Waning measles immunity among vaccinated individuals may result in an attenuated illness. This study compares the epidemiological, clinical, and laboratory profile of measles cases with waning immunity with other measles cases. METHODS: Polymerase chain reaction-positive (+) measles cases notified to Victoria's Department of Health and Human Services from 2008 to 2017 with immunoglobulin (Ig) M and IgG tested at diagnosis were classified according to serology at diagnosis: IgG negative (-) (nonimmune), IgM+/IgG+ (indeterminate), or IgM-/IgG+ (waning immunity). RESULTS: Between 2008 and 2017, 297 measles cases were notified, of whom 190 (64%) were included; 151 of 190 (79%) were nonimmune at diagnosis, 26 (14%) were indeterminate, and 13 (7%) had waning immunity. Between 2008-2013 and 2014-2017, the proportion of cases with waning immunity increased from 0 of 87 (0%) to 13 of 103 (13%) (P < .001) and the diagnostic sensitivity of initial IgM fell from 93% to 81% (P = .012), respectively. Seven (54%) waning immunity cases reported receiving measles-containing vaccines; 1 case had 2 documented doses. Compared with nonimmune and indeterminate cases, waning immunity cases were more likely to be male; less likely to report fever, coryza, and cough; and had lower burden of virus (higher cycle threshold values). Waning immunity cases had higher IgG titers than indeterminate cases (mean optical density values, 1.96 vs 0.71; P = .004). Onward transmission from 1 waning immunity case was documented. CONCLUSIONS: Waning immunity among measles cases, associated with secondary vaccine failure and modified clinical illness, is emerging in Victoria with transmission potential.
Authors: Kyunghyun Song; Ju Mi Lee; Eun Ju Lee; Bo Ram Lee; Ji Young Choi; Jihee Yun; Se Na Lee; Mi Young Jang; Han Wool Kim; Han-Sung Kim; Song Mi Moon; Yong Kyun Kim Journal: Eur J Clin Microbiol Infect Dis Date: 2022-01-09 Impact factor: 3.267
Authors: Muhammad Naveed; Allah Rakha Yaseen; Hira Khalid; Urooj Ali; Ali A Rabaan; Mohamed Garout; Muhammad A Halwani; Abbas Al Mutair; Saad Alhumaid; Zainab Al Alawi; Yousef N Alhashem; Naveed Ahmed; Chan Yean Yean Journal: Vaccines (Basel) Date: 2022-05-29
Authors: Ali A Rabaan; Abbas Al Mutair; Saad Alhumaid; Mohammed Garout; Roua A Alsubki; Fatimah S Alshahrani; Wadha A Alfouzan; Jeehan H Alestad; Abdullah E Alsaleh; Maha A Al-Mozaini; Thoyaja Koritala; Sultan Alotaibi; Mohamad-Hani Temsah; Ali Akbar; Rafiq Ahmad; Zainab Khalid; Javed Muhammad; Naveed Ahmed Journal: Medicina (Kaunas) Date: 2022-05-20 Impact factor: 2.948
Authors: Donald R Latner; Sun B Sowers; Kiana Anthony; Heather Colley; Christine Badeau; Jessica Coates; Phili Wong; Yetunde Fakile; Cristina Interiano; Kevin B Pannell; Van Leung-Pineda; Manisha M Patel; Paul A Rota; Brandi M Limbago; Carole J Hickman Journal: J Clin Microbiol Date: 2020-05-26 Impact factor: 5.948