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[Several indices of humoral anti-measles immunity in children, previously immunized with live measles vaccine, who have developed measles].

The dynamics of the total content of measles antibody with reference to their physico-chemical nature and the dynamics of the content of the main classes of serum immunoglobulins (A, M, G) in children previously vaccinated and not vaccinated with live measles vaccine who developed measles were studied. Measles in the vaccines was found to run a course of the type of primary and secondary infection. In the former case, the normal dynamics of specific antibody was found with timely change of synthesis of antibody of various physico-chemical nature. In the latter case, immunity to measles developed according to the secondary type and was characterized by the absence of IgM measles antibody. The secondary immunological response was also characterized by higher antibody titers in the first days of the disease and decreased content of IgG and IgM in sera in the convalescent stage. Besides, in such children, hyperthermia occurred 3 times less frequently.

Adolescent

Epidemiologic studies of measles, measles vaccine, and subacute sclerosing panencephalitis.

Histories obtained in 350 of 375 clinically cofirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles. Forty of the latter patients received live, attenuated measles virus vaccine. In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 7.0 years before onset of SSPE. In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 3.3 years after vaccination. Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (0.5 to 1.1 cases/106) appears to be less than the risk following measles (5.2 to 9.7 cases/106). Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.

Adolescent

Measles vaccination after exposure to natural measles.

When an extensive measles epidemic broke out in Turku in late 1975, the availability of a previous study on measles vaccination reactions in 442 children permitted a comparative evaluation to be made on reactions to and the efficacy of measles vaccine (Schwartz strain) administered after exposure to natural measles. In a preliminary study, nine children were vaccinated one to 14 days after exposure to natural measles but before prodromal symptoms appeared. Only one of these nine children developed symptoms and signs comparable to those of the natural disease. In five day-care centers the children were vaccinated when five or more children out of 30 to 40 at each center had measles. In only five of 74 exposed children were the signs and symptoms comparable to those of natural measles. No marked differences in signs and symptoms after the vaccinations were observed between the exposed and nonexposed children. It is concluded that vaccination is safe, can usually prevent measles, even when administered after a prolonged interval following exposure to natural disease, and can usually control an epidemic in progress.

Adolescent

Immunocytochemical studies for the localisation of measles antigens in multiple sclerosis plaques and measles virus-infected CNS tissue.

Actively demyelinating central nervous system (CNS) lesions from a patient with acute multiple sclerosis (MS) were tested for measles antigens using peroxidase-conjugated antimeasles antibody. No evidence of measles antigens was found. Similarly reacted tissue from 2 patients with chronic MS also revealed no evidence of measles antigens. Identically treated and simultaneously tested measles-infected CNS cultures and human SSPE brain tissue stained strongly for measles antigens. The possible reasons underlying the failure to detect measles antigens in MS are discussed.

Adult

The use of a measles latex reagent for the determination of measles antibodies and in a specific test for multiple sclerosis.

Measles virus antigens covalently linked to latex spheres were used for measuring measles-specific antibodies in a direct agglutination test either in microtitre plates or as a rapid slide-agglutination test. The titres were compared to that obtained by conventional assays. The measles-latex spheres were also used as the antigen for a radio-immuno assay. By incorporating a 14C-radioactive marker into the measles-latex spheres their interaction with lymphocytes from multiple sclerosis and control patients was determined. Lymphocytes from multiple sclerosis patients reacted with a higher percentage of beads at low bead/lymphocyte ratios compared with controls, whereas the reverse was found when the ratio of beads was increased.

Antibodies, Viral

Alterations in immune responsiveness in acute measles and chronic post-measles chest disease.

Immune responses in 24 children with acute measles (AM) were compared with those in 20 children who had chronic pulmonary complications (CPMC) following measles. The immuno-suppressive effects of acute measles were extensive: total white cells were reduced and this reduction was accounted for entirely by lymphopenia which was equally expressed among the major lymphocyte sub-populations studied; the function of 'T' cells, assessed by radio-isotope incorporation into phytohaemagglutin (PHA) transformed lymphocytes and delayed skin hypersensitivity (DHR) to dinitrochlorobenzene (DNCB), was depressed. Serum IgA was reduced in AM patients. In contrast there was a relative sparing of the measured indices of immunity in patients with chronic post-measles chest disease, with the major defect being an impaired DHR to DNCB. There were minor alterations of complement components in both groups of patients.

Acute Disease

Clinical trial of live measles vaccine given alone and live vaccine preceded by killed vaccine. Fourth report to the medical research council by the measles sub-committee of the committee on development of vaccines and immunisation procedures.

Follow-up of 5000 children given a single dose of live attenuated measles vaccine (Schwarz strain) when aged 10 months to 2 years shows a high level of protection in comparison with an unvaccinated group. This protection has been maintained for 12 years. Measles in vaccinated children was less severe as well as less frequent throughout the period. There is no evidence from the follow-up so far that a further injection of vaccine is needed; this has been confirmed by measles haemagglutination-inhibiting antibody estimations in a sample of the children.

Antibodies, Viral

Transfer of measles, mumps, and rubella antibodies from mother to infant. Its effect on measles, mumps, and rubella immunization.

Sera from 42 mother-infant pairs were examined to determine the effect of passively acquired enhanced neutralizing (ENt) antibody on immunization. The ENt antibodies to measles, mumps, and rubella were greater in term newborns than in their mothers, with mean ratio of 1.8:1, 1.3:1, and 1.2:1, respectively. In 21% to 25% of the children, these antibodies persisted until 12 months of age. When immunized with trivalent measles-mumps-rubella vaccine, children who had persisting ENt measles and rubella titers had significantly lower mean antibody responses than children without detectable antibodies to the two viruses. Persisting ENt mumps antibodies did not affect the postimmunization titers. Seroconversion rates to any of the three viruses were not different in children with or without preexisting ENt antibody.

Antibodies, Viral

Growth of measles virus in nervous tissues. IV. Neurovirulence of wild measles and SSPE viruses in monkeys.

Neurovirulence of in vivo-passed wild measles virus and that of the cell-associated SSPE virus were compared by intracerebral inoculation into monkeys. The wild measles virus was found to lack neutrovirulence without producing neurological signs or significant histological changes in the brains, whereas the virus was confirmed to preserve the properties characteristic of the wild virus. In contrast, inoculation of the SSPE virus induced rapid onset of neurological signs with mild but definite histological changes including degeneration of nerve cells. The fact that SSPE virus exhibited neurovirulence in monkeys indicated importance of the current assay system for neurovirulence of measles vaccine by intracerebral inoculation into monkeys.

Animals

Measles antibodies in nasal secretions and sera of children with measles.

Measles antibodies were determined, in the course of measles, in sera and nasal secretions of 54 and 27 children, respectively. The examinations were performed on the 3rd or 4th day (1st period) and between the 10th and 14th day (2nd period) after onset of rash in both sera and nasal secretions and after 25 to 60 days (3rd period) in sera only. Geometric mean titres of antibodies in sera determined by haemmagglutination inhibition (HI) and neutralization tests in the 1st period were 126.3 and 115.3 respectively. For the 2nd period the respective figures were 318.4 and 396.1 and for the 3rd period--388.0 and 445.6. Fractionation on Sephadex G-200 of sera from the 1st period revealed HI and neutralizaing antibodies associated mainly with the IgM serum globulin class. Measles HI and neutralizing antibodies were also found in nasal secretions of all 27 children, but their titres were much lower than in serum. The antibodies determined by indirect immunofluorescence in nasal secretions were associated with IgA in 26 and with IgG immunoglobulin in 15 of the 27 subjects. No IgM antibodies were found.

Antibodies, Viral

Transient appearance of oligoclonal immunoglobulins and measles virus antibodies in the cerebrospinal fluid in a case of acute measles encephalitis.

Acute measles encephalitis with severe sequelae in a 25-year-old man was studied. A transient appearance of oligoclonal IgG in cerebrospinal fluid and of intrathecally produced measles antibodies was found during 2 months after the onset of the disease. On the basis of this finding of local hyperimmunization it is proposed that in the case studied the measles virus infection may have been directly responsible for the disease process in the central nervous system.

Adult

Measles as a cause of fetal defects. A retrospective study of tem measles epidemics in Greenland.

In a retrospective study of ten epidemics of measles in virgin-soil populations in Greenland, 368 women were found to be pregnant at the time of their infection with measles. Information on the course of the pregnancies was obtained in 327 of these women and a clinical examination was made of 252 of their children. The risk of fetal death among women infected in the first trimester was found to be high. About half of 20 women infected during their first two months of pregnancy and a fifth of 31 women infected in the third month had abortions. 9% of 64 women infected in the first trimester and going to term had stillbirths. 28 women infected in the first two months of pregnancy had live children, but four of these had congenital malformations, three of extreme rarity and severity, leading to death. The rate of perinatal mortality and prematurity was equal among infants exposed to measles in the first, second and third trimester of fetal life.

Congenital Abnormalities

Further observations on subacute sclerosing encephalitis in adult hamsters: the effects of intranasal infections with Langat virus, measles virus and SSPE-measles virus.

Passage by i.c. inoculations of suckling hamsters enhanced the virulence for adult hamsters of Langat virus (TP21), neurotropic strain of measles virus (HNT) and SSPE-measles virus (HBS), not only for i.c. infections but also for intranasal instillations. The various viral strains passaged in hamsters showed a great similarity of behaviour including the ability of producing in a proportion of apparently unaffected survivors a subacute sclerosing encephalitis, leading to atrophy of parts of the brain especially the rhinencephalon. When large groups of animals were used for transmission experiments it became obvious that within one week after intranasal exposure, all the hamsters either died or became clinically affected, or did not show signs of disease but developed acute inflammatory brain lessions. tlater on, between 2-6 weeks following inoculations only 90% of hamsters were affected with either overt signs of disease or subacute brain lesions, suggesting that in about 10% of hamsters the initial infection did not progress further and that in these animals the early brain lesions disappeared. Passage levels, irrespective of the virus used, did not influence the total numbers of infected hamsters but showed a significant effect on the mortality in TP21 and HNT infections where the number of dead and clinically affected increased in the higher passes. In these higher passes the number of survivors with subacute brain lesions decreased. In SSPE-measles virus the number of clinically affected hamsters and those surviving but developing brain lesions remained constant throughout. Vacuolated neurons were present in the brains of hamsters that survived one of the above 3 viral infections. They were seen beginning from 6 weeks after infection only in animals that developed subacute sclerosing lesions and were most commonly found in the amygdaloid nuclei and in the pyriform cortex. There was a dramatic increase in the number of brains with vacuolated neurons in hamsters infected with the high viral passes; however, in the 36th hamster passage of TP21 no vacuolated neurons were present but the total number of survivors was small, the majority had no brain lesions and none had subacute sclerosing changes.

Age Factors

Serum complement concentrations, nutritional status and the outcome of measles and measles pneumonia.

A prospective study of children with measles has shown a significant association between malnutrition and a poor prognosis. Levels of a number of complement components bore no relationship to the severity of the disease or to its prognosis. Some of the children with acute measles had depressed serum concentrations of factor D, Clq or C3, but complement deficiency does not appear to be implicated in the heightened susceptibility to secondary bacterial and viral infection so commonly found after acute measles.

Body Weight

Persistent measles virus infection in a calf kidney cell line. Note I. Establishment of calf kidney cell lines chronically infected with measles virus and some of their biological characteristics.

Several types of persistent measles virus infection resulting in lytic infections could be established in a calf kidney cell line, according to the passage level of the substrate and to the virus strain inoculated. Persistent measles virus infection in calf kidney cells was characterized by the limited proportion of infected cells, the large amount of infectant virus, and the alteration of morphological and growth characteristics of the cells. The mechanism of this persistent infection is discussed.

Animals

Persistent measles virus infection in a calf kidney cell line. Note II. Study of some biological markers of the measles virus isolated from a selected chronically infected cell line.

The biological characteristics of a measles virus strain (Co-69/pi) isolated from a selected chronically infected calf kidney cell line (K-2) are studied in comparison with those of thw wild parental CO-69 and of the attenuated Schwarz measles virus strain. Co-69/pi is a variant of the parental Co-69 virus and has characteristics of an attenuated strain. Some of the characteristics acquired by the Co-69/pi strain (cytopathogenicity, size of plaques) proved to be stable in the course of passages on a simian substrate. The mechanism having led to the appearance of this variant in the chronically infected cell line are discussed.

Cell Line

[What is wrong with the measles vaccine in Mexico? Study of an epidemic outbrake of measles].

The study included 205 children with measles seen after an epidemic outbreak in Distrito Federal during the first six months of 1976. 65.8% of the cases had not been given specific immunization and out of the 70 vaccinated cases (34.2%), one half of them were under one year old and were not given re-enforcement afterwards. The clinical picture suffered no changes in vaccinated children, 40% of infants showed initial exanthema on chest and abdomen with centrifugal distribution and in 41.5% of them, diarrhea appeared during the prodromal period. The most outstanding elements of this epidemic outbreak were the high number of sensible cases and the high percentage of children vaccinated before the age of one year and who were not later given re-vaccination. Indequate handling of the vaccine or combination of vaccine withe gammaglobulin used in 1969 and 1970, are also mentioned as a possibility to explain failures of the vaccine in ths group of well vaccinated children.

Child, Preschool