Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1992 Jul;30(7):1778–1782. doi: 10.1128/jcm.30.7.1778-1782.1992

Secondary immune response in a vaccinated population during a large measles epidemic.

G Ozanne 1, M A d'Halewyn 1
PMCID: PMC265380  PMID: 1629334

Abstract

The rates of secondary immune response (SIR) and secondary vaccine failure (SVF) during a measles epidemic (10,184 notifications) were evaluated. A patient with SIR was defined as a subject for whom all sera were immunoglobulin G (IgG) positive and IgM negative with a significant increase in complement fixation titer. A patient with SVF was defined as a vaccinated symptomatic subject showing a SIR. Sequential sera from 898 subjects were tested for measles antibody by enzyme-linked immunosorbent assay (IgG and IgM) and by complement fixation. Evidence of recent anti-measles virus specific immune response was found in 496 subjects (55.5%). The vaccination rate was estimated at 74.6% (99% confidence interval [CI], 67.9 to 80.7%). The number of exposed vaccinated subjects was estimated at 370 (74.6% of 496). The SIR rate was 4.03% (20 of 496) (99% CI, 2.1 to 6.9%) among subjects with immune response. These 20 subjects were 2 with measles (Centers for Disease Control's definition), 6 with measles with rash of unknown duration, 8 with presumed measles with either rash or fever, 3 asymptomatic subjects (2 with recent contact with a measles case), and 1 undocumented subject. Since 3 patients with SIR were asymptomatic and 2 others were documented as not vaccinated, there was a maximum of 15 probable occurrences of SVF among the 20 patients with SIR. The SVF rate among exposed vaccinated subjects was estimated at 4.05% (15 of 370) (99% CI, 1.9 to 7.5%). In conclusion, neither prior vaccination nor detectable SIR ensures protective immunity. Measles virus may induce asymptomatic SIR in IgG-seropositive subjects. SVF led to typical or modified measles but did not seem to have played an important role during this epidemic.

Full text

PDF
1778

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cherry J. D., Feigin R. D., Shackelford P. G., Hinthorn D. R., Schmidt R. R. A clinical and serologic study of 103 children with measles vaccine failure. J Pediatr. 1973 May;82(5):802–808. doi: 10.1016/s0022-3476(73)80070-8. [DOI] [PubMed] [Google Scholar]
  2. Cherry J. D. The 'new' epidemiology of measles and rubella. Hosp Pract. 1980 Jul;15(7):49–57. doi: 10.1080/21548331.1980.11946629. [DOI] [PubMed] [Google Scholar]
  3. Edmonson M. B., Addiss D. G., McPherson J. T., Berg J. L., Circo S. R., Davis J. P. Mild measles and secondary vaccine failure during a sustained outbreak in a highly vaccinated population. JAMA. 1990 May 9;263(18):2467–2471. [PubMed] [Google Scholar]
  4. Gustafson T. L., Lievens A. W., Brunell P. A., Moellenberg R. G., Buttery C. M., Sehulster L. M. Measles outbreak in a fully immunized secondary-school population. N Engl J Med. 1987 Mar 26;316(13):771–774. doi: 10.1056/NEJM198703263161303. [DOI] [PubMed] [Google Scholar]
  5. Mathias R. G., Meekison W. G., Arcand T. A., Schechter M. T. The role of secondary vaccine failures in measles outbreaks. Am J Public Health. 1989 Apr;79(4):475–478. doi: 10.2105/ajph.79.4.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Murray D. L., Lynch M. A. Determination of immune status to measles, rubella, and varicella-zoster viruses among medical students: assessment of historical information. Am J Public Health. 1988 Jul;78(7):836–838. doi: 10.2105/ajph.78.7.836. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ozanne G., d'Halewyn M. A. Performance and reliability of the Enzygnost measles enzyme-linked immuno-sorbent assay for detection of measles virus-specific immunoglobulin M antibody during a large measles epidemic. J Clin Microbiol. 1992 Mar;30(3):564–569. doi: 10.1128/jcm.30.3.564-569.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Pedersen I. R., Mordhorst C. H., Ewald T., von Magnus H. Long-term antibody response after measles vaccination in an isolated arctic society in Greenland. Vaccine. 1986 Sep;4(3):173–178. doi: 10.1016/0264-410x(86)90006-x. [DOI] [PubMed] [Google Scholar]
  9. Pedersen I. R., Mordhorst C. H., Glikmann G., von Magnus H. Subclinical measles infection in vaccinated seropositive individuals in arctic Greenland. Vaccine. 1989 Aug;7(4):345–348. doi: 10.1016/0264-410x(89)90199-0. [DOI] [PubMed] [Google Scholar]
  10. Rossier E., Miller H., McCulloch B., Sullivan L., Ward K. Comparison of immunofluorescence and enzyme immunoassay for detection of measles-specific immunoglobulin M antibody. J Clin Microbiol. 1991 May;29(5):1069–1071. doi: 10.1128/jcm.29.5.1069-1071.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Salonen E. M., Vaheri A., Suni J., Wager O. Rheumatoid factor in acute viral infections: interference with determination of IgM, IgG, and IgA antibodies in an enzyme immunoassay. J Infect Dis. 1980 Aug;142(2):250–255. doi: 10.1093/infdis/142.2.250. [DOI] [PubMed] [Google Scholar]
  12. Sekla L., Stackiw W., Eibisch G., Johnson I. An evaluation of measles serodiagnosis during an outbreak in a vaccinated community. Clin Invest Med. 1988 Aug;11(4):304–309. [PubMed] [Google Scholar]
  13. Smith F. R., Curran A. S., Raciti K. A., Black F. L. Reported measles in persons immunologically primed by prior vaccination. J Pediatr. 1982 Sep;101(3):391–393. doi: 10.1016/s0022-3476(82)80064-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES