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Wang W, O'Driscoll M, Wang Q, Zhao S, Salje H, Yu H. Dynamics of measles immunity from birth and following vaccination. Nat Microbiol 2024; 9:1676-1685. [PMID: 38740931 DOI: 10.1038/s41564-024-01694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/03/2024] [Indexed: 05/16/2024]
Abstract
Measles remains a major threat to human health despite widespread vaccination. While we know that maternal antibodies can impair vaccine-induced immunity, the relative contributions of pre-existing immunity levels, maternal and infant characteristics on vaccine responses remain unclear, hampering evidence-based vaccination policy development. Here we combine serological data from 1,505 individuals (aged 0-12 years) in a mother-infant cohort and in a child cohort with empirical models to reconstruct antibody trajectories from birth. We show that while highly heterogeneous across a population, measles antibody evolution is strongly predictive from birth at the individual level, including following vaccination. Further, we find that caesarean section births were linked with 2.56 (95% confidence interval: 1.06-6.37) increased odds of primary vaccine failure, highlighting the long-term immunological consequences of birth route. Finally, we use our new understanding of antibody evolution to critically assess the population-level consequences of different vaccination schedules, the results of which will allow country-level evaluations of vaccine policy.
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Affiliation(s)
- Wei Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | | | - Qianli Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Sihong Zhao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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2
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Barmpakou A, Mavrouli M, Pana A, Kourkouni E, Panagiotou I, Spanakis N, Michos A. Seroprevalence of Measles in Pairs of Mothers and Newborns in Southern Greece. Viral Immunol 2023; 36:642-648. [PMID: 38127419 DOI: 10.1089/vim.2023.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Maternal immunoglobulin G (IgG) antibodies that are passively transferred to newborns through the placenta confer protection if they are exposed to measles virus. A measles outbreak occurred in several European countries including Greece, between 2016 and 2018. A prospective study was conducted in the General Hospital of Lakonia, regarding the measles seropositivity status of mother and newborn pairs. IgG antibody titer for measles was measured in serum samples acquired from pairs of mothers and newborns. The samples were analyzed through quantitative enzyme-linked immunosorbent assay, and antimeasles IgG >200 IU/mL was considered to be protective. Demographic data for mothers and neonates and data regarding immunization status of mothers were analyzed. Study population included 206 mothers and their newborns. In total, 12.6% of mothers (n = 26) and 10.7% of newborns (n = 22) did not have protective serology. A statistically significant positive linear association between maternal and neonatal antibodies was found (rho = 0.924) (p = 0.001). Neonates whose mothers were seropositive had higher antibodies [geometric mean concentration (GMC): 804.8 (728.3-889.2)] than neonates whose mothers were seronegative/borderline [GMC: 97.7 (64.2-148.8)] (p = 0.001). In the study area, a significant rate of mothers and newborns was found to have nonprotective measles serology that exceeds the limit required for herd immunity. Vaccination coverage in women of reproductive age should be increased to reduce potential for future measles epidemics.
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Affiliation(s)
- Afroditi Barmpakou
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
- Department of Pediatrics, General Hospital of Lakonia, Sparti, Greece
| | - Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Pana
- Department of Pediatrics, General Hospital of Lakonia, Sparti, Greece
| | - Eleni Kourkouni
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | | | - Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Michos
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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3
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Gao S, Wei M, Chu K, Li J, Zhu F. Effects of maternal antibodies in infants on the immunogenicity and safety of inactivated polio vaccine in infants. Hum Vaccin Immunother 2022; 18:2050106. [PMID: 35394898 PMCID: PMC9196670 DOI: 10.1080/21645515.2022.2050106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The presence of maternal poliovirus antibodies may interfere with the immune response to inactivated polio vaccine (IPV), and its influence on the safety of vaccination is not yet understood. A total of 1146 eligible infants were randomly assigned (1:1) to the IPV and Sabin IPV (SIPV) groups to compare and analyze the efficacy of the two vaccines in preventing poliovirus infection. We pooled the SIPV and IPV groups and reclassified them into the maternal poliovirus antibody-positive group (MAPG; ≥1: 8) and the maternal poliovirus antibody-negative group (MANG; <1: 8). We evaluated the impact of maternal poliovirus antibodies by comparing the geometric mean titer (GMT), seroconversion rate, and geometric mean increase (GMI) of types I-III poliovirus neutralizing antibodies post-vaccination, and incidence rates of adverse reactions following vaccination between the MAPG and MANG. Respective seroconversion rates in the MAPG and MANG were 94% and 100%, 79.27% and 100%, and 93.26% and 100% (all serotypes, P < .01) for types I-III poliovirus, respectively. The GMT of all types of poliovirus antibodies in the MAPG (1319.13, 219.91, 764.11, respectively) were significantly lower than those in the MANG (1584.92, 286.73, 899.59, respectively) (P < .05). The GMI in the MAPG was significantly lower than that in the MANG (P < .05). No statistically significant difference in the incidence of local and systemic adverse reactions was observed between the MAPG and MANG. Thus, the presence of maternal poliovirus antibodies does not affect the safety of IPV but can negatively impact the immune responses in infants after IPV vaccination.
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Affiliation(s)
- Shuyu Gao
- School of Public Health, Southeast University, Nanjing, PR China
| | - Mingwei Wei
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Kai Chu
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.,NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, PR China
| | - Fengcai Zhu
- School of Public Health, Southeast University, Nanjing, PR China.,Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.,NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, PR China
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4
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Zhou J, Zhou Y, Luo K, Liao Q, Zheng W, Gong H, Shi H, Zhao S, Wang K, Qiu Q, Dai B, Ren L, Wang L, Gao L, Xu M, Liu N, Lu W, Zheng N, Chen X, Chen Z, Yang J, Cauchemez S, Yu H. The transfer of maternal antibodies and dynamics of maternal and natural infection-induced antibodies against coxsackievirus A16 in Chinese children 0-13 years of age: a longitudinal cohort study. BMC Med 2022; 20:436. [PMID: 36352415 PMCID: PMC9645321 DOI: 10.1186/s12916-022-02604-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A major hand-foot-and-mouth disease (HFMD) pathogen, coxsackievirus A16 (CVA16), has predominated in several of the last 10 years and caused the largest number of HFMD outbreaks between 2011 and 2018 in China. We evaluated the efficacy of maternal anti-CVA16 antibody transfer via the placenta and explored the dynamics of maternal and natural infection-induced neutralizing antibodies in children. METHODS Two population-based longitudinal cohorts in southern China were studied during 2013-2018. Participants were enrolled in autumn 2013, including 2475 children aged 1-9 years old and 1066 mother-neonate pairs, and followed for 3 years. Blood/cord samples were collected for CVA16-neutralizing antibody detection. The maternal antibody transfer efficacy, age-specific seroprevalence, geometric mean titre (GMT) and immune response kinetics were estimated. RESULTS The average maternal antibody transfer ratio was 0.88 (95% CI 0.80-0.96). Transferred maternal antibody levels declined rapidly (half-life: 2.0 months, 95% CI 1.9-2.2 months). The GMT decayed below the positive threshold (8) by 1.5 months of age. Due to natural infections, it increased above 8 after 1.4 years and reached 32 by 5 years of age, thereafter dropping slightly. Although the average duration of maternal antibody-mediated protection was < 3 months, the duration extended to 6 months on average for mothers with titres ≥ 64. CONCLUSIONS Anti-CVA16 maternal antibodies are efficiently transferred to neonates, but their levels decline quickly. Children aged 0-5 years are the main susceptible population and should be protected by CVA16 vaccination, with the optimal vaccination time between 1.5 months and 1 year of age.
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Affiliation(s)
- Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yonghong Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Kaiwei Luo
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Qiaohong Liao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Wen Zheng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hui Gong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Huilin Shi
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Shanlu Zhao
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Kai Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qi Qiu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Bingbing Dai
- Anhua County Center for Disease Control and Prevention, Yiyang, China
| | - Lingshuang Ren
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lili Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lidong Gao
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Meng Xu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Nuolan Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Wanying Lu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Nan Zheng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zhiyuan Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université de Paris, UMR2000, CNRS, 75015, Paris, France
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Measles susceptibility in maternal-infant dyads-Bamako, Mali. Vaccine 2022; 40:1316-1322. [PMID: 35101263 PMCID: PMC8861573 DOI: 10.1016/j.vaccine.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/26/2021] [Accepted: 01/10/2022] [Indexed: 11/24/2022]
Abstract
Measles is endemic in Africa; measles mortality is highest among infants. Infant measles antibody titer at birth is related to maternal immune status. Older mothers are likelier to have had measles infection, which provides higher antibody titers than vaccine-induced immunity. We investigated the relationship between maternal age and measles susceptibility in mother-infant pairs in Mali through six months of infancy. We measured serum measles antibodies in 340 mother-infant pairs by plaque reduction neutralization test (PRNT) and calculated the proportion of mothers with protective titers (>120 mIU/mL) at delivery and the proportion of infants with protective titers at birth, and at three and six months of age. We explored associations between maternal age and measles antibodies in mothers and infants at the timepoints noted. Ten percent of Malian newborns were susceptible to measles; by six months nearly all were. Maternal and infant antibody titers were highly correlated. At delivery, 11% of mothers and 10% of newborns were susceptible to measles. By three and six months, infant susceptibility increased to 72% and 98%, respectively. Infants born to younger mothers were most susceptible at birth and three months. Time to susceptibility was 6.6 weeks in infants born to mothers with measles titer >120-<430 mIU/mL versus 15.4 weeks when mothers had titers ≥430 mIU/mL. Maternal and newborn seroprotective status were positively correlated. Improved strategies are needed to protect susceptible infants from measles infection and death. Increasing measles immunization coverage in vaccine eligible populations, including nonimmune reproductive-aged women and older children should be considered.
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6
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Oguti B, Ali A, Andrews N, Barug D, Anh Dang D, Halperin SA, Thu Hoang HT, Holder B, Kampmann B, Kazi AM, Langley JM, Leuridan E, Madavan N, Maertens K, Maldonado H, Miller E, Munoz-Rivas FM, Omer SB, Pollard AJ, Rice TF, Rots N, Sundaram ME, Wanlapakorn N, Voysey M. The half-life of maternal transplacental antibodies against diphtheria, tetanus, and pertussis in infants: an individual participant data meta-analysis. Vaccine 2021; 40:450-458. [PMID: 34949496 DOI: 10.1016/j.vaccine.2021.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/21/2021] [Accepted: 12/02/2021] [Indexed: 12/12/2022]
Abstract
AIM There are few reliable estimates of the half-lives of maternal antibodies to the antigens found in the primary series vaccines. We aimed to calculate the half-lives of passively acquired diphtheria, tetanus and pertussis (DTP) antibodies in infants. We aimed to determine whether decay rates varied according to country, maternal age, gestational age, birthweight, World Bank income classifications, or vaccine received by the mother during pregnancy. METHODS De-identified data from infants born to women taking part in 10 studies, in 9 countries (UK, Belgium, Thailand, Vietnam, Canada, Pakistan, USA, Guatemala and the Netherlands) were combined in an individual participant data meta-analysis. Blood samples were taken at two timepoints before any DTP-containing vaccines were received by the infant: at birth and at 2-months of age. Decay rates for each antigen were log2-transformed and a mixed effects model was applied. Half-lives were calculated by taking the reciprocal of the absolute value of the mean decay rates. RESULTS Data from 1426 mother-infant pairs were included in the analysis. The half-lives of the 6 antigen-specific maternal antibodies of interest were similar, with point estimates ranging from 28.7 (95% CI: 24.4 - 35) days for tetanus toxoid antibodies to 35.1 (95% CI: 30.7 - 41.1) days for pertactin antibodies. The decay of maternal antibodies did not significantly differ by maternal age, gestational age, birthweight, maternal vaccination status or type of vaccine administered. CONCLUSION Maternal antibodies decay at different rates for the different antigens; however, the magnitude of the difference is small. Decay rates are not modified by key demographic or vaccine characteristics.
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Affiliation(s)
- Blanché Oguti
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, United Kingdom
| | - Asad Ali
- Aga Khan University, Karachi, Pakistan
| | | | - Daan Barug
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, the Netherlands
| | - Duc Anh Dang
- National Institute of Hygiene and Epidemiology, Vietnam
| | | | | | - Beth Holder
- Department of Metabolism, Digestion and Reproduction, Imperial College London, United Kingdom
| | - Beate Kampmann
- London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | - Elke Leuridan
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Belgium
| | | | - Kirsten Maertens
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Belgium
| | | | | | | | | | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, United Kingdom
| | - Thomas F Rice
- Department of Metabolism, Digestion and Reproduction, Imperial College London, United Kingdom
| | - Nynke Rots
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, the Netherlands
| | - Maria E Sundaram
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, USA
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, United Kingdom.
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7
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Dynamics of maternally transferred antibodies against measles, mumps, and rubella in infants in Sri Lanka. Int J Infect Dis 2021; 107:129-134. [PMID: 33895406 DOI: 10.1016/j.ijid.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Determining the dynamics of maternally transferred antibodies against measles, mumps, and rubella infections in infants is important for making evidence-based policy decisions regarding the timing of vaccination. METHODS The levels of serum immunoglobulin G (IgG) developed against measles, mumps, and rubella infections were assessed using commercial ELISA kits in mother-newborn pairs (n = 294) and 6-12-month-old infants (n = 280) recruited from Colombo District, Sri Lanka. Antibody levels of mothers and their newborns were assessed with respect to sex and parity. Antibody levels and the protection conferred were assessed in a sample of infants who completed 6-12 months of age in relation to their age and sex. Antibody levels were compared between different age and sex groups using the Mann-Whitney U-test, and correlations of antibody titers were performed using the Spearman correlation test. RESULTS The prevalence rates of seropositivity for measles, mumps, and rubella were 91.5%, 89%, and 88%, respectively, in mothers, and 95%, 91.5%, and 93%, respectively, in their newborns. The newborns had mean IgG levels exceeding those of the mothers (P < 0.001). Mothers with natural infections had higher antibody levels compared to vaccinated mothers, which resulted in a higher level of maternal transfer. All of the infants who were 9-10 months of age or older were seronegative for measles, all of those who were 10-11 months of age or older were seronegative for rubella, and all of those who were 11-12 months old were seronegative for mumps. CONCLUSIONS The maternal transfer of antibodies to newborns is efficient and renders protection until the infants are 6-7 months old in the case of mumps and rubella and 7-8 months old in the case of measles. Hence infants remain vulnerable to infections before the first dose of the MMR vaccine.
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8
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Alonso S, Vidal M, Ruiz-Olalla G, González R, Manaca MN, Jairoce C, Vázquez-Santiago M, Balcells R, Vala A, Rupérez M, Cisteró P, Fuente-Soro L, Cova M, Angov E, Nhacolo A, Sevene E, Aponte JJ, Macete E, Aguilar R, Mayor A, Menéndez C, Dobaño C, Moncunill G. Reduced Placental Transfer of Antibodies Against a Wide Range of Microbial and Vaccine Antigens in HIV-Infected Women in Mozambique. Front Immunol 2021; 12:614246. [PMID: 33746958 PMCID: PMC7965965 DOI: 10.3389/fimmu.2021.614246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/08/2021] [Indexed: 01/16/2023] Open
Abstract
Transplacental transfer of antibodies is essential for conferring protection in newborns against infectious diseases. We assessed the impact of different factors, including gestational age and maternal infections such as HIV and malaria, on the efficiency of cord blood levels and placental transfer of IgG subclasses. We measured total IgG and IgG subclasses by quantitative suspension array technology against 14 pathogens and vaccine antigens, including targets of maternal immunization, in 341 delivering HIV-uninfected and HIV-infected mother-infant pairs from southern Mozambique. We analyzed the association of maternal HIV infection, Plasmodium falciparum exposure, maternal variables and pregnancy outcomes on cord antibody levels and transplacental transfer. Our results show that maternal antibody levels were the main determinant of cord antibody levels. Univariable and multivariable analysis showed that HIV reduced the placental transfer and cord levels of IgG and IgG1 principally, but also IgG2 to half of the antigens tested. P. falciparum exposure and prematurity were negatively associated with cord antibody levels and placental transfer, but this was antigen-subclass dependent. Our findings suggest that lower maternally transferred antibodies may underlie increased susceptibility to infections of HIV-exposed infants. This could affect efficacy of maternal vaccination, especially in sub-Saharan Africa, where there is a high prevalence of HIV, malaria and unfavorable environmental factors.
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Affiliation(s)
- Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Raquel González
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - M. Nelia Manaca
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Chenjerai Jairoce
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Reyes Balcells
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Anifa Vala
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - María Rupérez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Laura Fuente-Soro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Marta Cova
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Evelina Angov
- U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
| | - Arsenio Nhacolo
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Department of Physiologic Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - John J. Aponte
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Eusebio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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9
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Alonso S, Vidal M, Ruiz-Olalla G, González R, Jairoce C, Manaca MN, Vázquez-Santiago M, Balcells R, Vala A, Rupérez M, Cisteró P, Fuente-Soro L, Angov E, Coppel RL, Gamain B, Cavanagh D, Beeson JG, Nhacolo A, Sevene E, Aponte JJ, Macete E, Aguilar R, Mayor A, Menéndez C, Dobaño C, Moncunill G. HIV infection and placental malaria reduce maternal transfer of multiple antimalarial antibodies in Mozambican women. J Infect 2021; 82:45-57. [PMID: 33636218 DOI: 10.1016/j.jinf.2021.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Maternal Plasmodium falciparum-specific antibodies may contribute to protect infants against severe malaria. Our main objective was to evaluate the impact of maternal HIV infection and placental malaria on the cord blood levels and efficiency of placental transfer of IgG and IgG subclasses. METHODS In a cohort of 341 delivering HIV-negative and HIV-positive mothers from southern Mozambique, we measured total IgG and IgG subclasses in maternal and cord blood pairs by quantitative suspension array technology against eight P. falciparum antigens: Duffy-binding like domains 3-4 of VAR2CSA from the erythrocyte membrane protein 1, erythrocyte-binding antigen 140, exported protein 1 (EXP1), merozoite surface proteins 1, 2 and 5, and reticulocyte-binding-homologue-4.2 (Rh4.2). We performed univariable and multivariable regression models to assess the association of maternal HIV infection, placental malaria, maternal variables and pregnancy outcomes on cord antibody levels and antibody transplacental transfer. RESULTS Maternal antibody levels were the main determinants of cord antibody levels. HIV infection and placental malaria reduced the transfer and cord levels of IgG and IgG1, and this was antigen-dependent. Low birth weight was associated with an increase of IgG2 in cord against EXP1 and Rh4.2. CONCLUSIONS We found lower maternally transferred antibodies in HIV-exposed infants and those born from mothers with placental malaria, which may underlie increased susceptibility to malaria in these children.
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Affiliation(s)
- Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Raquel González
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Chenjerai Jairoce
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - M Nelia Manaca
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Miquel Vázquez-Santiago
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Reyes Balcells
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Anifa Vala
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - María Rupérez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique; Present address: London School of Hygiene and Tropical Medicine (LSHTM). Keppel Street, WC1E 7HT, London, UK
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Laura Fuente-Soro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Evelina Angov
- U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, USA
| | - Ross L Coppel
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, VIC, Australia
| | - Benoit Gamain
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, Laboratoire d'Excellence GR-Ex, Paris, France
| | - David Cavanagh
- Institute of Immunology & Infection Research and Centre for Immunity, Infection & Evolution, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, King's Buildings, Charlotte Auerbach Rd, Edinburgh, EH9 3FL, UK
| | | | - Arsenio Nhacolo
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique; Department of Physiologic Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - John J Aponte
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Eusébio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique.
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique.
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10
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Pollard AJ, Bijker EM. A guide to vaccinology: from basic principles to new developments. Nat Rev Immunol 2020; 21:83-100. [PMID: 33353987 PMCID: PMC7754704 DOI: 10.1038/s41577-020-00479-7] [Citation(s) in RCA: 607] [Impact Index Per Article: 151.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 12/17/2022]
Abstract
Immunization is a cornerstone of public health policy and is demonstrably highly cost-effective when used to protect child health. Although it could be argued that immunology has not thus far contributed much to vaccine development, in that most of the vaccines we use today were developed and tested empirically, it is clear that there are major challenges ahead to develop new vaccines for difficult-to-target pathogens, for which we urgently need a better understanding of protective immunity. Moreover, recognition of the huge potential and challenges for vaccines to control disease outbreaks and protect the older population, together with the availability of an array of new technologies, make it the perfect time for immunologists to be involved in designing the next generation of powerful immunogens. This Review provides an introductory overview of vaccines, immunization and related issues and thereby aims to inform a broad scientific audience about the underlying immunological concepts. This Review, aimed at a broad scientific audience, provides an introductory guide to the history, development and immunological basis of vaccines, immunization and related issues to provide insight into the challenges facing immunologists who are designing the next generation of vaccines.
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Affiliation(s)
- Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK. .,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK.
| | - Else M Bijker
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK
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11
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Qamruddin AA, Qamruddin R, Malik A. Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia. Malays J Med Sci 2020; 27:130-140. [PMID: 33154709 PMCID: PMC7605828 DOI: 10.21315/mjms2020.27.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/12/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. METHODS Cross-sectional analysis was carried out looking at all suspected and laboratory-confirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. RESULTS The incidence rate for suspected measles showed an increasing trend from 2015-2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. CONCLUSION Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.
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Affiliation(s)
| | | | - Ayu Malik
- Larut Matang and Selama District Health Office, Perak, Malaysia
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12
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Measles vaccination of young infants in China: A cost-effectiveness analysis. Vaccine 2020; 38:4616-4624. [PMID: 32451210 DOI: 10.1016/j.vaccine.2020.04.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although global progress in measles control has been realized, achieving elimination has proven difficult in many regions of the world. China has adopted a goal of measles elimination but recent outbreaks predominantly affecting children <8 months who are ineligible for vaccination and incompletely protected by maternal antibodies has impeded progress. We assess the cost-effectiveness of adding an initial measles vaccine dose in China to earlier than the currently recommended 8 months of age. METHODS We conducted a cost-utility analysis comparing the costs and health benefits associated with adding a measles vaccine dose to the routine schedule at 4, 5, 6 or 7 months compared to the current recommendation for the first dose at age 8 months. A decision analytic model was developed in Microsoft Excel, including five non-severe and two fatal health outcomes associated with measles infection. Model parameters were informed by the literature and surveillance data. Future costs and health benefits were discounted at 3%. Primary outcomes included costs, Quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) over a lifetime time horizon. RESULTS Lowering the recommended age for initiating the measles vaccination series to address susceptibility in children <8 months provided incremental health gains compared to minimal costs at the individual-level. The ICER was most favorable ($232.70 per QALY gain) for administering an initial dose at 4 months of age due to fewer incremental program costs when shifting measles administration to an immunization visit already established under the Chinese vaccination program. CONCLUSION We found potential beneficial health gains at a minimum cost associated with adding an earlier measles dose <8 months of age in China. Further investigation about disease transmission dynamics is required to more fully assess the tradeoffs of administering measles at a younger age to infants in China.
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13
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Azad C, Arya A, Raina D, Gupta R. Atypical Subacute Sclerosing Panencephalitis in a Young Child: Implications for Change in Vaccination Strategy. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0039-1677711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AbstractSubacute sclerosing panencephalitis (SSPE) is a serious neurological complication of measles with no satisfactory treatment options. The prolonged incubation period makes it rare in young children. The occurrence of primary measles infection in infants before age of vaccination can be prevented only by ensuring adequate vaccination of all females in childbearing age. Here, we present a case of an atypical presentation of SSPE in a toddler who contracted measles at 6 months of age.
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Affiliation(s)
- Chandrika Azad
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Adhi Arya
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Deepti Raina
- Government Institute for Rehabilitation of Intellectual Disabilities, Chandigarh, India
| | - Rekha Gupta
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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14
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Kuba Y, Kyan H, Iha Y, Kato T, Oyama M, Miyahira M, Kakita T, Takara T, Yamauchi M, Kamiya H, Sunagawa T, Kawakami Y, Nidaira M, Kudaka J, Yamakawa M, Itokazu T, Itokazu K. Emergent measles-containing vaccination recommendation for aged 6-11 months and detection of vaccine-associated measles during a large measles outbreak in Okinawa, Japan, in 2018. Vaccine 2020; 38:2361-2367. [PMID: 32037227 DOI: 10.1016/j.vaccine.2020.01.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
Okinawa Prefecture, Japan, experienced a large measles outbreak from March to May 2018. During this outbreak, there were 99 laboratory-confirmed cases and 14 vaccine-associated measles cases. In addition to the reinforcement of routine immunization, Okinawa prefectural government introduced emergent measles-containing vaccination recommendations for infants aged 6-11 months as part of the outbreak response. Increased concern exists in Okinawa about measles in infants following a previous outbreak from 1998 to 2001, when nine children including four infants died. Of 8062 infants aged 6-11 months who received measles-containing vaccine (MCV), six developed vaccine-associated measles; incidence was 0.74 per 1000 doses (95%CI 0.27-1.62). This was similar to that of first dose routine immunization recipients at one year of age (IR 0.60, 95%CI 0.20-1.78). Among 14 vaccine-associated measles cases, throat swab samples showed the highest positive rate (92.9%) by real-time reverse transcription polymerase chain reaction (RT-qPCR), followed by urine (25.0%) and whole blood (7.7%) samples. Furthermore, one throat swab sample classified as equivocal by RT-qPCR was positive by conventional RT-PCR (RT-PCR). During an outbreak, it is critical to distinguish between cases with measles-like symptoms caused by wild circulating virus and those caused by vaccine-derived virus as accurately and urgently as possible because the public health response will be quite different. No infant deaths were observed during this outbreak, and no severe adverse events following immunization were seen among infants 6-11 months old who were given MCV as a public health response. Thus, we conclude that introduction of emergent MCV was effective and describing the characteristics of vaccine-associated measles cases during a measles outbreak will be helpful for future outbreak response efforts.
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Affiliation(s)
- Yumani Kuba
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan.
| | - Hisako Kyan
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Yoshiyuki Iha
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Takashi Kato
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Minori Oyama
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Masato Miyahira
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Tetsuya Kakita
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Taketoshi Takara
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Miyuki Yamauchi
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
| | - Hajime Kamiya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshino Kawakami
- Regional Health Division, Department of Public Health and Medical Care, Okinawa Prefectural Government, Okinawa, Japan
| | - Minoru Nidaira
- Regional Health Division, Department of Public Health and Medical Care, Okinawa Prefectural Government, Okinawa, Japan
| | - Jun Kudaka
- Regional Health Division, Department of Public Health and Medical Care, Okinawa Prefectural Government, Okinawa, Japan
| | - Munesada Yamakawa
- Regional Health Division, Department of Public Health and Medical Care, Okinawa Prefectural Government, Okinawa, Japan
| | - Toru Itokazu
- Regional Health Division, Department of Public Health and Medical Care, Okinawa Prefectural Government, Okinawa, Japan
| | - Kiyomasa Itokazu
- Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
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15
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Graham M, Winter AK, Ferrari M, Grenfell B, Moss WJ, Azman AS, Metcalf CJE, Lessler J. Measles and the canonical path to elimination. Science 2019; 364:584-587. [PMID: 31073065 PMCID: PMC7745123 DOI: 10.1126/science.aau6299] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 04/11/2019] [Indexed: 11/25/2022]
Abstract
All World Health Organization regions have set measles elimination goals. We find
that as countries progress toward these goals, they undergo predictable changes
in the size and frequency of measles outbreaks. A country’s position on
this “canonical path” is driven by both measles control activities
and demographic factors, which combine to change the effective size of the
measles-susceptible population, thereby driving the country through
theoretically established dynamic regimes. Further, position on the path to
elimination provides critical information for guiding vaccination efforts, such
as the age profile of susceptibility, that could only otherwise be obtained
through costly field studies or sophisticated analysis. Equipped with this
information, countries can gain insight into their current and future measles
epidemiology and select appropriate strategies to more quickly achieve
elimination goals.
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Affiliation(s)
- Matthew Graham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,These authors contributed equally to this work
| | - Amy K Winter
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,These authors contributed equally to this work
| | - Matthew Ferrari
- Department of Biology, The Pennsylvania State University, University Park, PA, USA
| | - Bryan Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.,Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - William J Moss
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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16
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de Alwis R, Tu LTP, Quynh NLT, Thompson CN, Anders KL, Van Thuy NT, Hieu NT, Vi LL, Chau NVV, Duong VT, Chau TTH, Tuyen HT, Nga TVT, Minh PV, Tan TV, Thu TNH, Nhu TDH, Thwaites GE, Simmons C, Baker S. The Role of Maternally Acquired Antibody in Providing Protective Immunity Against Nontyphoidal Salmonella in Urban Vietnamese Infants: A Birth Cohort Study. J Infect Dis 2019; 219:295-304. [PMID: 30321351 PMCID: PMC6306017 DOI: 10.1093/infdis/jiy501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/16/2018] [Indexed: 11/24/2022] Open
Abstract
Background Nontyphoidal Salmonella (NTS) organisms are a major cause of gastroenteritis and bacteremia, but little is known about maternally acquired immunity and natural exposure in infant populations residing in areas where NTS disease is highly endemic. Methods We recruited 503 pregnant mothers and their infants (following delivery) from urban areas in Vietnam and followed infants until they were 1 year old. Exposure to the dominant NTS serovars, Salmonella enterica serovars Typhimurium and Enteritidis, were assessed using lipopolysaccharide (LPS) O antigen–specific antibodies. Antibody dynamics, the role of maternally acquired antibodies, and NTS seroincidence rates were modeled using multivariate linear risk factor models and generalized additive mixed-effect models. Results Transplacental transfer of NTS LPS–specific maternal antibodies to infants was highly efficient. Waning of transplacentally acquired NTS LPS–specific antibodies at 4 months of age left infants susceptible to Salmonella organisms, after which they began to seroconvert. High seroincidences of S. Typhimurium and S. Enteritidis LPS were observed, and infants born with higher anti-LPS titers had greater plasma bactericidal activity and longer protection from seroconversion. Conclusions Although Vietnamese infants have extensive exposure to NTS, maternally acquired antibodies appear to play a protective role against NTS infections during early infancy. These findings suggest that prenatal immunization may be an appropriate strategy to protect vulnerable infants from NTS disease.
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Affiliation(s)
- Ruklanthi de Alwis
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom.,Program in Emerging Infectious Diseases, Duke University-National University of Singapore (Duke-NUS) Medical School, Singapore.,Viral Research and Experimental Medicine Centre, SingHealth Duke-NUS Academic Medical Centre, Singapore
| | - Le Thi Phuong Tu
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Nhi Le Thi Quynh
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Corinne N Thompson
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Nguyen Thi Van Thuy
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | | | - Lu Lan Vi
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Vu Thuy Duong
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran Thi Hong Chau
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran Vu Thieu Nga
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Trinh Van Tan
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Trang Nguyen Hoang Thu
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran Do Hoang Nhu
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Guy E Thwaites
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom
| | - Cameron Simmons
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom.,Department of Microbiology and Immunology, University of Melbourne, Melbourne, Australia
| | - Stephen Baker
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom.,Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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17
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Collins CA, Gelinas L, Yasukawa LL, Audet S, Abu-Raya B, Turvey SE, Beeler JA, Kollmann TR, Gans HA. Measles Maternal Antibodies With Low Avidity Do Not Interfere With the Establishment of Robust Quantity and Quality Antibody Responses After the Primary Dose of Measles, Mumps, and Rubella Vaccine Administered at 12-Months of Age. J Pediatric Infect Dis Soc 2019; 9:752-755. [PMID: 31644795 PMCID: PMC7864143 DOI: 10.1093/jpids/piz074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 10/08/2019] [Indexed: 11/14/2022]
Abstract
In this study, we illustrate, for the first time, that preexisting low-avidity neutralizing measles maternal antibodies do not interfere with the development of high concentrations of high-avidity measles antibodies in children immunized at age 12 months. This suggests that the quality of measles maternal antibodies, rather than the quantity, impacts immunogenicity of primary measles immunization.
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Affiliation(s)
- Cathleen A Collins
- Department of Pediatrics, Rady Children’s Hospital San Diego/University of California–San Diego,, San Diego, California, USA
| | - Laura Gelinas
- Department of Pediatrics, University of British Columbia, BC Children’s Hospital Vancouver, Vancouver, Canada
| | - Linda L Yasukawa
- Department of Pediatrics, Stanford University Medical School, Stanford, California, USA
| | - Susette Audet
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Bahaa Abu-Raya
- Department of Pediatrics, University of British Columbia, BC Children’s Hospital Vancouver, Vancouver, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, BC Children’s Hospital Vancouver, Vancouver, Canada
| | - Judy A Beeler
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Tobias R Kollmann
- Department of Pediatrics, University of British Columbia, BC Children’s Hospital Vancouver, Vancouver, Canada
| | - Hayley A Gans
- Department of Pediatrics, Stanford University Medical School, Stanford, California, USA,Correspondence: Hayley Gans, Stanford University Medical Center, 300 Pasteur Drive, G312, Stanford, CA 94305–5208 ()
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18
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Minter A, Retkute R. Approximate Bayesian Computation for infectious disease modelling. Epidemics 2019; 29:100368. [PMID: 31563466 DOI: 10.1016/j.epidem.2019.100368] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/20/2019] [Accepted: 08/30/2019] [Indexed: 12/23/2022] Open
Abstract
Approximate Bayesian Computation (ABC) techniques are a suite of model fitting methods which can be implemented without a using likelihood function. In order to use ABC in a time-efficient manner users must make several design decisions including how to code the ABC algorithm and the type of ABC algorithm to use. Furthermore, ABC relies on a number of user defined choices which can greatly effect the accuracy of estimation. Having a clear understanding of these factors in reducing computation time and improving accuracy allows users to make more informed decisions when planning analyses. In this paper, we present an introduction to ABC with a focus of application to infectious disease models. We present a tutorial on coding practice for ABC in R and three case studies to illustrate the application of ABC to infectious disease models.
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Affiliation(s)
- Amanda Minter
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Renata Retkute
- The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, UK
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19
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Eilertson KE, Fricks J, Ferrari MJ. Estimation and prediction for a mechanistic model of measles transmission using particle filtering and maximum likelihood estimation. Stat Med 2019; 38:4146-4158. [PMID: 31290184 PMCID: PMC6771900 DOI: 10.1002/sim.8290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/15/2019] [Accepted: 05/31/2019] [Indexed: 11/17/2022]
Abstract
Disease incidence reported directly within health systems frequently reflects a partial observation relative to the true incidence in the population. State‐space models present a general framework for inferring both the dynamics of infectious disease processes and the unobserved burden of disease in the population. Here, we present a state‐space model of measles transmission and vaccine‐based interventions at the country‐level and a particle filter‐based estimation procedure. Our dynamic transmission model builds on previous work by incorporating population age‐structure to allow explicit representation of age‐targeted vaccine interventions. We illustrate the performance of estimators of model parameters and predictions of unobserved states on simulated data from two dynamic models: one on the annual time‐scale of observations and one on the biweekly time‐scale of the epidemiological dynamics. We show that our model results in approximately unbiased estimates of unobserved burden and the underreporting rate. We further illustrate the performance of the fitted model for prediction of future disease burden in the next one to 15 years.
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Affiliation(s)
| | - John Fricks
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ
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20
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KARAAYVAZ S, OĞUZ MM, BEYAZOVA U, KORUKLUOĞLU G, COŞGUN Y, GÜZELKÜÇÜK Z, BARAN AKSAKAL N, ŞAHİN DAĞLI F. Evaluation of measles immunity in Turkey: is it still a threat? Turk J Med Sci 2019; 49:336-340. [PMID: 30761852 PMCID: PMC7350803 DOI: 10.3906/sag-1809-54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background/aim Measles is one of the important vaccine-preventable diseases with many complications in childhood. This study presents cross-sectional seroepidemiological data, beginning from neonatal cord blood in infants to children under 6 years of age, about waning of measles antibody and tries to suggest the proper time for measles immunization. Materials and methods A total of 564 blood samples consisting of neonatal cord blood and samples taken from infants and children at ages of 6, 9, 24–48, and 49–72 months were analyzed for measles seropositivity in a period of 6 months. Results Measles seropositivity rate was 72.5% in 109 cord blood samples, 2.6% in 117 infants of 6 months of age, and 3.6% in 111 infants of 9 months of age. Seropositivity was determined in 118 children at 24–48 months and in 109 children at 49–72 months and was 80.5% and 66%, respectively (P = 0.001). These children were vaccinated in the 12th month. Conclusion Though measles immunization coverage is 97% in Turkey, population immunity is somewhat lower than expected. Increases of measles cases in Europe and the refugee problem in the country could easily lead to outbreaks. Implementing the first dose of the immunization at 9 months may be an option.
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Affiliation(s)
- Selda KARAAYVAZ
- Division of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Acıbadem Mehmet Ali Aydınlar University, İstanbulTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Melahat Melek OĞUZ
- Department of Pediatrics, Dr. Sami Ulus Children’s Hospital Research and Education Center, Ministry of Health, AnkaraTurkey
| | - Ufuk BEYAZOVA
- Division of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Gazi University, AnkaraTurkey
| | - Gülay KORUKLUOĞLU
- National Virology Reference Laboratory, Public Health General Directorate Microbiology Reference Laboratory,Ministry of Health, AnkaraTurkey
| | - Yasemin COŞGUN
- National Virology Reference Laboratory, Public Health General Directorate Microbiology Reference Laboratory,Ministry of Health, AnkaraTurkey
| | - Zeliha GÜZELKÜÇÜK
- Department of Pediatrics, University of Health Sciences Ankara Children’s Health andDiseases Hematology and Oncology Training and Research Hospital, AnkaraTurkey
| | - Nur BARAN AKSAKAL
- Department of Public Health, Faculty of Medicine, Gazi UniversityTurkey
| | - Figen ŞAHİN DAĞLI
- Division of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Gazi University, AnkaraTurkey
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Abstract
BACKGROUND Recent studies report delayed anti-HIV antibody clearance (seroreversion) among HIV-exposed uninfected infants that may affect diagnostic practices. We evaluated the age-specific seroreversion rates in Thailand. METHODS The medical records of HIV-exposed uninfected infants born in January 2000-December 2014 were reviewed. Anti-HIV seroreversion rates at 12, 18 and 24 months were analyzed in 3 periods according to the Thai National Guidelines of prevention of mother-to-child transmission of HIV: zidovudine with or without single dose nevirapine to all women (2000-2006), adding lamivudine plus nevirapine to zidovudine in women with CD4 count <200 cells/mm (2007-2009) and zidovudine plus lamivudine plus boosted lopinavir to all women (2010-2014). In 2013, the serologic test kit was changed from third- to fourth-generation (4G) assay. All the infants were formula fed. RESULTS Among 736 infants, the overall seroreversion rates at 12, 18 and 24 months of age were 59.38%, 94.57% and 100%, respectively. The seroreversion rates at 12 months of age declined from 68% in 2000-2006 and 65.9% in 2007-2009, to 42.9% in 2010-2014 (P = 0.001). Seroreversion rates at 18 months of age were more than 96.5% before 2013 and decreased to 79.1% in 2013-2014 (P = 0.001) with use of 4G. Multivariate analysis identified antepartum protease inhibitors treatment and the use of 4G testing as independent factors associated with delayed seroreversion. CONCLUSIONS Anti-HIV seroreversion delay in HIV-exposed uninfected infants was associated with use of protease inhibitors and 4G HIV testing, complicating the interpretation to exclude perinatal HIV infection.
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Jallow S, Mahdi SA. Possible implications of maternal HIV infection for increasing measles susceptibility in young infants. Future Virol 2018. [DOI: 10.2217/fvl-2018-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Sabelle Jallow
- Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Vaccines & Immunology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Shabir A Mahdi
- Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Department of Science & Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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Eom H, Park Y, Kim J, Yang JS, Kang H, Kim K, Chun BC, Park O, Hong JI. Occurrence of measles in a country with elimination status: Amplifying measles infection in hospitalized children due to imported virus. PLoS One 2018; 13:e0188957. [PMID: 29447169 PMCID: PMC5813900 DOI: 10.1371/journal.pone.0188957] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/16/2017] [Indexed: 11/26/2022] Open
Abstract
The Republic of Korea declared measles elimination in 2006. However, a measles outbreak occurred in 2013. This study aimed to identify the epidemiological characteristics of the sources of infection and the pattern of measles transmission in 2013 in South Korea. We utilized surveillance data, epidemiological data, immunization registry data, and genetic information. We describe the epidemiological characteristics of all measles case patients (sex, age distribution, vaccination status, sources of infection) as well as details of the outbreak (the pattern of transmission, duration, mean age of patients, and generation time). In 2013, a total of 107 measles cases were notified. Most patients were infants (43.0%) and unvaccinated individuals (60.7%). We identified 4 imported and 103 import-related cases. A total of 105 cases were related to four outbreaks that occurred in Gyeongnam, northern Gyeonggi, southern Gyeonggi, and Seoul. The predominant circulating genotype was B3 type, which was identified in the Gyeongnam, northern Gyeonggi, and southern Gyeonggi outbreaks. The B3 type had not been in circulation in South Korea in the previous 3 years; virologic evidence suggests that these outbreaks were import-related. Most measles cases in South Korea have been associated with imported measles virus. Although Korea has maintained a high level of herd immunity, clustering of susceptible people can cause such measles outbreaks.
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Affiliation(s)
- HyeEun Eom
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - YoungJoon Park
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - JooWhee Kim
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Jeong-Sun Yang
- Division of Respiratory Viruses, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - HaeJi Kang
- Division of Respiratory Viruses, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Kisoon Kim
- Division of Respiratory Viruses, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University Medical College, Seongbuk-gu, Seoul, Republic of Korea
- * E-mail:
| | - Ok Park
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Jeong Ik Hong
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea
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24
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Boulton ML, Wang X, Wagner AL, Zhang Y, Carlson BF, Gillespie BW, Ding Y. Measles Antibodies in Mother-Infant Dyads in Tianjin, China. J Infect Dis 2017; 216:1122-1129. [PMID: 28968908 DOI: 10.1093/infdis/jix453] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/30/2017] [Indexed: 11/13/2022] Open
Abstract
Background Many measles cases in Tianjin, China, occur in infants whose mothers were born after widespread vaccination programs. We assessed age-specific decreases in maternal measles antibodies in infants and examined maternal and infant characteristics in relation to infant antibody titers. Methods Infant and mother dyads were enrolled from a sample of immunization clinics in all Tianjin districts. Participants' antibody titers were measured from dried blood spots. A multivariable log-linear model regressed infant antibody titers onto infant and mother characteristics. Results Among 551 infants aged ≤8 months, protective levels of measles antibodies were observed in infants whose mothers had measles titers ≥800 IU/mL (mean antibody titer, 542.5 IU/mL) or 400 to <800 IU/mL (mean, 202.2 IU/mL). Compared with infants whose mothers had no history of disease or vaccination, those with a history of disease had 1.60 times higher titers (95% confidence interval, 1.06-2.43). Conclusions Limited vaccination programs in the 1980s have resulted in many Chinese women with inadequate protection against measles and an accordingly low efficiency of transplacental transmission to a fetus. Current vaccination programs, which target children aged 8 months through adolescence may be ineffective in controlling transmission of measles to infants.
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Affiliation(s)
- Matthew L Boulton
- Department of Epidemiology, School of Public Health.,Department of Internal Medicine, Division of Infectious Diseases
| | - Xiexiu Wang
- Division of Expanded Programs on Immunization, Tianjin Centers for Disease Control and Prevention, China
| | | | - Ying Zhang
- Division of Expanded Programs on Immunization, Tianjin Centers for Disease Control and Prevention, China
| | | | - Brenda W Gillespie
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor
| | - Yaxing Ding
- Division of Expanded Programs on Immunization, Tianjin Centers for Disease Control and Prevention, China
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Drivers of measles mortality: the historic fatality burden of famine in Bangladesh. Epidemiol Infect 2017; 145:3361-3369. [PMID: 29168439 DOI: 10.1017/s0950268817002564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Measles is a major cause of childhood morbidity and mortality in many parts of the world. Estimates of the case-fatality rate (CFR) of measles have varied widely from place to place, as well as in the same location over time. Amongst populations that have experienced famine or armed conflict, measles CFR can be especially high, although past work has mostly focused on refugee populations. Here, we estimate measles CFR between 1970 and 1991 in a rural region of Bangladesh, which experienced civil war and famine in the 1970s. We use historical measles mortality data and a mechanistic model of measles transmission to estimate the CFR of measles. We first demonstrate the ability of this model to recover the CFR in the absence of incidence data, using simulated mortality data. Our method produces CFR estimates that correspond closely to independent estimates from surveillance data and we can capture both the magnitude and the change in CFR suggested by these previous estimates. We use this method to quantify the sharp increase in CFR that resulted in a large number of deaths during a measles outbreak in the region in 1976. Most of the children who died during this outbreak were born during a famine in 1974, or in the 2 years preceding the famine. Our results suggest that the period of turmoil during and after the 1971 war and the sustained effects of the famine, is likely to have contributed to the high fatality burden of the 1976 measles outbreak in Matlab.
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Abstract
Immunisation of the newborn represents a key global strategy in overcoming morbidity and mortality due to infection in early life. Potential limitations, however, include poor immunogenicity, safety concerns and the development of tolerogenicity or hypo-responsiveness to either the same antigen and/or concomitant antigens administered at birth or in the subsequent months. Furthermore, the neonatal immunological milieu is polarised towards Th2-type immunity with dampening of Th1-type responses and impaired humoral immunity, resulting in qualitatively and quantitatively poorer antibody responses compared to older infants. Innate immunity also shows functional deficiency in antigen-presenting cells: the expression and signalling of Toll-like receptors undergo maturational changes associated with distinct functional responses. Nevertheless, the effectiveness of BCG, hepatitis B and oral polio vaccines, the only immunisations currently in use in the neonatal period, is proof of concept that vaccines can be successfully administered to the newborn via different routes of delivery to induce a range of protective mechanisms for three different diseases. In this review paper, we discuss the rationale for and challenges to neonatal immunisation, summarising progress made in the field, including lessons learnt from newborn vaccines in the pipeline. Furthermore, we explore important maternal, infant and environmental co-factors that may impede the success of current and future neonatal immunisation strategies. A variety of approaches have been proposed to overcome the inherent regulatory constraints of the newborn innate and adaptive immune system, including alternative routes of delivery, novel vaccine configurations, improved innate receptor agonists and optimised antigen-adjuvant combinations. Crucially, a dual strategy may be employed whereby immunisation at birth is used to prime the immune system in order to improve immunogenicity to subsequent homologous or heterologous boosters in later infancy. Similarly, potent non-specific immunomodulatory effects may be elicited when challenged with unrelated antigens, with the potential to reduce the overall risk of infection and allergic disease in early life.
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Affiliation(s)
- Anja Saso
- Centre of International Child Health, Department of Paediatrics, Imperial College London, W2 1NY, London, UK
| | - Beate Kampmann
- Centre of International Child Health, Department of Paediatrics, Imperial College London, W2 1NY, London, UK.
- Vaccines and Immunity Theme, MRC Unit The Gambia, Fajara, The Gambia.
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27
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Julik E, Reyes-Del Valle J. A Recombinant Measles Vaccine with Enhanced Resistance to Passive Immunity. Viruses 2017; 9:v9100265. [PMID: 28934110 PMCID: PMC5691617 DOI: 10.3390/v9100265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022] Open
Abstract
Current measles vaccines suffer from poor effectiveness in young infants due primarily to the inhibitory effect of residual maternal immunity on vaccine responses. The development of a measles vaccine that resists such passive immunity would strongly contribute to the stalled effort toward measles eradication. In this concise communication, we show that a measles virus (MV) with enhanced hemagglutinin (H) expression and incorporation, termed MVvac2-H2, retained its enhanced immunogenicity, previously established in older mice, when administered to very young, genetically modified, MV-susceptible mice in the presence of passive anti-measles immunity. This immunity level mimics the sub-neutralizing immunity prevalent in infants too young to be vaccinated. Additionally, toward a more physiological small animal model of maternal anti-measles immunity interference, we document vertical transfer of passive anti-MV immunity in genetically-modified, MV susceptible mice and show in this physiological model a better MVvac2-H2 immunogenic profile than that of the parental vaccine strain. In sum, these data support the notion that enhancing MV hemagglutinin incorporation can circumvent in vivo neutralization. This strategy merits additional exploration as an alternative pediatric measles vaccine.
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Affiliation(s)
- Emily Julik
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA.
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jorge Reyes-Del Valle
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA.
- Process Development Department, Virus and Gene Therapy, Merck KGaA, 64293 Darmstadt, Germany.
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Jallow S, Cutland CL, Masbou AK, Adrian P, Madhi SA. Maternal HIV infection associated with reduced transplacental transfer of measles antibodies and increased susceptibility to disease. J Clin Virol 2017; 94:50-56. [PMID: 28759772 DOI: 10.1016/j.jcv.2017.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/08/2017] [Accepted: 07/16/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transplacental transfer of measles antibodies from mother to fetus is important in protecting against measles during early infancy. Changes in population immunity against measles in adults, including waning of immunity among HIV-infected pregnant women, could affect passive immunity acquired in utero by newborns. OBJECTIVES To evaluate the effect of maternal HIV infection on transplacental transfer of measles antibody in mother-newborn dyads in a setting of high maternal HIV prevalence. STUDY DESIGN Serum at birth was obtained from 303 mother-newborn dyads, including 196 HIV-infected and 107 HIV-uninfected women, and tested for measles IgG antibodies by ELISA. Seronegativity was defined as antibody levels <150mIU/ml and seroprotective titers as ≥330mIU/ml. RESULTS HIV-infected and -uninfected women had similar measles antibody titers, however, cord-blood titers were lower among HIV-exposed (788.06mIU/ml) compared to HIV- unexposed newborns (1306.6mIU/ml; p≤0.001), due to lower transplacental antibody transfer ratio in HIV-exposed (0.63) than in HIV-unexposed newborns (0.97; p≤0.001). Maternal age <25years of age was associated with lower antibody titers and lower percentage with seroprotective titer, as well as less likelihood of their newborns having seroprotective titers (70.2% vs. 86.5%; p=0.001). CONCLUSIONS Lower levels of measles antibody in HIV-exposed newborns and in younger women <25years old, increases the susceptibility of their newborns to developing measles. This suggest a need to re-evaluate measles immunization of women of child bearing age and the timing of measles vaccination among infants in settings with a high prevalence of maternal HIV-infection.
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Affiliation(s)
- Sabelle Jallow
- Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Centre for Vaccines and Immunology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
| | - Clare L Cutland
- Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Peter Adrian
- Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Centre for Vaccines and Immunology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
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29
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Marchant A, Sadarangani M, Garand M, Dauby N, Verhasselt V, Pereira L, Bjornson G, Jones CE, Halperin SA, Edwards KM, Heath P, Openshaw PJ, Scheifele DW, Kollmann TR. Maternal immunisation: collaborating with mother nature. THE LANCET. INFECTIOUS DISEASES 2017; 17:e197-e208. [PMID: 28433705 DOI: 10.1016/s1473-3099(17)30229-3] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/07/2016] [Accepted: 01/18/2017] [Indexed: 12/15/2022]
Abstract
Maternal immunisation has the potential to substantially reduce morbidity and mortality from infectious diseases after birth. The success of tetanus, influenza, and pertussis immunisation during pregnancy has led to consideration of additional maternal immunisation strategies to prevent group B streptococcus and respiratory syncytial virus infections, among others. However, many gaps in knowledge regarding the immunobiology of maternal immunisation prevent the optimal design and application of this successful public health intervention. Therefore, we did an innovative landscape analysis to identify research priorities. Key topics were delineated through review of the published literature, consultation with vaccine developers and regulatory agencies, and a collaborative workshop that gathered experts across several maternal immunisation initiatives-group B streptococcus, respiratory syncytial virus, pertussis, and influenza. Finally, a global online survey prioritised the identified knowledge gaps on the basis of expert opinion about their importance and relevance. Here we present the results of this worldwide landscape analysis and discuss the identified research gaps.
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Affiliation(s)
- Arnaud Marchant
- Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium.
| | - Manish Sadarangani
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; Division of Infectious Diseases, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada; Vaccine Evaluation Center, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Mathieu Garand
- Vaccine Evaluation Center, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada; Vaccine and Immunity Theme, Medical Research Council Unit, Fajara, The Gambia
| | - Nicolas Dauby
- Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium; Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Valerie Verhasselt
- Faculty of Molecular Science, University of Western Australia, Perth, WA, Australia
| | | | - Gordean Bjornson
- Vaccine Evaluation Center, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Christine E Jones
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George's, University of London, London, UK
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, Izaak Walton Killam Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - Kathryn M Edwards
- Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Paul Heath
- St George's Vaccine Institute, Institute of Infection and Immunity, St George's, University of London, London, UK
| | - Peter J Openshaw
- Respiratory Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - David W Scheifele
- Division of Infectious Diseases, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada; Vaccine Evaluation Center, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Tobias R Kollmann
- Division of Infectious Diseases, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada; Vaccine Evaluation Center, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada.
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Jacob D, Ruffie C, Combredet C, Formaglio P, Amino R, Ménard R, Tangy F, Sala M. Yeast lysates carrying the nucleoprotein from measles virus vaccine as a novel subunit vaccine platform to deliver Plasmodium circumsporozoite antigen. Malar J 2017; 16:259. [PMID: 28662722 PMCID: PMC5492716 DOI: 10.1186/s12936-017-1908-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background Yeast cells represent an established bioreactor to produce recombinant proteins for subunit vaccine development. In addition, delivery of vaccine antigens directly within heat-inactivated yeast cells is attractive due to the adjuvancy provided by the yeast cell. In this study, Pichia pastoris yeast lysates carrying the nucleoprotein (N) from the measles vaccine virus were evaluated as a novel subunit vaccine platform to deliver the circumsporozoite surface antigen (CS) of Plasmodium. When expressed in Pichia pastoris yeast, the N protein auto-assembles into highly multimeric ribonucleoparticles (RNPs). The CS antigen from Plasmodium berghei (PbCS) was expressed in Pichia pastoris yeast in fusion with N, generating recombinant PbCS-carrying RNPs in the cytoplasm of yeast cells. Results When evaluated in mice after 3–5 weekly subcutaneous injections, yeast lysates containing N-PbCS RNPs elicited strong anti-PbCS humoral responses, which were PbCS-dose dependent and reached a plateau by the pre-challenge time point. Protective efficacy of yeast lysates was dose-dependent, although anti-PbCS antibody titers were not predictive of protection. Multimerization of PbCS on RNPs was essential for providing benefit against infection, as immunization with monomeric PbCS delivered in yeast lysates was not protective. Three weekly injections with N-PbCS yeast lysates in combination with alum adjuvant produced sterile protection in two out of six mice, and significantly reduced parasitaemia in the other individuals from the same group. This parasitaemia decrease was of the same extent as in mice immunized with non-adjuvanted N-PbCS yeast lysates, providing evidence that the yeast lysate formulation did not require accessory adjuvants for eliciting efficient parasitaemia reduction. Conclusions This study demonstrates that yeast lysates are an attractive auto-adjuvant and efficient platform for delivering multimeric PbCS on measles N-based RNPs. By combining yeast lysates that carry RNPs with a large panel of Plasmodium antigens, this technology could be applied to developing a multivalent vaccine against malaria. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1908-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daria Jacob
- Institut Pasteur, Viral Genomics and Vaccination Unit, CNRS, UMR-3965, 28, Rue Du Dr Roux, 75015, Paris, France.
| | - Claude Ruffie
- Institut Pasteur, Viral Genomics and Vaccination Unit, CNRS, UMR-3965, 28, Rue Du Dr Roux, 75015, Paris, France
| | - Chantal Combredet
- Institut Pasteur, Viral Genomics and Vaccination Unit, CNRS, UMR-3965, 28, Rue Du Dr Roux, 75015, Paris, France
| | - Pauline Formaglio
- Institut Pasteur, Malaria Biology and Genetics Unit, 75015, Paris, France.,Institute of Molecular and Clinical Immunology, Otto-von-Guericke University, Magdeburg, Germany
| | - Rogerio Amino
- Institut Pasteur, Malaria Biology and Genetics Unit, 75015, Paris, France
| | - Robert Ménard
- Institut Pasteur, Malaria Biology and Genetics Unit, 75015, Paris, France
| | - Frédéric Tangy
- Institut Pasteur, Viral Genomics and Vaccination Unit, CNRS, UMR-3965, 28, Rue Du Dr Roux, 75015, Paris, France
| | - Monica Sala
- Institut Pasteur, Viral Genomics and Vaccination Unit, CNRS, UMR-3965, 28, Rue Du Dr Roux, 75015, Paris, France
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31
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Fu C, Shen J, Lu L, Li Y, Cao Y, Wang M, Pei S, Yang Z, Guo Q, Shaman J. Pre-vaccination evolution of antibodies among infants 0, 3 and 6months of age: A longitudinal analysis of measles, enterovirus 71 and coxsackievirus 16. Vaccine 2017; 35:3817-3822. [PMID: 28610823 DOI: 10.1016/j.vaccine.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Due to waning levels of maternal antibodies (measles; enterovirus 71, EV71; and coxsackievirus A16, CoxA16), some infants may lose protection against infection prior to vaccination. Using a longitudinal design, we examine how maternal antibody levels evolve over time in infants prior to vaccination. METHODS In 2013-2014, we collected sera at ages 0, 3 and 6months from infants. We assayed for levels of measles IgG antibody (717, 233 and 75 sample sera tested at months 0, 3 and 6, respectively), and neutralizing antibodies for EV71 and CoxA16 (225, 217, and 72). Demographic and health information were collected, and a linear mixed model (LMM) was used to describe antibody levels over time. RESULTS Pre-vaccination monotonic antibody decreases were observed for measles (1410, 195 and 22mIU/ml, p<0.001), EV71 (1:19.9, 6.3 and 4.5, p<0.001) and CoxA16 (1:16.3, 5.9, and 4.5, p<0.001). At 6months of age, only 2.7% (95%CI, 0.6-8.3), 6.8% (95%CI, 2.7-14.4) and 5.6% (95%CI, 1.9-12.7) of infants were antibody positive for measles, EV71 and CoxA16, respectively. LMM findings indicated that infants with higher antibody titers at birth experienced a greater loss of antibody level. An infection rate of 1.3% (95%CI, 0.1-6.1) was reported for both EV71 and CoxA16. CONCLUSIONS Further modifications of vaccination strategies for measles, earlier vaccination for EV71 infection, and deployment of a CoxA16 vaccine need to be considered to limit infection among the very young.
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Affiliation(s)
- Chuanxi Fu
- Zhejiang Chinese Medical University, Hangzhou, China; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
| | - Jichuan Shen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Long Lu
- Liwan District Maternal and Child Health Hospital, Guangzhou, China
| | - Yajing Li
- Sinovac Biotech Co., Ltd, Beijing, China
| | - Yimin Cao
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Ming Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Zhicong Yang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Qing Guo
- Zhejiang Chinese Medical University, Hangzhou, China.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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Veazey RS, Lu Y, Xu H, Ziani W, Doyle-Meyers LA, Ratterree MS, Wang X. Maternal antibodies against tetanus toxoid do not inhibit potency of antibody responses to autologous antigen in newborn rhesus monkeys. J Med Primatol 2017; 47:35-39. [PMID: 28585307 DOI: 10.1111/jmp.12281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Our previous study suggested newborns have competent immune systems with the potential to respond to foreign antigens and vaccines. In this study, we examined infant immune responses to tetanus toxoid (TT) vaccination in the presence of maternal antibody to TT. METHODS We examined changes in plasma levels of tetanus toxoid-specific IgG1 (anti-TT IgG1) in a total of eight infant rhesus macaques from birth through 6 months of age using a commercial Monkey Anti-TT IgG1 ELISA kit. RESULTS A significant correlation between anti-TT IgG1 levels in vaccinated dams and their paired newborn infants was detected in control (non-vaccinated) infants as previously reported. Maternal anti-TT IgG1 levels declined rapidly within 1 month of birth in non-vaccinated infants (n=4). In four infants vaccinated with TT at birth, we found two had rapid and robust antibody responses to vaccination. Interestingly, the other two first showed declining TT antibody levels for 2 weeks followed by increasing levels without additional vaccine boosts, indicating all four had good antibody responses to primary TT vaccination at birth, despite the presence of high levels of maternal antibodies to TT in all four infants. CONCLUSIONS Our data indicate that newborn macaques have competent immune systems that are capable of generating their own primary antibody responses to vaccination, at least to tetanus antigens. Maternal antibodies thus do not significantly impair antibody response to the vaccination, even when received on the day of birth in infant rhesus macaques.
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Affiliation(s)
- Ronald S Veazey
- Division of Comparative Pathology, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
| | - Yingjie Lu
- Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA
| | - Huanbin Xu
- Division of Comparative Pathology, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
| | - Widade Ziani
- Division of Comparative Pathology, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
| | - Lara A Doyle-Meyers
- Division of Veterinary Medicine, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
| | - Marion S Ratterree
- Division of Veterinary Medicine, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
| | - Xiaolei Wang
- Division of Comparative Pathology, Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA, USA
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Jain S, Seth A, Khare S, Chandra J. Seroprevalence of transplacentally acquired measles antibodies in HIV-exposed versus HIV-unexposed infants at six months of age. Indian J Med Res 2017; 145:536-542. [PMID: 28862187 PMCID: PMC5663169 DOI: 10.4103/ijmr.ijmr_44_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND & OBJECTIVES Measles infection is reported to be more severe, prolonged and associated with a higher complication rate in children with HIV infection. Reports indicate that infants born to HIV-infected women [HIV exposed infants (HEI)] may be more vulnerable to measles. The World Health Organization recommends measles vaccination starting at six months of age in these infants who may be HIV-infected themselves. However, in India, they are given measles vaccination at nine months of age like all other infants. In this study, the seroprevalence of transplacentally acquired measles antibodies was compared in HEI and unexposed infants (HUnI) at six months of age and the proportion of HEI undergoing seroconversion after immunization with measles vaccine was assessed. METHODS In this prospective longitudinal study, measles IgG antibodies were estimated in serum of 49 HEI and 50 HUnI aged 6-7 months. Measles vaccine was then administered to HEI. Assessment for measles IgG antibodies was repeated 8-12 wk post-immunization. RESULTS Measles IgG antibodies were detected in two of 49 (4.1%) HEI and 16 of 50 (32%) HUnI. HEI were 11 times more likely to lack measles antibodies as compared to HUnI (odds ratio=11.05, 95% confidence interval=2.989-40.908). Post-vaccination, seroprevalence of measles antibodies increased to 38.5 per cent (PInterpretation & conclusions: Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s) of measles/measles-containing vaccine.
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Affiliation(s)
- Sneha Jain
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Anju Seth
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Shashi Khare
- Division of Microbiology, National Centre for Disease Control, New Delhi, India
| | - Jagdish Chandra
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
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Murungi LM, Sondén K, Odera D, Oduor LB, Guleid F, Nkumama IN, Otiende M, Kangoye DT, Fegan G, Färnert A, Marsh K, Osier FHA. Cord blood IgG and the risk of severe Plasmodium falciparum malaria in the first year of life. Int J Parasitol 2016; 47:153-162. [PMID: 27890694 PMCID: PMC5297353 DOI: 10.1016/j.ijpara.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 08/31/2016] [Accepted: 09/03/2016] [Indexed: 01/18/2023]
Abstract
Severe malaria episodes are rare during the first few months of life. The rate of decay of cord blood IgG is inversely proportional to the starting concentration. Antibody dependent respiratory burst mediated by cord IgG protects from severe malaria during the first 6 months of infancy.
Young infants are less susceptible to severe episodes of malaria but the targets and mechanisms of protection are not clear. Cord blood antibodies may play an important role in mediating protection but many studies have examined their association with the outcome of infection or non-severe malaria. Here, we investigated whether cord blood IgG to Plasmodium falciparum merozoite antigens and antibody-mediated effector functions were associated with reduced odds of developing severe malaria at different time points during the first year of life. We conducted a case-control study of well-defined severe falciparum malaria nested within a longitudinal birth cohort of Kenyan children. We measured cord blood total IgG levels against five recombinant merozoite antigens and antibody function in the growth inhibition activity and neutrophil antibody-dependent respiratory burst assays. We also assessed the decay of maternal antibodies during the first 6 months of life. The mean antibody half-life range was 2.51 months (95% confidence interval (CI): 2.19–2.92) to 4.91 months (95% CI: 4.47–6.07). The rate of decline of maternal antibodies was inversely proportional to the starting concentration. The functional assay of antibody-dependent respiratory burst activity predicted significantly reduced odds of developing severe malaria during the first 6 months of life (Odds ratio (OR) 0.07, 95% CI: 0.007–0.74, P = 0.007). Identification of the targets of antibodies mediating antibody-dependent respiratory burst activity could contribute to the development of malaria vaccines that protect against severe episodes of malaria in early infancy.
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Affiliation(s)
- Linda M Murungi
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya.
| | - Klara Sondén
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Dennis Odera
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Loureen B Oduor
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Fatuma Guleid
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Irene N Nkumama
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Mark Otiende
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - David T Kangoye
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya; Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso
| | - Greg Fegan
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Anna Färnert
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Kevin Marsh
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya; African Academy of Sciences, P.O. Box 24916-00502, Nairobi, Kenya; Nuffield Department of Medicine, Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Faith H A Osier
- Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230-80108, Kilifi, Kenya
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Corey KC, Noymer A. A 'post-honeymoon' measles epidemic in Burundi: mathematical model-based analysis and implications for vaccination timing. PeerJ 2016; 4:e2476. [PMID: 27672515 PMCID: PMC5028774 DOI: 10.7717/peerj.2476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/23/2016] [Indexed: 12/27/2022] Open
Abstract
Using a mathematical model with realistic demography, we analyze a large outbreak of measles in Muyinga sector in rural Burundi in 1988–1989. We generate simulated epidemic curves and age × time epidemic surfaces, which we qualitatively and quantitatively compare with the data. Our findings suggest that supplementary immunization activities (SIAs) should be used in places where routine vaccination cannot keep up with the increasing numbers of susceptible individuals resulting from population growth or from logistical problems such as cold chain maintenance. We use the model to characterize the relationship between SIA frequency and SIA age range necessary to suppress measles outbreaks. If SIAs are less frequent, they must expand their target age range.
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Affiliation(s)
- Katelyn C Corey
- Fielding School of Public Health, University of California , Los Angeles , CA , United States
| | - Andrew Noymer
- Department of Population Health and Disease Prevention, University of California , Irvine , CA , United States
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JC virus infection is acquired very early in life: evidence from a longitudinal serological study. J Neurovirol 2016; 23:99-105. [PMID: 27538993 DOI: 10.1007/s13365-016-0477-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/20/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
JC virus (JCV) is a widespread member of the Polyomaviridae family. Following primary infection, which occurs asymptomatically during childhood, JCV establishes latency in the host. JCV seroprevalence can reach 80 % in healthy adults, but the age of viral exposure has not been yet characterized. This study was conducted to define JCV seroprevalence in Italian infants and to estimate the date of primary infection. A JCV viral protein 1 (VP1)-GST fusion protein was used in conjunction with a homemade indirect enzyme-linked immunosorbent assay (ELISA) to test for the presence of IgG antibodies to JCV in 981 serum samples collected from 644 Italian infants of different ages (1 day to 3 years old) and in 102 breast milk samples. IgM antibody presence was also evaluated in longitudinally collected samples from 17 selected children. JCV antibody prevalence and normalized optical density (nOD) were calculated. For the longitudinal analysis, generalized estimating equation techniques and spline functions were used to estimate the possible non-linear effects of time on antibody production kinetics. JCV IgG was detected in 71.8 % of the sera. Prevalence increased over time from 46.1 % (1 month old) to 80.7 % (12 months old), 85.9 % (24 months old), and 85.5 % (36 months old). As determined by nOD, the longitudinal analysis of serum IgG amounts in children of this study (ages 1 day to 3 years old) illustrated IgG kinetic changes with statistically significant trends (p = 0.001). One-month-old children were largely negative for JCV IgM (82.4 %), and 58.8 % of children produced JCV IgM within the second and sixth months of life. JCV IgG was detected in 27.3 % of breast milk samples. JCV primary infection likely occurs before 6 months of age, and a sizeable percentage of Italian infants will become JCV seropositive within 2 years of age. This study can be used to determine the optimal age for potential future JCV vaccination in infants.
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Abstract
Measles is an infectious disease in humans caused by the measles virus (MeV). Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. However, endemic transmission continues in many parts of the world. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. Case fatality ratio estimates vary from <0.01% in industrialized countries to >5% in developing countries. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication.
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Thompson KM, Odahowski CL. Systematic Review of Measles and Rubella Serology Studies. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:1459-1486. [PMID: 26077609 DOI: 10.1111/risa.12430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Serological tests provide information about individual immunity from historical infection or immunization. Cross-sectional serological studies provide data about the age- and sex-specific immunity levels for individuals in the studied population, and these data can provide a point of comparison for the results of transmission models. In the context of developing an integrated model for measles and rubella transmission, we reviewed the existing measles and rubella literature to identify the results of national serological studies that provided cross-sectional estimates of population immunity at the time of data collection. We systematically searched PubMed, the Science Citation Index, and references we identified from relevant articles published in English. We extracted serological data for comparison to transmission model outputs. For rubella, serological studies of women of child-bearing age provide information about the potential risks of infants born with congenital rubella syndrome. Serological studies also document the loss of maternal antibodies, which occurs at different rates for the different viruses and according to the nature of the induced immunity (i.e., infection or vaccine). The serological evidence remains limited for some areas, with studies from developed countries representing a disproportionate part of the evidence. The collection and review of serological evidence can help program managers identify immunity gaps in the population, which may help them better understand the characteristics of individuals within their populations who may participate in transmission and manage risks.
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Affiliation(s)
- Kimberly M Thompson
- Kid Risk, Inc, Orlando, FL, USA
- University of Central Florida, College of Medicine, Orlando, FL, USA
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Babakhanyan A, Ekali GL, Dent A, Kazura J, Nguasong JT, Fodjo BAY, Yuosembom EK, Esemu LF, Taylor DW, Leke RGF. Maternal Human Immunodeficiency Virus-Associated Hypergammaglobulinemia Reduces Transplacental Transfer of Immunoglobulin G to Plasmodium falciparum Antigens in Cameroonian Neonates. Open Forum Infect Dis 2016; 3:ofw092. [PMID: 28487863 PMCID: PMC4943556 DOI: 10.1093/ofid/ofw092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/06/2016] [Indexed: 11/14/2022] Open
Abstract
Background. Human immunodeficiency virus (HIV) infection reduces placental transfer of antibodies from mother to the fetus for many antigens; however, conflicting data exist for transfer of immunoglobulin G (IgG) to malarial antigens. The mechanism(s) underlying reduced placental transfer is unknown. Methods. Levels of maternal and cord total IgG, IgG subclasses, and cord-to-mother ratios (CMRs) were measured in 107 mother-cord pairs to 3 malarial antigens: circumsporozoite protein (CSP), apical membrane antigen 1 (AMA-1), merozoite surface protein 1 (MSP-1), and tetanus toxoid C-fragment (TTc). Results. Immunoglobulin G levels to CSP and TTc were lower in HIV+ mothers, and cord IgG to CSP, MSP-1, and TTc were significantly lower in neonates born to HIV+ mothers (all P values <.05). The prevalence of mothers with hypergammaglobulinemia was significantly higher among HIV+ women (68%) compared with HIV− mothers (8%) (P < .0001). Maternal hypergammaglobulinemia was associated with reduction in transplacental transfer of antibodies to CSP (P = .03), MSP-1 (P = .004), and TTc (P = .012), and CMRs <1 were found for MSP-1 (odds ratio [OR] = 6.5), TTc (OR = 4.95), and IgG1 to CSP (OR = 3.75, P = .025) in statistical models adjusted for maternal IgG. Conclusions. Data confirmed that HIV infections are associated with lower cord antibody levels to malarial antigens and that hypergammaglobulinemia may contribute to reduced antibody transfer.
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Affiliation(s)
- Anna Babakhanyan
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu
| | - Gabriel Loni Ekali
- Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé 1, Cameroon
| | - Arlene Dent
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
| | - James Kazura
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
| | - John Tamo Nguasong
- Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé 1, Cameroon
| | | | - Emile Keming Yuosembom
- Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé 1, Cameroon
| | - Livo Forgu Esemu
- Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé 1, Cameroon
| | - Diane Wallace Taylor
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu
| | - Rose Gana Fomban Leke
- Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé 1, Cameroon
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Gonçalves G, Nunes C, Mesquita JR, Nascimento MSJ, Frade J. Measles antibodies in cord blood in Portugal: Possible consequences for the recommended age of vaccination. Vaccine 2016; 34:2750-7. [PMID: 27109563 DOI: 10.1016/j.vaccine.2016.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/24/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
Abstract
The optimum age to give the first dose of measles vaccine must balance the risks of disease and vaccine failure. Both are influenced by the levels of transplacentally acquired maternal antibodies. This study was conducted in the Obstetric service of Portuguese hospital, in 2012-2013. Mothers were recruited after informed consent. Measles IgG was measured in 206 cord sera, using a commercial immunoassay. Geometric mean concentrations (and 95% CI) were 1849mIU/ml (1196-2857) and 790mIU/ml (618-1008) in cord sera of newborns from unvaccinated and vaccinated mothers respectively. Maternal age and vaccination status were both associated with the concentration in cord sera, but maternal age was the major predictor. The likely explanation is the same already mentioned in other studies: as a vaccination program progresses, vaccination coverage increases as measles incidence decreases. That results newborns from younger vaccinated mothers having less measles antibodies while the older mothers are more likely to have been infected with the wild virus. As the proportion of vaccinated mothers increase, developed countries tend to anticipate the recommended age of the first dose to 12 months of age. Models using hypothetical measles antibody decay rates in infancy were explored. Anticipating the first dose of MMR1 in Portugal to the age of 12 months might have not been the best decision but results were not conclusive, and arguments supporting or not the anticipation were discussed.
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Affiliation(s)
- Guilherme Gonçalves
- Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Carla Nunes
- Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - João Rodrigo Mesquita
- Agrarian Superior School, Polytechnic Institute of Viseu, Quinta da Alagoa - Estrada de Nelas, Ranhados, 3500-606 Viseu, Portugal.
| | - Maria São José Nascimento
- Laboratory of Microbiology, Department of Biological Sciences, Faculty of Pharmacy of University of Porto, Rua de Jorge Viterbo Ferreira n.°228, 4050-313 Porto, Portugal.
| | - João Frade
- Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Health Research Unit of School of Health Sciences, Polytechnic Institute of Leiria, Campus 2 - Morro do Lena - Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal.
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Hales CM, Johnson E, Helgenberger L, Papania MJ, Larzelere M, Gopalani SV, Lebo E, Wallace G, Moturi E, Hickman CJ, Rota PA, Alexander HS, Marin M. Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014. Open Forum Infect Dis 2016; 3:ofw064. [PMID: 27186587 PMCID: PMC4866552 DOI: 10.1093/ofid/ofw064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/21/2016] [Indexed: 12/03/2022] Open
Abstract
Background. A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods. We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results. Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions. Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.
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Affiliation(s)
- Craig M Hales
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Eliaser Johnson
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Louisa Helgenberger
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Mark J Papania
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Maribeth Larzelere
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Sameer V Gopalani
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Emmaculate Lebo
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Greg Wallace
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Edna Moturi
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Carole J Hickman
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Paul A Rota
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Hinden S Alexander
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Mona Marin
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
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Kampmann B, Jones CE. Factors influencing innate immunity and vaccine responses in infancy. Philos Trans R Soc Lond B Biol Sci 2016; 370:rstb.2014.0148. [PMID: 25964459 DOI: 10.1098/rstb.2014.0148] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Despite significant progress in reducing the burden of mortality in children under the age of five, reducing mortality in newborns remains a major challenge. Infection plays a significant role in infant deaths and interventions such as early vaccination or antenatal immunization could make a significant contribution to prevention of such deaths. In the last few years, we have gained new insights into immune ontogeny and are now beginning to understand the impact of vaccines, nutrition and environmental factors on 'training' of the immune response in early life. This review article sets out to explain why vaccine responses can be heterogeneous between populations and individuals by providing examples chosen to illustrate the impact of host, pathogen and environmental factors on shaping the immune 'interactome' in young children.
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Affiliation(s)
- Beate Kampmann
- Vaccines and Immunity Theme, MRC Unit, The Gambia, Atlantic Road, Fajara, The Gambia Academic Department of Paediatrics, Imperial College London, Norfolk Place, London, UK
| | - Christine E Jones
- Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's, University of London, Cranmer Terrace, London, UK
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Metcalf CJE, Graham AL, Martinez-Bakker M, Childs DZ. Opportunities and challenges of Integral Projection Models for modelling host-parasite dynamics. J Anim Ecol 2015; 85:343-55. [PMID: 26620440 PMCID: PMC4991293 DOI: 10.1111/1365-2656.12456] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/29/2015] [Indexed: 11/28/2022]
Abstract
Epidemiological dynamics are shaped by and may in turn shape host demography. These feedbacks can result in hard to predict patterns of disease incidence. Mathematical models that integrate infection and demography are consequently a key tool for informing expectations for disease burden and identifying effective measures for control. A major challenge is capturing the details of infection within individuals and quantifying their downstream impacts to understand population‐scale outcomes. For example, parasite loads and antibody titres may vary over the course of an infection and contribute to differences in transmission at the scale of the population. To date, to capture these subtleties, models have mostly relied on complex mechanistic frameworks, discrete categorization and/or agent‐based approaches. Integral Projection Models (IPMs) allow variance in individual trajectories of quantitative traits and their population‐level outcomes to be captured in ways that directly reflect statistical models of trait–fate relationships. Given increasing data availability, and advances in modelling, there is considerable potential for extending this framework to traits of relevance for infectious disease dynamics. Here, we provide an overview of host and parasite natural history contexts where IPMs could strengthen inference of population dynamics, with examples of host species ranging from mice to sheep to humans, and parasites ranging from viruses to worms. We discuss models of both parasite and host traits, provide two case studies and conclude by reviewing potential for both ecological and evolutionary research.
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Affiliation(s)
- C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.,Office of Population Research, The Woodrow Wilson School, Princeton University, Princeton, NJ, USA
| | - Andrea L Graham
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | | | - Dylan Z Childs
- Department of Animal and Plant Sciences, Sheffield University, Sheffield, UK
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Hoang HTT, Leuridan E, Maertens K, Nguyen TD, Hens N, Vu NH, Caboré RN, Duong HT, Huygen K, Van Damme P, Dang AD. Pertussis vaccination during pregnancy in Vietnam: Results of a randomized controlled trial Pertussis vaccination during pregnancy. Vaccine 2015; 34:151-9. [PMID: 26529073 DOI: 10.1016/j.vaccine.2015.10.098] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/14/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Abstract
A pertussis vaccination during pregnancy has recently been adopted in several countries to indirectly protect young infants. This study assessed the effect of adding a pertussis component to the tetanus vaccination, in the pregnancy immunization program in Vietnam. A randomized controlled trial was performed. Pregnant women received either a Tdap (tetanus, diphtheria acellular pertussis) vaccine or a tetanus only vaccine between 19 and 35 weeks' gestational age. Immunoglobulin G (IgG) against tetanus (TT), diphtheria (DT), pertussis toxin (PT), filamentous hemaglutinin (FHA) and pertactin (Prn) were measured using commercial ELISA tests, at baseline, 1 month after maternal vaccination, at delivery, and in infants from cord blood and before and after the primary series (EPI: month 2-3-4) of a pertussis containing vaccine. Significantly higher geometric mean concentrations (GMC) were observed for all 3 measured pertussis antigens in the offspring of the Tdap group, up to 2 months of age. One month after completion of the primary infant vaccination schedule, anti-Prn GMC, but not anti-PT and anti-FHA GMCs, was significantly (p=0.006) higher in the control group. Maternal antibodies induced by vaccination during pregnancy close the susceptibility gap for pertussis in young infants. Limited interference with the infant vaccine responses was observed. Whether this interference effect disappears with the administration of a fourth vaccine dose is further studied.
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Affiliation(s)
- Ha Thi Thu Hoang
- National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi 10000, Vietnam.
| | - Elke Leuridan
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610 Antwerpen, Belgium
| | - Kirsten Maertens
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610 Antwerpen, Belgium
| | - Trung Dac Nguyen
- National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi 10000, Vietnam
| | - Niel Hens
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belguim; Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium
| | - Ngoc Ha Vu
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Raissa Nadège Caboré
- National Reference Centre Bordetella, Service Immunology, Scientific Institute of Public Health (WIV-ISP), 1180 Brussels, Belgium
| | - Hong Thi Duong
- National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi 10000, Vietnam
| | - Kris Huygen
- National Reference Centre Bordetella, Service Immunology, Scientific Institute of Public Health (WIV-ISP), 1180 Brussels, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610 Antwerpen, Belgium
| | - Anh Duc Dang
- National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi 10000, Vietnam.
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Shrivastava SR, Shrivastava PS, Ramasamy J. Measles in India: Challenges & recent developments. Infect Ecol Epidemiol 2015; 5:27784. [PMID: 26015306 PMCID: PMC4444763 DOI: 10.3402/iee.v5.27784] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Jegadeesh Ramasamy
- Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India
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Goeyvaerts N, Leuridan E, Faes C, Van Damme P, Hens N. Multi-disease analysis of maternal antibody decay using non-linear mixed models accounting for censoring. Stat Med 2015; 34:2858-71. [PMID: 25908267 DOI: 10.1002/sim.6518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 11/10/2022]
Abstract
Biomedical studies often generate repeated measures of multiple outcomes on a set of subjects. It may be of interest to develop a biologically intuitive model for the joint evolution of these outcomes while assessing inter-subject heterogeneity. Even though it is common for biological processes to entail non-linear relationships, examples of multivariate non-linear mixed models (MNMMs) are still fairly rare. We contribute to this area by jointly analyzing the maternal antibody decay for measles, mumps, rubella, and varicella, allowing for a different non-linear decay model for each infectious disease. We present a general modeling framework to analyze multivariate non-linear longitudinal profiles subject to censoring, by combining multivariate random effects, non-linear growth and Tobit regression. We explore the hypothesis of a common infant-specific mechanism underlying maternal immunity using a pairwise correlated random-effects approach and evaluating different correlation matrix structures. The implied marginal correlation between maternal antibody levels is estimated using simulations. The mean duration of passive immunity was less than 4 months for all diseases with substantial heterogeneity between infants. The maternal antibody levels against rubella and varicella were found to be positively correlated, while little to no correlation could be inferred for the other disease pairs. For some pairs, computational issues occurred with increasing correlation matrix complexity, which underlines the importance of further developing estimation methods for MNMMs.
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Affiliation(s)
- Nele Goeyvaerts
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Agoralaan 1 Building D, 3590, Diepenbeek, Belgium.,Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Elke Leuridan
- Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Christel Faes
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Agoralaan 1 Building D, 3590, Diepenbeek, Belgium
| | - Pierre Van Damme
- Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Agoralaan 1 Building D, 3590, Diepenbeek, Belgium.,Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
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Abstract
BACKGROUND The World Health Organization (WHO) targeted China for measles elimination by 2012. Although China made significant progress, transmission continues, warranting examination of China's measles vaccination program. The World Health Organization recommends that children receive at least 2 doses of a measles containing vaccine (MCV) to ensure protection. In Tianjin, China, MCV is given in 3 doses: 8 months [measles vaccine (MV)], 18-24 months [measles-mumps-rubella (MMR)-1] and 5 years MMR-2). MMR-2 is important because of the young age for MV administration. This study describes MCV coverage, assesses administration timeliness and evaluates completion of the MCV series for children living in Tianjin, China. METHODS In July 2012, immunization records were selected from Tianjin's Immunization Information Management System. Records were abstracted for children born from 2004 to 2011, who were aged 8 months or older. Descriptive statistics characterized the study population and assessed timeliness and coverage for each MCV dose. RESULTS We examined records of 205,982 children living in Tianjin, China. Among children who were age-appropriate for each vaccine, 98.6% received MV, 97.6% received MMR-1 and 76.9% received MMR-2. Of the children who were old enough to receive MMR-2, 78.8% received the complete series and 71.6% were fully immunized for measles by age 6 years. CONCLUSIONS Tianjin has high rates of MV and MMR-1 coverage, with lower levels for MMR-2. Most children who completed the series did so on time. Maintaining high coverage and timely administration of MV and MMR-1 and increasing coverage of MMR-2 are necessary for China to attain the goal of national measles elimination.
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McKee A, Ferrari MJ, Shea K. The effects of maternal immunity and age structure on population immunity to measles. THEOR ECOL-NETH 2015; 8:261-271. [PMID: 26140058 PMCID: PMC4485449 DOI: 10.1007/s12080-014-0250-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Measles was successfully eradicated in the Pan-American Health Region in 2002. However, maintenance of elimination in parts of Africa, Europe, the USA, and other regions is proving difficult, despite apparently high vaccine coverage. This may be due to the different age structure in developed and developing populations, as well as to differences in the duration of maternal immunity. We explore the interaction between maternal immunity and age structure and quantify the resulting immunity gap between vaccine coverage and population immunity; we use this immunity gap as a novel metric of vaccine program success as it highlights the difference between actual and estimated immunity. We find that, for some combinations of maternal immunity and age structure, the accepted herd immunity threshold is not maintainable with a single-dose vaccine strategy for any combination of target age and coverage. In all cases, the herd immunity threshold is more difficult to maintain in a population with developing age structure. True population immunity is always improved if the target age at vaccination is chosen for the specific combination of maternal immunity and age structure.
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Affiliation(s)
- A McKee
- Department of Biology, Pennsylvania State University, 208 Mueller Laboratory, University Park, PA 16802, USA
| | - M J Ferrari
- Department of Biology, Pennsylvania State University, W243 Millennium Science Complex, University Park, PA 16802, USA
| | - K Shea
- Department of Biology, Pennsylvania State University, 208 Mueller Laboratory, University Park, PA 16802, USA
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Le Doare K, Allen L, Kampmann B, Heath PT, Taylor S, Hesseling AC, Gorringe A, Jones CE. Anti-group B Streptococcus antibody in infants born to mothers with human immunodeficiency virus (HIV) infection. Vaccine 2014; 33:621-7. [PMID: 25543061 PMCID: PMC4315133 DOI: 10.1016/j.vaccine.2014.12.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND HIV-exposed uninfected infants have increased infection risk and mortality compared to HIV-unexposed infants. HIV-exposed infants may be at increased risk of invasive GBS disease due to reduced maternal antibody against GBS. METHODS We quantified antibodies that bind to the surface of whole Group B Streptococcus (GBS) of serotypes Ia, Ib, II, III and V using novel flow cytometry assays in South African HIV-infected and non-infected mothers and their uninfected infants. Antibody-mediated complement C3b/iC3b deposition onto GBS of these serotypes was also quantified by a novel flow cytometry assay. RESULTS Geometric mean concentration (GMC) of both surface-binding anti-GBS antibody and antibody-mediated complement deposition onto GBS were reduced in HIV-infected women (n=46) compared to HIV-uninfected women (n=58) for ST1a (surface-binding: 19.3 vs 29.3; p=0.003; complement deposition: 2.9 vs 5.3 SU/mL; p=0.003), STIb (24.9 vs 47.6; p=0.003; 2.6 vs 4.9 SU/mL; p=0.003), STII (19.8 vs 50.0; p=0.001; 3.1 vs 6.2 SU/mL; p=0.001), STIII (27.8 vs 60.1; p=0.001; 2.8 vs 5.3 SU/mL; p=0.001) and STV (121.9 vs 185.6 SU/mL; p<0.001) and in their infants for STIa (complement deposition 9.4 vs 27.0 SU/mL; p=0.02), STIb (13.4 vs 24.5 SU/mL; p=0.02), STII (14.6 vs 42.7 SU/mL; p=0.03), STIII (26.6 vs 62.7 SU/mL; p=0.03) and STV (90.4 vs 165.8 SU/mL; p=0.04). Median transplacental transfer of antibody from HIV-infected women to their infants was reduced compared to HIV-uninfected women for GBS serotypes II (0.42 [IQR 0.22-0.59] vs 1.0 SU/mL [0.42-1.66]; p<0.001), III (0.54 [0.31-1.03] vs 0.95 SU/mL [0.42-3.05], p=0.05) and V (0.51 [0.28-0.79] vs 0.75 SU/mL [0.26-2.9], p=0.04). The differences between infants remained significant at 16 weeks of age. CONCLUSIONS Maternal HIV infection was associated with lower anti-GBS surface binding antibody concentration and antibody-mediated C3b/iC3b deposition onto GBS bacteria of serotypes Ia, Ib, II, III and V. This may render these infants more susceptible to early and late onset GBS disease.
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Affiliation(s)
- Kirsty Le Doare
- Wellcome Trust/Imperial Centre for Global Health Research/Department of Academic Paediatrics, Imperial College London, Norfolk Place, London W2 1NY, UK; Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
| | - Lauren Allen
- Public Health England, Porton Down, Salisbury SP4 0JG, UK
| | - Beate Kampmann
- Wellcome Trust/Imperial Centre for Global Health Research/Department of Academic Paediatrics, Imperial College London, Norfolk Place, London W2 1NY, UK; Medical Research Council, Atlantic Road, Fajara, Gambia
| | - Paul Trafford Heath
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Stephen Taylor
- Public Health England, Porton Down, Salisbury SP4 0JG, UK
| | - Anneke C Hesseling
- Desmond Tutu TB Center, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | | | - Christine Elizabeth Jones
- Wellcome Trust/Imperial Centre for Global Health Research/Department of Academic Paediatrics, Imperial College London, Norfolk Place, London W2 1NY, UK; Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Desmond Tutu TB Center, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
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la Grange H, Verster J, Dempers JJ, de Beer C. Review of immunological and virological aspects as contributory factors in Sudden Unexpected Death in Infancy (SUDI). Forensic Sci Int 2014; 245:12-6. [DOI: 10.1016/j.forsciint.2014.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/05/2014] [Accepted: 09/24/2014] [Indexed: 11/25/2022]
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