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1.
mBio ; 11(3)2020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32561657

RESUMO

We propose the concept that administration of an unrelated live attenuated vaccine, such as MMR (measles, mumps, rubella), could serve as a preventive measure against the worst sequelae of coronavirus disease 2019 (COVID-19). There is mounting evidence that live attenuated vaccines provide nonspecific protection against lethal infections unrelated to the target pathogen of the vaccine by inducing "trained" nonspecific innate immune cells for improved host responses against subsequent infections. Mortality in COVID-19 cases is strongly associated with progressive lung inflammation and eventual sepsis. Vaccination with MMR in immunocompetent individuals has no contraindications and may be especially effective for health care workers who can easily be exposed to COVID-19. Following the lead of other countries conducting clinical trials with the live attenuated Mycobacterium bovis BCG (BCG) vaccine under a similar concept, a clinical trial with MMR in high-risk populations may provide a "low-risk-high-reward" preventive measure in saving lives during this unprecedented COVID-19 pandemic.


Assuntos
Vacina BCG/imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Proteção Cruzada/imunologia , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Atenuadas/imunologia , Ensaios Clínicos como Assunto , Infecções por Coronavirus/patologia , Humanos , Sarampo/imunologia , Caxumba/imunologia , Mycobacterium bovis/imunologia , Pneumonia Viral/patologia , Rubéola (Sarampo Alemão)/imunologia , Vacinação
2.
BMC Infect Dis ; 20(1): 197, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138688

RESUMO

BACKGROUND: The incidence rate of measles in China reached a nadir in 2012 after 2 supplementary immunization activities (SIAs) were undertaken in 2009 and 2010. However, the disease began re-emerging in 2013, with a high prevalence rate observed in 2013-2014 in the southern province of Guangdong. In this study, we assessed the changes that occurred in measles epidemiology during 2009-2016, particularly between 2009 and 2011 (when the influence of the SIAs were in full effect) and between 2012 and 2016 (when this influence subsided). METHODS: Data from 22,362 patients with measles diagnosed between 2009 and 2016, and whose diagnoses were confirmed clinically and/or with laboratory testing, were extracted from the National Infectious Disease Monitoring Information System. Descriptive analyses were performed, and changes in epidemiological characteristics between 2009 and 2011 and 2012-2016 were compared. RESULTS: There was a substantial surge in 0-8-month-old patients after 2012; the incidence rate increased from 4.0 per 100,000 population in 2011 (10.3% of the total) to 280 per 100,000 population in 2013 (32.8% of the total). Patients aged 0-6 years represented 73.4% of the total increase between 2011 and 2013. Compared with 2009-2011, adults aged ≥25 years accounted for a higher proportion of patients in 2013 and after (p < 0.01), and were highest in 2016 (31% of the patient total). CONCLUSION: Despite the remarkable results achieved by SIAs in terms of providing herd immunity, the 2013 resurgence of measles revealed insufficient immunization coverage among children. Therefore routine immunization programs should be strengthened, and supplementary vaccinations targeting adults should also be contemplated.


Assuntos
Sarampo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Imunidade Coletiva , Programas de Imunização/métodos , Programas de Imunização/tendências , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/imunologia , Vacina contra Sarampo/administração & dosagem , Vacina contra Sarampo/imunologia , Estudos Retrospectivos , Cobertura Vacinal/estatística & dados numéricos , Cobertura Vacinal/tendências , Adulto Jovem
4.
PLoS One ; 15(3): e0230329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32208432

RESUMO

Given the complicated history of Japan's National Immunization Program, a significant proportion of Japanese people including healthcare workers (HCWs) still lack adequate immunity against measles, mumps, and rubella (MMR), resulting in occasional outbreaks. In 2014, the Japanese Society of Infection Prevention and Control (JSIPC) published vaccination guidelines for HCWs. We evaluated antibody titers before and after MMR vaccination in HCWs at the Nara Medical University Hospital, the attainment rate of the target antibody titers defined by the JSIPC guidelines, and the safety of vaccines. We measured MMR antibody titers in HCWs, followed by inoculation with the respective monovalent vaccines and/or trivalent MMR (tMMR) vaccine according to the JSIPC guidelines. Among 467 HCWs evaluated, antibody titers against measles and mumps measured using the IgG-enzyme immunoassay increased from 11.0 [interquartile range (IQR): 8.0-13.6] to 13.7 (IQR: 11.3-16.9; P < 0.001) and from 2.8 (IQR: 2.1-3.5) to 4.8 (IQR: 3.7-5.7; P < 0.001), respectively. By evaluating a logarithmic value of log2(X + 1) converted from an antibody titer X, antibody titers against rubella measured using the hemagglutination assay increased from 3.2 (IQR: 0-4.1) to 6.0 (IQR: 4.6-8.0; P < 0.001). Antibody titer elevated following tMMR vaccination was lower than that following monovalent vaccination in a single dose of the measles-containing, a single dose of the mumps-containing, and two doses of rubella-containing vaccine groups (P = 0.01, 0.01, and <0.001, respectively). After vaccination, 20.0%, 61.5%, and 46.2% of HCWs attained target antibody titers specified by the JSIPC guidelines for measles, rubella, and mumps, respectively. The systemic response in female HCWs who underwent monovalent mumps vaccination was statistically higher than that in others. Although the vaccination program for HCWs according to the JSIPC guidelines caused increased MMR antibody titers, the rates of attaining the target criteria were low.


Assuntos
Anticorpos Antivirais/sangue , Surtos de Doenças/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Vacinação em Massa/organização & administração , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Adulto , Anticorpos Antivirais/imunologia , Feminino , Implementação de Plano de Saúde , Humanos , Esquemas de Imunização , Japão , Masculino , Vacinação em Massa/normas , Vacinação em Massa/estatística & dados numéricos , Sarampo/imunologia , Sarampo/prevenção & controle , Sarampo/virologia , Pessoa de Meia-Idade , Caxumba , Guias de Prática Clínica como Assunto , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/imunologia
6.
Braz J Infect Dis ; 24(1): 51-57, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31866191

RESUMO

INTRODUCTION: Vaccines are well-established public health interventions with major impact on the prevalence of infectious diseases, but outbreaks are occurring frequently due to primary and secondary failures, despite high coverage. Surveillance of efficacy and duration of induced immunity is a difficult task as it requires invasive blood sampling in children and teenagers. Saliva can be an acceptable alternative source of IgG to assess vaccine efficacy and toxoplasmosis incidence. We investigated IgG response for measles, mumps, rubella, and T. gondii in saliva samples of vaccinated young people. METHODS: Saliva was collected from 249 public schools students from São Paulo, Brazil, aged 7 to 13 years old, during an interactive exhibition on hygiene. We used S. aureus protein A solid phase capture assay for IgG reactive to biotinylated purified proteins. Paired saliva and serum (47) were tested from young adults with serum evidence of T. gondii infection and from negative children less than 12 month old for standardization. Reproducibility was greater than 98% and sensitivity and specificity of the saliva assays were greater than 95%, as well as the concordance of paired saliva and serum samples. RESULTS: Saliva from high school students showed a prevalence of 8.5% (95% CI: 5.0-11.9%) for anti T. gondii IgG; 96.8% (94.6-99%) of anti-measles IgG; 59.1% (53-65%) of anti-rubella IgG, and 57.5% (51.3-63.6%) of anti-mumps IgG. DISCUSSION: The prevalence of antibodies against mumps and rubella after 6-8 years of vaccination was lower than against measles among students. The findings of this study demonstrate the feasibility of saliva sampling for follow-up of vaccine immune status in teenagers. This useful approach allows for IgG detection for vaccine control or epidemiological studies.


Assuntos
Anticorpos Antiprotozoários/análise , Anticorpos Antivirais/análise , Imunoglobulina G/análise , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Saliva/imunologia , Estudantes/estatística & dados numéricos , Adolescente , Brasil , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Técnicas Imunoenzimáticas , Imunoglobulina G/imunologia , Masculino , Sarampo/imunologia , Sarampo/prevenção & controle , Caxumba/imunologia , Caxumba/prevenção & controle , Curva ROC , Valores de Referência , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Toxoplasmose/imunologia , Toxoplasmose/prevenção & controle
8.
Science ; 366(6465): 599-606, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31672891

RESUMO

Measles virus is directly responsible for more than 100,000 deaths yearly. Epidemiological studies have associated measles with increased morbidity and mortality for years after infection, but the reasons why are poorly understood. Measles virus infects immune cells, causing acute immune suppression. To identify and quantify long-term effects of measles on the immune system, we used VirScan, an assay that tracks antibodies to thousands of pathogen epitopes in blood. We studied 77 unvaccinated children before and 2 months after natural measles virus infection. Measles caused elimination of 11 to 73% of the antibody repertoire across individuals. Recovery of antibodies was detected after natural reexposure to pathogens. Notably, these immune system effects were not observed in infants vaccinated against MMR (measles, mumps, and rubella), but were confirmed in measles-infected macaques. The reduction in humoral immune memory after measles infection generates potential vulnerability to future infections, underscoring the need for widespread vaccination.


Assuntos
Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Tolerância Imunológica , Memória Imunológica , Sarampo/imunologia , Adolescente , Animais , Diversidade de Anticorpos , Criança , Pré-Escolar , Epitopos/imunologia , Humanos , Macaca mulatta , Masculino , Vacina contra Sarampo-Caxumba-Rubéola
9.
PLoS One ; 14(11): e0225606, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31770412

RESUMO

Measles and rubella are highly contagious viral diseases transmitted via respiratory secretions and aerosolized droplets. Thailand has implemented universal vaccination against measles using the monovalent measles (M) or the trivalent measles-mumps-rubella (MMR) vaccine for the past 30 years. Nevertheless, incidence of measles and rubella remains in some parts of the country. We conducted a seroprevalence study to evaluate the antibodies to measles and rubella virus among Thais of all ages and to determine pre-existing immunity resulting from either vaccination and/or natural exposure. A total of 1,781 serum samples collected in 2014 was tested for IgG to measles and rubella virus by commercial enzyme-linked immunosorbent assays (ELISA). Percentages of individuals with protective antibody levels and the geometric mean concentrations (GMC) of IgG in each age group were analysed. The GMC of anti-measles IgG and anti-rubella IgG were 653.7 IU/L (95% confidence interval (CI); 555.9-751.4) and 39.5 IU/mL (95% CI;35.0-43.9), respectively. Thais between the ages of six months and 25 years did not demonstrate sufficient protective herd immunity for measles. This observation is consistent with the recent measles outbreaks in this age group. Lower prevalence of immunity against rubella was found among children ages 5-6 years who may not have completed vaccination as infants. Our findings identify gaps in rubella and measles immunity in specific age groups and support recommendations for catch-up MMR vaccination in individuals 30 years of age or younger.


Assuntos
Anticorpos Antivirais/sangue , Sarampo/imunologia , Rubéola (Sarampo Alemão)/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Sarampo/epidemiologia , Morbillivirus/imunologia , Rubéola (Sarampo Alemão)/epidemiologia , Vírus da Rubéola/imunologia , Tailândia/epidemiologia , Vacinação , Adulto Jovem
10.
Medicine (Baltimore) ; 98(43): e17507, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651854

RESUMO

This study aimed to investigate measles antibody level and its associated factors in a healthy Chinese population, so as to provide evidence to measles prevention and control measures in the future.We conducted a cross-sectional survey by using probability proportionate to size sampling (PPS) among a healthy population aged 8 months to 45 years. Information on measles vaccination status was obtained from the vaccination certificates. Serum measles IgG antibody was detected by enzyme-linked immunosorbent assay. Multivariate logistic and linear regression models were used to analysis the associated factors of measles antibody.Of the 663 study subjects, the positive rate, protective rate, and geometric mean concentration (GMC) of measles antibodies were 92.76%, 77.53%, 1612.55 mIU/ml, respectively. The antibody concentration was higher in Han ethnical majority than in Hui minority. The positive rate, protective rate and concentration of antibodies in different age groups and regions were clearly disparate. Age, area, and measles-containing vaccine (MCV) immunization history were the prominent influencing factors of antibody positive rate and protective rate. Ethnicity, age, area, and MVC immunization history were the influencing factors of antibody concentration.Our major findings suggest that, children in rural China, especially in impoverished mountainous regions, were more likely to suffer from delays in measles vaccination. Various measures in optimizing vaccination practices should be implemented in order to prevent possible measles epidemic, even outbreak in these regions.


Assuntos
Anticorpos Antivirais/sangue , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Sarampo/imunologia , Morbillivirus/imunologia , Saúde da População/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Criança , Pré-Escolar , China , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/imunologia , Lactente , Modelos Lineares , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Pessoa de Meia-Idade , Análise Multivariada , Vacinação/estatística & dados numéricos , Adulto Jovem
12.
BMC Med ; 17(1): 180, 2019 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-31551070

RESUMO

BACKGROUND: Vaccination has reduced the global incidence of measles to the lowest rates in history. However, local interruption of measles virus transmission requires sustained high levels of population immunity that can be challenging to achieve and maintain. The herd immunity threshold for measles is typically stipulated at 90-95%. This figure does not easily translate into age-specific immunity levels required to interrupt transmission. Previous estimates of such levels were based on speculative contact patterns based on historical data from high-income countries. The aim of this study was to determine age-specific immunity levels that would ensure elimination of measles when taking into account empirically observed contact patterns. METHODS: We combined estimated immunity levels from serological data in 17 countries with studies of age-specific mixing patterns to derive contact-adjusted immunity levels. We then compared these to case data from the 10 years following the seroprevalence studies to establish a contact-adjusted immunity threshold for elimination. We lastly combined a range of hypothetical immunity profiles with contact data from a wide range of socioeconomic and demographic settings to determine whether they would be sufficient for elimination. RESULTS: We found that contact-adjusted immunity levels were able to predict whether countries would experience outbreaks in the decade following the serological studies in about 70% of countries. The corresponding threshold level of contact-adjusted immunity was found to be 93%, corresponding to an average basic reproduction number of approximately 14. Testing different scenarios of immunity with this threshold level using contact studies from around the world, we found that 95% immunity would have to be achieved by the age of five and maintained across older age groups to guarantee elimination. This reflects a greater level of immunity required in 5-9-year-olds than established previously. CONCLUSIONS: The immunity levels we found necessary for measles elimination are higher than previous guidance. The importance of achieving high immunity levels in 5-9-year-olds presents both a challenge and an opportunity. While such high levels can be difficult to achieve, school entry provides an opportunity to ensure sufficient vaccination coverage. Combined with observations of contact patterns, further national and sub-national serological studies could serve to highlight key gaps in immunity that need to be filled in order to achieve national and regional measles elimination.


Assuntos
Busca de Comunicante/estatística & dados numéricos , Erradicação de Doenças/métodos , Imunidade Coletiva , Vírus do Sarampo/imunologia , Sarampo/epidemiologia , Sarampo/imunologia , Sarampo/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Erradicação de Doenças/organização & administração , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Feminino , Geografia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Imunidade Coletiva/fisiologia , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/transmissão , Vacina contra Sarampo/uso terapêutico , Modelos Estatísticos , Estudos Soroepidemiológicos , Vacinação/estatística & dados numéricos , Adulto Jovem
15.
Hum Vaccin Immunother ; 15(12): 2854-2855, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31442102

RESUMO

Marchi et al. in their article (Measles in pregnancy: a threat for Italian women? Hum Vaccin Immunother. 2019 Jun 20:1-3) observed that 96.9% of pregnant women were positive for anti-measles IgG (with a higher risk of contracting measles in those aged 19-29 years) emphasizing the importance of serological screening before pregnancy. We evaluated seroprotection/seropositivity rates to Measles, Mumps and Rubella in 324 adults with an acquired immune-deficiency needing an immunization program. We found that younger patients (20-29 years) had a seroprevalence below 85%. Overall, a relevant proportion (21.6%, 54/250) of patients was susceptible to at least one infection needing immunization. Our results confirm the usefulness of proper strategies for identifying individuals susceptible to vaccine-preventable infections and protecting them through vaccination.


Assuntos
Anticorpos Antivirais/sangue , Hospedeiro Imunocomprometido , Sarampo/epidemiologia , Caxumba/epidemiologia , Rubéola (Sarampo Alemão)/epidemiologia , Adulto , Idoso , Feminino , Humanos , Itália/epidemiologia , Masculino , Programas de Rastreamento , Sarampo/imunologia , Vacina contra Sarampo-Caxumba-Rubéola , Pessoa de Meia-Idade , Caxumba/imunologia , Razão de Chances , Rubéola (Sarampo Alemão)/imunologia , Estudos Soroepidemiológicos , Testes Sorológicos , Adulto Jovem
16.
PLoS One ; 14(8): e0220780, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31415584

RESUMO

Measles virus is highly infectious and remains a leading cause of vaccine preventable deaths in children. Neutralizing antibody responses elicited by measles virus infection or immunization are a serological correlate of protection. We describe a high-throughput neutralization assay to improve surveillance for measles immunity. Measles virus-antibody mixtures were incubated on Vero cell monolayers and 24 hours later cell-lysates harvested and subjected to one-step SYBR green RT-qPCR to amplify a target sequence within the measles virus nucleoprotein gene. Neutralization endpoint titers were interpolated to determine the dilution that inhibited the relative amplicon copy number by at least 90% compared to the mean signal obtained in virus control wells in the absence of serum. Anti-measles virus and anti-measles hemagglutinin antisera specifically neutralized measles virus in the microneutralization RT-qPCR assay while pre-immune sera and sera raised against other viruses did not. The microneutralization RT-qPCR assay obeyed the Percentage Law for measles virus inputs ranging from 100-5000 TCID50/well. The linear range of the assay corresponds to measles antibody concentrations of 30 to 3000 mIU/mL. Bland-Altman analysis and two-way analysis of variance demonstrated that results obtained using the microneutralization RT-qPCR assay were comparable to those obtained using a plaque reduction neutralization test and correctly identified human serum samples that were seropositive (95% and 100%, sensitivity and specificity, respectively). Furthermore, these comparisons suggest that a concentration of 300 mIU/mL may be a conservative cut-point to use to identify individuals likely to be protected against severe measles disease when the endpoint is based on 90% inhibition of virus replication. Measles virus microneutralization RT-qPCR is a rapid, sensitive, specific, and robust assay for detecting measles neutralizing antibodies that may help to improve immunization strategies nationally and achieve measles elimination globally.


Assuntos
Anticorpos Neutralizantes/análise , Ensaio de Imunoadsorção Enzimática , Vírus do Sarampo/imunologia , Sarampo/prevenção & controle , Animais , Chlorocebus aethiops , Humanos , Sarampo/diagnóstico , Sarampo/imunologia , Testes de Neutralização/métodos , Vigilância da População , Sensibilidade e Especificidade , Células Vero
17.
Artigo em Inglês | MEDLINE | ID: mdl-31443341

RESUMO

Child blood lead concentrations have been associated with measures of immune dysregulation in nationally representative study samples. However, response to vaccination-often considered the gold standard in immunotoxicity testing-has not been examined in relation to typical background lead concentrations common among U.S. children. The present study estimated the association between blood lead concentrations and antigen-specific antibody levels to measles, mumps, and rubella in a nationally representative sample of 7005 U.S. children aged 6-17 years. Data from the 1999-2004 cycles of the National Health and Nutrition Examination Survey (NHANES) were used. In the adjusted models, children with blood lead concentrations between 1 and 5 µg/dL had an 11% lower anti-measles (95% CI: -16, -5) and a 6% lower anti-mumps antibody level (95% CI: -11, -2) compared to children with blood lead concentrations <1 µg/dL. The odds of a seronegative anti-measles antibody level was approximately two-fold greater for children with blood lead concentrations between 1 and 5 µg/dL compared to children with blood lead concentrations <1 µg/dL (OR = 2.0, 95% CI: 1.4, 3.1). The adverse associations observed in the present study provide further evidence of potential immunosuppression at blood lead concentrations <5 µg/dL, the present Centers for Disease Control and Prevention action level.


Assuntos
Anticorpos Antivirais/sangue , Chumbo/sangue , Morbillivirus/imunologia , Vírus da Caxumba/imunologia , Vírus da Rubéola/imunologia , Adolescente , Criança , Feminino , Humanos , Masculino , Sarampo/imunologia , Caxumba/imunologia , Inquéritos Nutricionais , Rubéola (Sarampo Alemão)/imunologia , Estados Unidos
18.
Am J Epidemiol ; 188(10): 1849-1857, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31318424

RESUMO

Household surveys remain an essential method for estimating vaccine coverage in developing countries. However, the resulting estimates have inevitable and currently unmeasurable information biases due to inaccuracies in recall, low retention of home-based records (HBRs; i.e., vaccination cards), and inaccurate recording of vaccination on HBRs. We developed an innovative method with which to overcome these biases, enhance the validity of survey results, and estimate true vaccine coverage using nested serological assessments of immune markers. We enrolled children aged 12-23 months in vaccine coverage surveys in Karachi, Pakistan, from January to December 2016. Vaccination history was collected through verbal recall by the caregiver and, when available, by HBR. One-third of survey participants were randomly enrolled for serological testing for anti-measles virus immunoglobulin G antibody. We applied Bayesian latent class models to evaluate the misalignment among measles vaccination histories derived by recall, HBRs, and measles serology and estimated true measles vaccine coverage. The model-based estimate of true measles vaccine coverage was 61.1% (95% credible interval: 53.5, 69.4) among all survey participants. The standard estimate of 73.2% (95% confidence interval: 71.3, 75.1) defined by positive recall or HBR documentation substantially overestimated the vaccine coverage. Researchers can correct for information biases using serological assessments in a subsample of survey participants and latent class analytical approaches.


Assuntos
Cobertura Vacinal/estatística & dados numéricos , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Teorema de Bayes , Viés , Biomarcadores/sangue , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Lactente , Masculino , Sarampo/imunologia , Sarampo/prevenção & controle , Paquistão , Cobertura Vacinal/métodos
19.
BMC Infect Dis ; 19(1): 587, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277599

RESUMO

BACKGROUND: In recent years Pakistan has faced frequent measles outbreaks killing hundreds of children despite the availability of vaccine for decades. This study was undertaken to determine the persistence of maternal transferred measles antibody levels in infants before measles vaccination with relation to their feeding practices. METHODS: A cross sectional study was conducted at district Islamabad over 1 year between 1st October 2013 to 30th Sept. 2016. Any infant less than 9 months of age, not suffering from an acute or debilitating illness and not vaccinated was enrolled in the study. After taking written informed consent from parents / guardians, information was collected on a pretested questionnaire. About 3 cc venous blood was taken to quantify any measles IgG antibodies. Data was analyzed by using Epi Info 7.2 version. RESULTS: Three hundred eighty-four infants were enrolled and were divided into three age groups, 1-90, 91-180 and 181-270 days age groups. Mean age of infants was 4.4 months ±3.2 SD. Male to female ratio was 1.2:1. A level of maternal measles IgG antibodies ≥12 U/ml was taken as protective. Of total 384 infants, 91(24%) had protective measles antibody titters (> 12 U/ml). and 65 (73%) of them were on breast milk. Highest antibody levels were found in 1-90 days age group. Analysis showed that 181-270 days aged infants had 3.1875 more odds of having unprotected/ low levels of antibodies against measles than children aged less than 180 days. Age group < 180 days found to be statistically significant with protective IgG levels (OR: 3.1875, P value: < 0.000063). CONCLUSION: Measles protective antibodies were found in infants < 180 days age group. Breast feeding provides early protection against measles. Levels drop down to low levels immediately after birth and then after 06 months. It is, therefore, recommended that measles vaccination should be considered for administration at 6 months or even earlier if measles immunity is desired.


Assuntos
Anticorpos Antivirais/sangue , Aleitamento Materno , Sarampo/imunologia , Leite Humano/imunologia , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Masculino , Sarampo/epidemiologia , Sarampo/transmissão , Vacina contra Sarampo/imunologia , Paquistão/epidemiologia , Placenta/imunologia , Gravidez , Estudos Soroepidemiológicos , Vacinação/estatística & dados numéricos
20.
Eur J Clin Microbiol Infect Dis ; 38(9): 1719-1729, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31289949

RESUMO

Several factors may explain why measles persisted in the European Union in 2017-2018. The study assessed mean measles vaccination coverage and anti-measles herd immunity levels in the target measles vaccination population in countries of the European Union during the 2015-2017 period. The study found that the measles vaccination coverage with two doses of vaccine was < 95% in 28 (96.5%) countries, and that the prevalence of individuals with vaccine-induced measles protection in the target vaccination population was lower than the herd immunity threshold of 94.4% in 22 (75.9%) countries during 2015-2017. The study found a significant negative correlation between the incidence of measles in 2017-2018 in different countries of the European Union and measles vaccination coverage with two doses of measles vaccine, prevalence of individuals with vaccine-induced measles protection and herd immunity levels in the target measles vaccination population during 2015-2017. Measles vaccination coverage and herd immunity levels did not improve from 2010-2015 to 2015-2017 in the European Union. Low percentages of measles vaccination coverage with two doses of vaccine and low herd immunity levels could explain measles incidence in countries of the European Union in 2017-2018. New measles prevention strategies should be developed to increase measles vaccination coverage and herd immunity levels in the European Union.


Assuntos
Imunidade Coletiva , Vacina contra Sarampo/administração & dosagem , Sarampo/imunologia , Sarampo/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Surtos de Doenças , Europa (Continente)/epidemiologia , União Europeia , Humanos , Incidência , Sarampo/epidemiologia , Vacina contra Sarampo/uso terapêutico , Prevalência
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