[Prevalence of maternal measles, rubella, mumps and varicella antibodies in the first six months of life]. / Ilk alti ayda maternal kizamik, kizamikçik, kabakulak ve suçiçegi antikorlarinin durumu.

The protection of infants against infections during the first few months of life is provided mainly by maternal antibodies. The presence of maternal antibodies can decrease vaccine efficacy. The waning time of maternal antibodies shows variations therefore seroepidemiological studies are important for the development of vaccination schedules. Some recent studies showed that the maternal measles antibodies may disappear around 3 months of age especially in infants born from mothers who were vaccinated. There are few cross-sectional studies from Turkey evaluating the maternal antibody levels of infants against measles in recent years. The aim of this prospective, multicentre study is to evaluate the seropositivity of measles, rubella, mumps, and varicella in mothers and their infants at 1 and 6 months after birth. The study was carried out at the Social Pediatrics Units of two university hospitals, a private hospital and a state hospital. The exclusion criteria were known impaired immune system or immune deficiency disorder in mother or child, preterm delivery (< 37 gestational week), administration of immunoglobulins or any blood products before admission or during the follow-up period, and history of vaccination or exposure to one of these diseases during the study period. The final analysis encompassed 209 mother-infant pairs. Blood samples were collected 1 month after birth from mothers and 1 and 6 months after birth from their babies. Antibody levels were determined by ELISA (Enzyme-Linked ImmunoSorbent Assay) method. Information on the socio-economic and demographic characteristics of the families were collected by a face-to-face questionnaire. Seropositivity was found as 95.7%, 92.8%, 92.8% and 96.7% for measles, mumps, rubella and varicella (MMRV) respectively. Majority of infants lost maternal antibodies at 6 months of age. Of all 6 month-old infants 25% were seropositive for measles,14.6% for mumps, 23.2% for rubella and 17.1% for varicella. The proportion of seropositive infants born from seropositive mothers was higher than those born from seronegative mothers for all four diseases. This difference was statistically significant only at 1 month of age (p= 0.001). Our study showed that maternal antibodies against MMRV decreased rapidly by 6 months of age therefore necessary measures should be taken to close this gap between the loss of maternal protection and the vaccination of infants for MMRV. As the epidemiology of the diseases changes in time, it is important to carry out such studies with large series in different countries and settings. Important results were determined in our study within this respect.

Low vaccine efficacy of mumps component among MMR vaccine recipients in Chennai, India.

Introduction of MMR vaccine was believed to have resulted in a decline in the incidence of measles, mumps and rubella infections. However, recent reports suggest the re-emergence of mumps infection worldwide in the vaccinated populations. It was proposed that the reason for this re-emergence was poor efficacy of MMR vaccine. The present study was aimed to investigate mumps infection in MMR vaccinated and non-vaccinated populations in Chennai, India. Blood samples were collected from acute mumps cases (n=74, 42<12 yr age, 54% males) and investigated for IgM antibody against mumps, IgG antibody against measles, mumps and rubella viruses by ELISA. Sixty seven (91%) patients had received MMR vaccine. All the 67 vaccinated cases were positive for parotitis, and mumps IgM. However, only 10 (15%) were positive for IgG. All samples (100%) were positive for rubella and measles IgG. These findings showed the occurrence of mumps infection among MMR vaccinated individuals in Chennai, India. The MMR vaccine failed to generate anti-mumps IgG. The reason may be low vaccine efficacy of the mumps component of the MMR vaccine used.

Estimating vaccination coverage for the trivalent measles-mumps-rubella vaccine from trivariate serological data.

The effectiveness of childhood immunization programs depends on the vaccination coverage actually achieved. Routinely collected coverage data are not always available, and comparability between countries is often compromised because of different data collection methods. In 2000, Gay developed a method to estimate trivalent vaccination coverage from readily available trivariate serological data on the basis of parametric assumptions related to the rate of seroconversion for each vaccine component and probabilities of natural exposure to infection. Gay's work was indirectly published in a paper by Altmann and Altmann, who derived exact solutions for the parameters on the basis of Gay's modeling equations. In this paper, we propose a general likelihood-based marginal model framework to extend Gay's model by relaxing two of its main assumptions. We use the Bahadur model for trivariate binary data to explicitly account for an association between the disease-specific exposure probabilities. We fit several correlation structures to measles, mumps, and rubella serology from Belgium and Ireland. For both countries, we estimate a small positive pairwise exposure correlation, which improves the fit to the data. However, the effect on the estimated vaccination coverage and its associated variability is fairly moderate. For both Belgium and Ireland, all models reveal that the vaccination coverage achieved during the first 15 years since the introduction of measles, mumps, and rubella immunization is insufficient to eliminate measles.

Phenotypic expression of autoimmune autistic disorder (AAD): a major subset of autism.

BACKGROUND: Autism causes incapacitating neurologic problems in children that last a lifetime. The author of this article previously hypothesized that autism may be caused by autoimmunity to the brain, possibly triggered by a viral infection. This article is a summary of laboratory findings to date plus new data in support of an autoimmune pathogenesis for autism. METHODS: Autoimmune markers were analyzed in the sera of autistic and normal children, but the cerebrospinal fluid (CSF) of some autistic children was also analyzed. Laboratory procedures included enzyme-linked immunosorbent assay and protein immunoblotting assay. RESULTS: Autoimmunity was demonstrated by the presence of brain autoantibodies, abnormal viral serology, brain and viral antibodies in CSF, a positive correlation between brain autoantibodies and viral serology, elevated levels of proinflammatory cytokines and acute-phase reactants, and a positive response to immunotherapy. Many autistic children harbored brain myelin basic protein autoantibodies and elevated levels of antibodies to measles virus and measles-mumps-rubella (MMR) vaccine. Measles might be etiologically linked to autism because measles and MMR antibodies (a viral marker) correlated positively to brain autoantibodies (an autoimmune marker)--salient features that characterize autoimmune pathology in autism. Autistic children also showed elevated levels of acute-phase reactants--a marker of systemic inflammation. CONCLUSIONS: The scientific evidence is quite credible for our autoimmune hypothesis, leading to the identification of autoimmune autistic disorder (AAD) as a major subset of autism. AAD can be identified by immune tests to determine immune problems before administering immunotherapy. The author has advanced a speculative neuroautoimmune (NAI) model for autism, in which virus-induced autoimmunity is a key player. The latter should be targeted by immunotherapy to help children with autism.