Talk:Abnormal Development - Measles Virus
Rubella and congenital rubella syndrome control and elimination - global progress, 2000-2012
MMWR Morb Mortal Wkly Rep. 2013 Dec 6;62(48):983-6.
Centers for Disease Control and Prevention (CDC).
Rubella virus usually causes a mild fever and rash in children and adults. However, infection during pregnancy, especially during the first trimester, can result in miscarriage, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy for introduction of rubella-containing vaccine (RCV) into national routine immunization schedules with an initial wide-age-range vaccination campaign that includes children aged 9 months-15 years. WHO also urged all member states to take the opportunity offered by accelerated measles control and elimination activities as a platform to introduce RCVs. The Global Measles and Rubella Strategic Plan (2012-2020) published by the Measles Rubella Initiative partners in 2012 and the Global Vaccine Action Plan endorsed by the World Health Assembly in 2012 include milestones to eliminate rubella and CRS in two WHO regions by 2015, and eliminate rubella in five WHO regions by 2020. This report summarizes the global progress of rubella and CRS control and elimination during 2000-2012. As of December 2012, a total of 132 (68%) WHO member states had introduced RCV, a 33% increase from 99 member states in 2000. A total of 94,030 rubella cases were reported to WHO in 2012 from 174 member states, an 86% decrease from the 670,894 cases reported in 2000 from 102 member states. The WHO Region of the Americas (AMR) and European Region (EUR) have established rubella elimination goals of 2010 and 2015, respectively. AMR has started to document the elimination of measles, rubella, and CRS; in EUR, rubella incidence has decreased significantly, although outbreaks continue to occur.
Prolonged persistence of measles virus RNA is characteristic of primary infection dynamics
Proc Natl Acad Sci U S A. 2012 Sep 11;109(37):14989-94. Epub 2012 Aug 7.
Lin WH, Kouyos RD, Adams RJ, Grenfell BT, Griffin DE. Source W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205.
Measles virus (MeV) is the poster child for acute infection followed by lifelong immunity. However, recent work shows the presence of MeV RNA in multiple sites for up to 3 mo after infection in a proportion of infected children. Here, we use experimental infection of rhesus macaques to show that prolonged RNA presence is characteristic of primary infection. We found that viral RNA persisted in the blood, respiratory tract, or lymph nodes four to five times longer than the infectious virus and that the clearance of MeV RNA from blood happened in three phases: rapid decline coincident with clearance of infectious virus, a rebound phase with increases up to 10-fold, and a phase of slow decrease to undetectable levels. To examine the effect of individual host immune factors on MeV load dynamics further, we developed a mathematical model that expressed viral replication and elimination in terms of the strength of MeV-specific T-cell responses, antibody responses, target cell limitations, and immunosuppressive activity of regulatory T cells. Based on the model, we demonstrate that viral dynamics, although initially regulated by T cells, require antibody to eliminate viral RNA. These results have profound consequences for our view of acute viral infections, the development of prolonged immunity, and, potentially, viral evolution.
Rapid titration of measles and other viruses: optimization with determination of replication cycle length
PLoS One. 2011;6(9):e24135. Epub 2011 Sep 7.
Grigorov B, Rabilloud J, Lawrence P, Gerlier D. Source INSERM, U758, Ecole Normale Supérieure de Lyon, Lyon, France, Université de Lyon, Lyon, France. firstname.lastname@example.org
Abstract BACKGROUND: Measles virus (MV) is a member of the Paramyxoviridae family and an important human pathogen causing strong immunosuppression in affected individuals and a considerable number of deaths worldwide. Currently, measles is a re-emerging disease in developed countries. MV is usually quantified in infectious units as determined by limiting dilution and counting of plaque forming unit either directly (PFU method) or indirectly from random distribution in microwells (TCID50 method). Both methods are time-consuming (up to several days), cumbersome and, in the case of the PFU assay, possibly operator dependent.
METHODS/FINDINGS: A rapid, optimized, accurate, and reliable technique for titration of measles virus was developed based on the detection of virus infected cells by flow cytometry, single round of infection and titer calculation according to the Poisson's law. The kinetics follow up of the number of infected cells after infection with serial dilutions of a virus allowed estimation of the duration of the replication cycle, and consequently, the optimal infection time. The assay was set up to quantify measles virus, vesicular stomatitis virus (VSV), and human immunodeficiency virus type 1 (HIV-1) using antibody labeling of viral glycoprotein, virus encoded fluorescent reporter protein and an inducible fluorescent-reporter cell line, respectively.
CONCLUSION: Overall, performing the assay takes only 24-30 hours for MV strains, 12 hours for VSV, and 52 hours for HIV-1. The step-by-step procedure we have set up can be, in principle, applicable to accurately quantify any virus including lentiviral vectors, provided that a virus encoded gene product can be detected by flow cytometry.
Two cases of measles in pregnant women immediately preceding delivery (case reports)
Clin Exp Obstet Gynecol. 2011;38(2):177-9.
Yoshida M, Matsuda H, Furuya K.Source
Department of Obstetrics and Gynecology, National Defense Medical College, Saitama Prefecture, Japan. email@example.com
Abstract Measles is an acute exanthema spread by airborne infection and still occurs sporadically in Japan. Its mortality rate is estimated to be 0.1% and it has no specific therapy. Here, we present two cases of measles in pregnant women immediately preceding delivery. It is required to prevent the perinatal spread of measles when pregnant women are infected immediately preceding delivery. We measured the measles antibody titer of 1,393 pregnant women by enzyme immunoassay between 2004 and 2008. The antibody-positive rate was 87.7%, but the antibody titer tended to be low in childbearing age. Preventive treatment with measles vaccination is extremely important before pregnancy in order to prevent perinatal measles.
The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study
Takahashi K, Ohkusa Y, Kim JY.
BMC Health Serv Res. 2011 Oct 7;11(1):254.
Measles and pregnancy (Article in French)
Presse Med. 2011 Aug 30.
Anselem O, Tsatsaris V, Lopez E, Krivine A, Le Ray C, Loulergue P, Floret D, Goffinet F, Launay O.
Source Faculté de médecine, université Paris-Descartes, Paris, France; Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France; Fondation PremUp, Paris, France.
Because of insufficient vaccine coverage, there is an outbreak of measles since 2008 in France with an increasing incidence of cases, most of them among children less than 1 year old or young adults. When measles occurs during pregnancy, maternal and fetal morbidity is increased. Particularly pregnant women are exposed to a higher risk of severe respiratory distress that might cause death. Measles virus can be detected in the placenta. Placental infection appears to be involved in some cases of fetal death. The virus is not responsible for congenital defects but can induce histologic damages inside the placenta which may lead to fetal death. Major perinatal risks are also miscarriage and prematurity. When measles occurs in late pregnancy, congenital infection is possible with variable expression and a risk of subacute sclerosing panencephalitis. Non immune pregnant women or neonates exposed to measles should receive an immunoglobulin prophylaxis within 6 days after contact in order to reduce the risk of infection and severe morbidity. In case of declared measles infection, symptomatic treatment can be proposed and tocolysis can be used if preterm labor is associated. Daily fetal monitoring during the 14 days following the beginning of the eruption can be offered when the fetus is viable. Vaccination is recommended for the people born in France after 1980 with 2 doses of vaccine against measles, rubeola and mumps. Measles vaccine, an attenuated living vaccine, should not be administered during pregnancy but must be proposed before pregnancy or during the post-partum period.
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
The measles virus replication cycle
Curr Top Microbiol Immunol. 2009;329:77-102.
Rima BK, Duprex WP.Source Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7BL, Northern Ireland, UK. firstname.lastname@example.org
This review describes the two interrelated and interdependent processes of transcription and replication for measles virus. First, we concentrate on the ribonucleoprotein (RNP) complex, which contains the negative sense genomic template and in encapsidated in every virion. Second, we examine the viral proteins involved in these processes, placing particular emphasis on their structure, conserved sequence motifs, their interaction partners and the domains which mediate these associations. Transcription is discussed in terms of sequence motifs in the template, editing, co-transcriptional modifications of the mRNAs and the phase of the gene start sites within the genome. Likewise, replication is considered in terms of promoter strength, copy numbers and the remarkable plasticity of the system. The review emphasises what is not known or known only by analogy rather than by direct experimental evidence in the MV replication cycle and hence where additional research, using reverse genetic systems, is needed to complete our understanding of the processes involved.
PLoS Med. 2007 Jan;4(1):e16.
Grais RF, Dubray C, Gerstl S, Guthmann JP, Djibo A, Nargaye KD, Coker J, Alberti KP, Cochet A, Ihekweazu C, Nathan N, Payne L, Porten K, Sauvageot D, Schimmer B, Fermon F, Burny ME, Hersh BS, Guerin PJ.Source Epicentre, Paris, France. email@example.com
BACKGROUND: Despite the comprehensive World Health Organization (WHO)/United Nations Children's Fund (UNICEF) measles mortality-reduction strategy and the Measles Initiative, a partnership of international organizations supporting measles mortality reduction in Africa, certain high-burden countries continue to face recurrent epidemics. To our knowledge, few recent studies have documented measles mortality in sub-Saharan Africa. The objective of our study was to investigate measles mortality in three recent epidemics in Niamey (Niger), N'Djamena (Chad), and Adamawa State (Nigeria). METHODS AND FINDINGS: We conducted three exhaustive household retrospective mortality surveys in one neighbourhood of each of the three affected areas: Boukoki, Niamey, Niger (April 2004, n = 26,795); Moursal, N'Djamena, Chad (June 2005, n = 21,812); and Dong District, Adamawa State, Nigeria (April 2005, n = 16,249), where n is the total surveyed population in each of the respective areas. Study populations included all persons resident for at least 2 wk prior to the study, a duration encompassing the measles incubation period. Heads of households provided information on measles cases, clinical outcomes up to 30 d after rash onset, and health-seeking behaviour during the epidemic. Measles cases and deaths were ascertained using standard WHO surveillance-case definitions. Our main outcome measures were measles attack rates (ARs) and case fatality ratios (CFRs) by age group, and descriptions of measles complications and health-seeking behaviour. Measles ARs were the highest in children under 5 y old (under 5 y): 17.1% in Boukoki, 17.2% in Moursal, and 24.3% in Dong District. CFRs in under 5-y-olds were 4.6%, 4.0%, and 10.8% in Boukoki, Moursal, and Dong District, respectively. In all sites, more than half of measles cases in children aged under 5 y experienced acute respiratory infection and/or diarrhoea in the 30 d following rash onset. Of measles cases, it was reported that 85.7% (979/1,142) of patients visited a health-care facility within 30 d after rash onset in Boukoki, 73.5% (519/706) in Moursal, and 52.8% (603/1,142) in Dong District. CONCLUSIONS: Children in these countries still face unacceptably high mortality from a completely preventable disease. While the successes of measles mortality-reduction strategies and progress observed in measles control in other countries of the region are laudable and evident, they should not overshadow the need for intensive efforts in countries that have just begun implementation of the WHO/UNICEF comprehensive strategy. Comment inPLoS Med. 2007 Jan;4(1):e24.
Measles infection in pregnancy
J Infect. 2003 Jul;47(1):40-4.
Chiba ME, Saito M, Suzuki N, Honda Y, Yaegashi N.
Source Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
OBJECTIVES: Measles during pregnancy has deleterious effects on both the perinatal outcome and the mother. However, in-depth knowledge about gestational measles is lacking. The objectives of this study were to describe the clinical course of eight cases of gestational measles and to study the effect of measles and pregnancy on each other.
METHODS: From late 2000 to early 2001, we experienced a measles outbreak with eight infected pregnant women. The clinical course of each case is described in detail.
RESULT: Three of the four cases before 24 weeks of gestation ended in spontaneous abortion or stillbirth. The clinical course of the three abortions and stillbirth were singular because of the sudden onset of the abortion and the spontaneous pregnancy termination. In contrast, the four pregnancies after 25 weeks of gestation ended in live-term delivery and two out of the four neonates were diagnosed with congenital measles. There was no maternal death, instead two pneumonia cases and one hemorrhagic shock case.
CONCLUSIONS: Gestational measles may potentially damage the fetus and is one of the serious complications that can occur during pregnancy.