Molecular epidemiology of measles virus before and after the 2003 mass vaccination campaign for measles/rubella in Iran

Molecular epidemiology of measles virus [MV] is important, not only to measure the success of measles vaccination programs but also to monitor the circulation and elimination of the virus worldwide. In this study, we compared MV obtained from patients before the 2003 mass vaccination MR campaign and viruses detected after 2003 until 2008 in Iran. The nucleoprotein [N] gene of 29 MV strains circulating in Iran between 2002 and 2008 were amplified by RT-PCR and subjected to sequence and phylogenetic analysis. Molecular characterization of MV studied here revealed that although the outbreaks in Iran were associated with MV genotype D4, the isolated viruses clearly belonged to several different lineages. Maximum and minimum homology within the 29 Iranian strains in our study was100% and 94.9% within the carboxyl terminus of the N gene, respectively. Using Clustal X program, the alignment of Iranian MV sequences showed nine lineages. This study provides the usefulness of MV sequence analysis for the demonstration of local interruption of indigenous strain transmission as well as providing a valuable means for monitoring the elimination processes of MV control

How much improvement is expected in ocular lesions of Behcet's disease treated with pulse cyclophospamide?

The natural history of ocular lesions in Behcet's disease is toward severe loss of vision/blindness in few years, whereas cytotoxic drugs have changed the outcome. Several open labeled cohort studies showed pulse cyclophosphamide [PCP] to be the best choice. Since one third of these patients are resistant to PCP it is important to know how much improve ment one can expect from the responders. To address this question, we selected patients who improved or maintained their baseline visual acuity after treatment. From a cohort of 528 patients [1056 eyes], 753 eyes were selected. At the beginning of the study PCP was given for one month as 0.75 to 1 g in perfusion, and then followed every 2 to 3 months. Prednisolone was also given as 0.5 mg/kg/daily and then tapered upon controlling inflammation. The mean +/- SD number of pulses was 11.5 +/- 8.5/month with follow-up of 20.6 +/- 19.8 months. Different disease activity indices such as visual acuity, posterior uveitis, retinal vasculitis, total inflammatory activity index [TIAI], total adjusted disease activity index [TADAI] were calculated at baseline and at last evaluation. The mean visual acuity improved from 2.4 to 4.4. The mean indices for posterior uveitis, retinal vasculitis, TIAI and TADAI improved from 2.2 to 1, 2.7 to 1.4, 19.3 to 9, and 27.2 to 20.5 respectively. The P value was less than 0.001 for all comparisons. Pulse cyclophosphamide is able to improve ocular lesions of Behcet's disease; therefore it may be used as a first choice, especially in retinal vasculitis