Relationship between aseptic meningitis and MMR vaccination

ABSTRACT

Mumps is a predominant disease of young children recognized by fever and parotitis. Meningitis and meningoencephalitis are the most frequent complications of the disease. Mumps live vaccine is available in many countries. In Iran routine 2 dose administration of MMR was launched in 2004. Vaccine produce a subclinical and noncommunicable infection but in part of Europes, Canada and Japan where different vaccines have been used, rates of vaccine-induced aseptic meningitis have been high. The purpose of this study is to survey the occurrence of Aseptic meningitis as an adverse effect of MMR vaccination and to determine its clinical and laborabry characteristics. In this prospective study during 2004-2005 cases of Aseptic meningitis who was admitted in Infection and neurology wards of Tabriz Pediatric Medical center were studied. Sex, age, clinical manifestations, lab data and duration between vaccination and appearance of symptoms were recorded and analyzed. In 44 cases of aseptic meningitis there was history of MMR vaccination within 30 days [average 21.7 days]. Seventy five percent of patients were male. The mean age of patients was 31 months. 40.9% of cases were 13 months old. Febrile seizure [54.5%] and meningeal signs with parotid enlargement [29.5%] were the most clinical manifestation. The mean Total and lymphocyte cell count in cerebrospinal fluid were 674.43 and 550.2/mm[3], respectively. The mean glucose and protein levels were found to be 54.3 and 48.34 mg/dl, respectively. The results of our study shows the occurrence of aseptic meningitis after immunization with the MMR vaccine which is being used by the health services in our country. According to Presence of wild virus Strains within community and to rule out the role of other viruses, PCR is recommended despite of its complexity and limitations. This complication must be considered important and followed up precisely in spite of its complete cure without any Sequela, because all of these cases occurred within 30 days after vaccination