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Torner N, Mercader S, Dominguez A, Martinez A, Costa J, Sowers SB, Abernathy ES, Bellini WJ, Hickman CJ. Etiological analysis of discarded measles in the context of a measles outbreak among a highly immunized population. Pediatr Int 2023; 65:e15430. [PMID: 36461709 PMCID: PMC10107150 DOI: 10.1111/ped.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Measles can lead to serious complications and remains an important cause of morbidity and mortality worldwide. In this study we aimed to assess the etiological diagnosis of discarded measles cases in the context of an outbreak among a highly immunized population. METHODS We conducted a retrospective observational study of discarded measles cases from an outbreak that occurred from October 2006 to July 2007 in Catalonia. A confirmed case was defined as having a positive measles serum IgM result and/or a positive result by RT-PCR in urine and/or nasopharyngeal swab; or an epidemiological link to a confirmed case. Serum specimens were tested by a commercially available indirect-format and by an in-house capture-format measles IgM enzyme immunoassays. RESULTS Testing of 89 samples discarded for measles determined the etiologies for 10 (11.2%), including one rubella, three human herpes virus 6, and six measles infections. Of 381 confirmed cases in the outbreak, 10% had received at least one dose of the measles-mumps-rubella vaccine versus 54% of the discarded for measles (OR: 0.09; 95% CI: 0.06, 0.14; p < 0.001). CONCLUSIONS Highly sensitive surveillance systems are critical to identifying cases, responding to outbreaks and verifying progress towards measles elimination. Molecular tools for measles detection and differential diagnosis, and collection of appropriate specimens for molecular and serological testing are essential to correctly diagnose suspected measles infection.
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Affiliation(s)
- Nuria Torner
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Department of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Sara Mercader
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Angela Dominguez
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Department of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Ana Martinez
- CIBER Epidemiology and Public Health CIBERESPInstitute Carlos IIIMadridSpain
- Public Health Agency of CataloniaBarcelonaSpain
| | - Josep Costa
- Virology Unit, Centre de Diagnòstic BiomèdicHospital ClínicBarcelonaSpain
| | - Sun B. Sowers
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Emily S. Abernathy
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - William J. Bellini
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
| | - Carol J. Hickman
- Division of Viral Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory DiseasesAtlantaGeorgiaUSA
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2
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Mercader S, McGrew M, Sowers SB, Williams NJ, Bellini WJ, Hickman CJ. Development and Use of an Endpoint Titration Assay To Characterize Mumps IgG Avidity following Measles, Mumps, and Rubella Vaccination and Wild-Type Mumps Infection. mSphere 2018; 3:e00320-18. [PMID: 30209129 PMCID: PMC6135962 DOI: 10.1128/msphere.00320-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/02/2018] [Indexed: 11/29/2022] Open
Abstract
Waning mumps IgG antibody and incomplete IgG avidity maturation may increase susceptibility to mumps virus infection in some vaccinees. To measure mumps IgG avidity, serum specimens serially diluted to the endpoint were incubated on a commercial mumps-specific IgG enzyme immunoassay and treated with the protein denaturant diethylamine (60 mM, pH 10). End titer avidity indices (etAIs [percent ratio of detected diethylamine-resistant IgG at endpoint]) were calculated. Unpaired serum specimens (n = 108) from 15-month-old children living in a low-incidence setting were collected 1 month and 2 years after the first measles, mumps, and rubella vaccine dose (MMR1) and tested for mumps avidity. Per the receiver operating characteristic curve, the avidity assay is accurate (area under the curve, 0.994; 95% confidence interval [CI], 0.956 to 1.000), 96.5% sensitive (95% CI, 87.9 to 99.6%), and 92.2% specific (95% CI, 81.1 to 97.8%) at an etAI of 30%. When 9 sets of paired serum specimens collected 1 to 60 months post-MMR1 were tested for mumps and measles IgG avidity using comparable methods, the mumps etAI increased from 11% to 40 to 60% in 6 months. From 6 to 60 months, avidity was sustained at a mean etAI of 50% (95% CI, 46 to 54%), significantly lower (P < 0.0001) than the mean measles etAI of 80% (95% CI, 74 to 86%). Mean etAIs in children 2 years post-MMR1 (n = 51), unvaccinated adults with distant mumps disease (n = 29), and confirmed mumps cases (n = 23) were 54, 62, and 57%, respectively. A mumps-specific endpoint avidity assay was developed and validated, and mumps avidity was determined to be generally sustained at etAIs of 40 to 60%, reaching etAIs of >80% in some individuals.IMPORTANCE Numerous outbreaks of mumps have occurred in the United States among two-dose measles-mumps-rubella (MMR)-vaccinated populations since 2006. The avidity of mumps-specific IgG antibodies may affect susceptibility to mumps virus infection in some vaccinated individuals. To accurately measure mumps avidity, we developed and validated a mumps-specific IgG avidity assay that determines avidity at the endpoint titer of serially diluted serum specimens, providing results that are independent of IgG concentration. At low antibody titers, endpoint methods are considered more accurate than methods that determine avidity at a single dilution. We determined that 6 months after the first MMR dose, mumps IgG avidity is high and generally sustained at avidity indices of 40 to 60%, reaching values of >80% in some individuals. Additionally, 4% (4/103) of individuals had avidity indices of ≤30% (low avidity) 2 years after vaccination. Inadequate mumps avidity maturation may be one factor influencing susceptibility to mumps virus infection among previously vaccinated or naturally infected individuals.
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Affiliation(s)
- Sara Mercader
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marcia McGrew
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sun B Sowers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nobia J Williams
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William J Bellini
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carole J Hickman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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3
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Fiebelkorn AP, Redd SB, Gastañaduy PA, Clemmons N, Rota PA, Rota JS, Bellini WJ, Wallace GS. A Comparison of Postelimination Measles Epidemiology in the United States, 2009-2014 Versus 2001-2008. J Pediatric Infect Dis Soc 2017; 6:40-48. [PMID: 26666559 PMCID: PMC4905815 DOI: 10.1093/jpids/piv080] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/25/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Measles, a vaccine-preventable disease that can cause severe complications, was declared eliminated from the United States in 2000. The last published summary of US measles epidemiology was during 2001-2008. We summarized US measles epidemiology during 2009-2014. METHODS We compared demographic, vaccination, and virologic data on confirmed measles cases reported to the Centers for Disease Control and Prevention during January 1, 2009-December 31, 2014 and January 1, 2001-December 31, 2008. RESULTS During 2009-2014, 1264 confirmed measles cases were reported in the United States, including 275 importations from 58 countries and 66 outbreaks. The annual median number of cases and outbreaks during this period was 130 (range, 55-667 cases) and 10 (range, 4-23 outbreaks), respectively, compared with an annual median of 56 cases (P = .08) and 4 outbreaks during 2001-2008 (P = .04). Among US-resident case-patients during 2009-2014, children aged 12-15 months had the highest measles incidence (65 cases; 8.3 cases/million person-years), and infants aged 6-11 months had the second highest incidence (86 cases; 7.3 cases/million person-years). During 2009-2014, 865 (74%) of 1173 US-resident case-patients were unvaccinated and 188 (16%) had unknown vaccination status; of 917 vaccine-eligible US-resident case-patients, 600 (65%) were reported as having philosophical or religious objections to vaccination. CONCLUSIONS Although the United States has maintained measles elimination since 2000, measles outbreaks continue to occur globally, resulting in imported cases and potential spread. The annual median number of cases and outbreaks more than doubled during 2009-2014 compared with the earlier postelimination years. To maintain elimination, it will be necessary to maintain high 2-dose vaccination coverage, continue case-based surveillance, and monitor the patterns and rates of vaccine exemption.
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Affiliation(s)
- Amy Parker Fiebelkorn
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Susan B. Redd
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Paul A. Gastañaduy
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Nakia Clemmons
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Paul A. Rota
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Jennifer S. Rota
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - William J. Bellini
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Gregory S. Wallace
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
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4
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Fowlkes AL, Witte D, Beeler J, Audet SA, Broadhead R, Bellini WJ, Cutts F, Helfand RF. Supplemental measles vaccine antibody response among HIV-infected and -uninfected children in Malawi after 1- and 2-dose primary measles vaccination schedules. Vaccine 2016; 34:1459-64. [PMID: 26873052 PMCID: PMC5737013 DOI: 10.1016/j.vaccine.2016.01.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 11/26/2022]
Abstract
Background The long-term antibody response to measles vaccine (MV) administered at age 6 months with or without subsequent doses is not well documented. Methods Measles serum antibody responses were evaluated after a supplemental dose of measles vaccine (sMV) administered at a median age of 20 months among Malawian children who had previously received 2 doses of measles vaccine (MV) at ages 6 and 9 months (HIV-infected and random sample of HIV-uninfected) or 1 dose at age 9 months (random sample of HIV-uninfected). We compared measles antibody seropositivity between groups by enzyme linked immunoassay and seroprotection by plaque reduction neutralization geometric mean concentrations. Results Of 1756 children enrolled, 887 (50.5%) received a sMV dose following MV at 9 months of age and had specimens available after sMV receipt, including 401 HIV-uninfected children who received one MV dose at 9 months, 464 HIV-uninfected and 22 HIV-infected children who received two doses of MV at ages 6 and 9 months. Among HIV-uninfected children, protective levels of antibody were found post sMV in 90–99% through ages 24–36 months and were not affected by MV schedule. Geometric mean concentration levels of measles antibody were significantly increased post-sMV among those HIV-uninfected children previously non-responsive to vaccination. Among HIV-infected children, the proportion seroprotected increased initially but by 9 months post-sMV was no higher than pre-sMV. Conclusions Our findings support early 2-dose MV to provide measles immunity for young infants without risk of interference with antibody responses to subsequent MV doses administered as part of SIAs.
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Affiliation(s)
- Ashley L Fowlkes
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA.
| | - Desiree Witte
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Judy Beeler
- Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, MD, USA
| | - Susette A Audet
- Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, MD, USA
| | | | | | - Felicity Cutts
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rita F Helfand
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
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5
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Zaman K, Fleming JA, Victor JC, Yunus M, Bari TIA, Azim T, Rahman M, Mowla SMN, Bellini WJ, McNeal M, Icenogle JP, Lopman B, Parashar U, Cortese MM, Steele AD, Neuzil KM. Noninterference of Rotavirus Vaccine With Measles-Rubella Vaccine at 9 Months of Age and Improvements in Antirotavirus Immunity: A Randomized Trial. J Infect Dis 2016; 213:1686-93. [PMID: 26823338 PMCID: PMC4857472 DOI: 10.1093/infdis/jiw024] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/01/2015] [Indexed: 11/30/2022] Open
Abstract
Background. The burden of rotavirus morbidity and mortality is high in children aged <5 years in developing countries, and evaluations indicate waning protection from rotavirus immunization in the second year. An additional dose of rotavirus vaccine may enhance the immune response and lengthen the period of protection against disease, but coadministration of this dose should not interfere with immune responses to concurrently given vaccines. Methods. A total of 480 9-month-old participants from Matlab, Bangladesh, were enrolled in a study with a primary objective to establish noninferiority of concomitant administration of measles-rubella vaccine (MR) and a third dose of human rotavirus vaccine (HRV; MR + HRV), compared with MR given alone. Secondary objectives included noninferiority of rubella antibody seroconversion and evaluating rotavirus IgA/IgG seroresponses in MR + HRV recipients. Results. Two months after vaccination, 75.3% and 74.3% of MR + HRV and MR recipients, respectively, had seroprotective levels of measles virus antibodies; 100.0% and 99.6%, respectively, showed anti–rubella virus immunoglobulin G (IgG) seroprotection. In the MR + HRV group, antirotavirus immunoglobulin A and IgG seropositivity frequencies before vaccination (52.7% and 66.3%, respectively) increased to 69.6% and 88.3% after vaccination. Conclusions. Vaccine-induced measles and rubella antibody responses are not negatively affected by concomitant administration of HRV. The HRV dose increases antirotavirus serum antibody titers and the proportion of infants with detectable antirotavirus antibody. Clinical Trials Registration. NCT01700621.
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Affiliation(s)
- K Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Mohammad Yunus
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Tasnim Azim
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | | | - Ben Lopman
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh Parashar
- Centers for Disease Control and Prevention, Atlanta, Georgia
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6
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Fiebelkorn AP, Redd SB, Gastanaduy P, Clemmons N, Rota P, Rota JS, Bellini WJ, Wallace GS. Measles in the United States, 2009–2014. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv131.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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7
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Smith C, Dutmer C, Schmid DS, Dishop MK, Bellini WJ, Gelfand EW, Asturias EJ. A Toddler With Rash, Encephalopathy, and Hemolytic Anemia. J Pediatric Infect Dis Soc 2015; 4:376-80. [PMID: 26407265 PMCID: PMC4681381 DOI: 10.1093/jpids/piv032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 04/25/2015] [Indexed: 11/12/2022]
Affiliation(s)
| | - Cullen Dutmer
- Department of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
| | - D. Scott Schmid
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Megan K. Dishop
- Department of Pathology, University of Colorado School of Medicine, Aurora
| | - William J. Bellini
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Erwin W. Gelfand
- Department of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
| | - Edwin J. Asturias
- Department of Pediatric Infectious Diseases,Center for Global Health, Colorado School of Public Health, Aurora
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8
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Fiebelkorn AP, Coleman LA, Belongia EA, Freeman SK, York D, Bi D, Kulkarni A, Audet S, Mercader S, McGrew M, Hickman CJ, Bellini WJ, Shivakoti R, Griffin DE, Beeler J. Measles Virus Neutralizing Antibody Response, Cell-Mediated Immunity, and Immunoglobulin G Antibody Avidity Before and After Receipt of a Third Dose of Measles, Mumps, and Rubella Vaccine in Young Adults. J Infect Dis 2015; 213:1115-23. [PMID: 26597262 DOI: 10.1093/infdis/jiv555] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/11/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Two doses of measles, mumps, and rubella (MMR) vaccine are 97% effective against measles, but waning antibody immunity to measles and failure of the 2-dose vaccine occur. We administered a third MMR dose (MMR3) to young adults and assessed immunogenicity over 1 year. METHODS Measles virus (MeV) neutralizing antibody concentrations, cell-mediated immunity (CMI), and immunoglobulin G (IgG) antibody avidity were assessed at baseline and 1 month and 1 year after MMR3 receipt. RESULTS Of 662 subjects at baseline, 1 (0.2%) was seronegative for MeV-neutralizing antibodies (level, <8 mIU/mL), and 23 (3.5%) had low antibody levels (8-120 mIU/mL). One month after MMR3 receipt, 1 subject (0.2%) was seronegative, and 6 (0.9%) had low neutralizing antibodies, with only 21 of 662 (3.2%) showing a ≥ 4-fold rise in neutralizing antibodies. One year after MMR3 receipt, no subject was seronegative, and 10 of 617 (1.6%) had low neutralizing antibody levels. CMI analyses showed low levels of spot-forming cells after stimulation, suggesting the presence of T-cell memory, but the response was minimal after MMR3 receipt. MeV IgG avidity did not correlate with findings of neutralization analyses. CONCLUSIONS Most subjects were seropositive before MMR3 receipt, and very few had a secondary immune response after MMR3 receipt. Similarly, CMI and avidity analyses showed minimal qualitative improvements in immune response after MMR3 receipt. We did not find compelling data to support a routine third dose of MMR vaccine.
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Affiliation(s)
- Amy Parker Fiebelkorn
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Daphne York
- Marshfield Clinic Research Foundation, Wisconsin
| | - Daoling Bi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashwin Kulkarni
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring
| | - Susette Audet
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring
| | - Sara Mercader
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marcia McGrew
- National Center for Immunization and Respiratory Diseases, 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
| | - William J Bellini
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rupak Shivakoti
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Diane E Griffin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Judith Beeler
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring
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9
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Siberry GK, Patel K, Bellini WJ, Karalius B, Purswani MU, Burchett SK, Meyer WA, Sowers SB, Ellis A, Van Dyke RB. Immunity to Measles, Mumps, and Rubella in US Children With Perinatal HIV Infection or Perinatal HIV Exposure Without Infection. Clin Infect Dis 2015; 61:988-95. [PMID: 26060291 DOI: 10.1093/cid/civ440] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Children with perinatal human immunodeficiency virus (HIV) infection (PHIV) may not be protected against measles, mumps, and rubella (MMR) because of impaired initial vaccine response or waning immunity. Our objectives were to estimate seroimmunity in PHIV-infected and perinatally HIV-exposed but uninfected (HEU) children and identify predictors of immunity in the PHIV cohort. METHODS PHIV and HEU children were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) at ages 7-15 years from 2007 to 2009. At annual visits, demographic, laboratory, immunization, and clinical data were abstracted and serologic specimens collected. Most recent serologic specimen was used to determine measles seroprotection by plaque reduction neutralization assay and rubella seroprotection and mumps seropositivity by enzyme immunoassay. Sustained combination antiretroviral therapy (cART) was defined as taking cART for at least 3 months. RESULTS Among 428 PHIV and 221 HEU PHACS participants, the prevalence was significantly lower in PHIV children for measles seroprotection (57% [95% confidence interval {CI}, 52%-62%] vs 99% [95% CI, 96%-100%]), rubella seroprotection (65% [95% CI, 60%-70%] vs 98% [95% CI, 95%-100%]), and mumps seropositivity (59% [95% CI, 55%-64%] vs 97% [95% CI, 94%-99%]). On multivariable analysis, greater number of vaccine doses while receiving sustained cART and higher nadir CD4 percentage between last vaccine dose and serologic testing independently improved the cumulative prediction of measles seroprotection in PHIV. Predictors of rubella seroprotection and mumps seropositivity were similar. CONCLUSIONS High proportions of PHIV-infected children, but not HEU children, lack serologic evidence of immunity to MMR, despite documented immunization and current cART. Effective cART before immunization is a strong predictor of current seroimmunity.
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Affiliation(s)
- George K Siberry
- Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Kunjal Patel
- Department of Epidemiology, Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - William J Bellini
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brad Karalius
- Department of Epidemiology, Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Murli U Purswani
- Albert Einstein College of Medicine, Bronx-Lebanon Hospital Center, New York
| | - Sandra K Burchett
- Boston Children's Hospital and Harvard Medical School, Massachusetts
| | | | - Sun Bae Sowers
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela Ellis
- Frontier Science and Technology Research Foundation, Inc, Buffalo, New York
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10
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Morris LE, Posada R, Hickman CJ, Latner DR, Singh TA, Rautenberg A, Jao J, Bellini WJ, Sperling R. Susceptibility to Measles Among Perinatally HIV-Infected Adolescents and Young Adults. J Pediatric Infect Dis Soc 2015; 4:63-6. [PMID: 25844166 PMCID: PMC4381743 DOI: 10.1093/jpids/pit054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 06/13/2013] [Indexed: 11/14/2022]
Abstract
Among our cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus, few (17.6%) had measles protective antibodies by plaque reduction neutralization (PRN). Agreement was demonstrated between the commercial enzyme immunoassay and the PRN assay (K = 0.59 [95% confidence interval: 0.23-0.95]). Further studies are needed to understand the determinants of immunity in this population.
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Affiliation(s)
- Lee E. Morris
- Division of Pediatric Infectious Disease, Mount Sinai School of Medicine, New York, New York
| | - Roberto Posada
- Division of Pediatric Infectious Disease, Mount Sinai School of Medicine, New York, New York
| | - Carole J. Hickman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donald R. Latner
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Jennifer Jao
- Department of OB/Gyn,Division of Infectious Disease, Mount Sinai School of Medicine, New York, New York
| | - William J. Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Lebo EJ, Kruszon-Moran DM, Marin M, Bellini WJ, Schmid S, Bialek SR, Wallace GS, McLean HQ. Seroprevalence of measles, mumps, rubella and varicella antibodies in the United States population, 2009-2010. Open Forum Infect Dis 2015; 2:ofv006. [PMID: 26034757 PMCID: PMC4438887 DOI: 10.1093/ofid/ofv006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/14/2015] [Indexed: 11/12/2022] Open
Abstract
Background. In the United States, measles, mumps, rubella, and varicella immunity is now primarily achieved through vaccination. Monitoring population immunity is necessary. Methods. We evaluated seroprevalence of antibodies to measles, mumps, rubella, and varicella using the National Health and Nutrition Examination Survey during 2009-2010. Results. Measles, mumps, rubella, and varicella seroprevalence was 92.0% (95% confidence interval [CI], 90.9%-93.0%), 87.6% (CI, 85.8%-89.2%), 95.3% (CI, 94.3%-96.2%), and 97.8% (CI, 97.1%-98.3%), respectively. United States (US)-born persons had lower mumps seroprevalence and higher varicella seroprevalence than non-US born persons. Conclusions. Seroprevalence was high (88%-98%) for all 4 viruses in the US population during 2009-2010.
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Affiliation(s)
- Emmaculate J Lebo
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Deanna M Kruszon-Moran
- Division of Health and Nutrition Examination Surveys , Center for Disease Control and Prevention , Hyattsville, Maryland
| | - Mona Marin
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - William J Bellini
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Scott Schmid
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Stephanie R Bialek
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Gregory S Wallace
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Huong Q McLean
- Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia ; Center for Clinical Epidemiology and Population Health , Marshfield Clinic Research Foundation , Wisconsin
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12
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Bayer DK, Martinez CA, Sorte HS, Forbes LR, Demmler-Harrison GJ, Hanson IC, Pearson NM, Noroski LM, Zaki SR, Bellini WJ, Leduc MS, Yang Y, Eng CM, Patel A, Rodningen OK, Muzny DM, Gibbs RA, Campbell IM, Shaw CA, Baker MW, Zhang V, Lupski JR, Orange JS, Seeborg FO, Stray-Pedersen A. Vaccine-associated varicella and rubella infections in severe combined immunodeficiency with isolated CD4 lymphocytopenia and mutations in IL7R detected by tandem whole exome sequencing and chromosomal microarray. Clin Exp Immunol 2014; 178:459-69. [PMID: 25046553 PMCID: PMC4238873 DOI: 10.1111/cei.12421] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 12/22/2022] Open
Abstract
In areas without newborn screening for severe combined immunodeficiency (SCID), disease-defining infections may lead to diagnosis, and in some cases, may not be identified prior to the first year of life. We describe a female infant who presented with disseminated vaccine-acquired varicella (VZV) and vaccine-acquired rubella infections at 13 months of age. Immunological evaluations demonstrated neutropenia, isolated CD4 lymphocytopenia, the presence of CD8(+) T cells, poor lymphocyte proliferation, hypergammaglobulinaemia and poor specific antibody production to VZV infection and routine immunizations. A combination of whole exome sequencing and custom-designed chromosomal microarray with exon coverage of primary immunodeficiency genes detected compound heterozygous mutations (one single nucleotide variant and one intragenic copy number variant involving one exon) within the IL7R gene. Mosaicism for wild-type allele (20-30%) was detected in pretransplant blood and buccal DNA and maternal engraftment (5-10%) demonstrated in pretransplant blood DNA. This may be responsible for the patient's unusual immunological phenotype compared to classical interleukin (IL)-7Rα deficiency. Disseminated VZV was controlled with anti-viral and immune-based therapy, and umbilical cord blood stem cell transplantation was successful. Retrospectively performed T cell receptor excision circle (TREC) analyses completed on neonatal Guthrie cards identified absent TREC. This case emphasizes the danger of live viral vaccination in severe combined immunodeficiency (SCID) patients and the importance of newborn screening to identify patients prior to high-risk exposures. It also illustrates the value of aggressive pathogen identification and treatment, the influence newborn screening can have on morbidity and mortality and the significant impact of newer genomic diagnostic tools in identifying the underlying genetic aetiology for SCID patients.
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Affiliation(s)
- D K Bayer
- Department of Pediatrics, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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13
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Xu S, Zhang Y, Rivailler P, Wang H, Ji Y, Zhen Z, Mao N, Li C, Bellini WJ, Xu W, Rota PA. Evolutionary genetics of genotype H1 measles viruses in China from 1993 to 2012. J Gen Virol 2014; 95:1892-1899. [PMID: 24914068 PMCID: PMC4135087 DOI: 10.1099/vir.0.066746-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Virologic surveillance is a critical component of measles management. One of the criteria for verification of elimination of endemic measles is genetic analysis of wild-type viruses to demonstrate lack of an indigenous genotype. Measles is yet to be eliminated in China, and genotype H1 has been detected continuously since virologic surveillance was initiated in 1993. Virologic surveillance has been very active in China, providing a unique opportunity to conduct a detailed study of the evolution of a single, endemic genotype over a timespan of nearly two decades. Phylogenetic analysis performed on the 450 nt coding sequence for the C-terminal 150 amino acids of the nucleoprotein (N-450), fusion (F) gene and haemagglutinin (H) gene confirmed the continued circulation of genotype H1 viruses for 19 years. No evidence of selective pressure for the H protein was found. The substitution rates ranged from 0.75×10(-3) substitutions site(-1) year(-1) for H to 1.65×10(-3) substitutions site(-1) year(-1) for N-450. The time of most recent common ancestor (TMRCA) for genotype H1 was estimated as approximately 1985 (95 % highest probability density, 1979-1989). Finally, the overall diversity of measles sequences from China decreased from 2005 to 2012, coincident with a substantial decrease in measles cases. The results suggest that detailed evolutionary analyses should facilitate the documentation of eventual measles elimination in China. Moreover, the molecular approaches used in this study can be applied in other countries approaching measles elimination.
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Affiliation(s)
- Songtao Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yan Zhang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Pierre Rivailler
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Huiling Wang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yixin Ji
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Zhu Zhen
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Naiying Mao
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Chongshan Li
- Shanghai Center for Disease Control and Prevention, Shanghai City, PR China
| | - William J Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wenbo Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Gastañaduy PA, Redd SB, Fiebelkorn AP, Rota JS, Rota PA, Bellini WJ, Seward JF, Wallace GS. Measles - United States, January 1-May 23, 2014. MMWR Morb Mortal Wkly Rep 2014; 63:496-9. [PMID: 24898167 PMCID: PMC5779360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Measles is a highly contagious, acute viral illness that can lead to serious complications and death. Although measles elimination (i.e., interruption of year-round endemic transmission) was declared in the United States in 2000, importations of measles cases from endemic areas of the world continue to occur, leading to secondary measles cases and outbreaks in the United States, primarily among unvaccinated persons. To update national measles data in the United States, CDC evaluated cases reported by states from January 1 through May 23, 2014. A total of 288 confirmed measles cases have been reported to CDC, surpassing the highest reported yearly total of measles cases since elimination (220 cases reported in 2011). Fifteen outbreaks accounted for 79% of cases reported, including the largest outbreak reported in the United States since elimination (138 cases and ongoing). The large number of cases this year emphasizes the need for health-care providers to have a heightened awareness of the potential for measles in their communities and the importance of vaccination to prevent measles.
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Affiliation(s)
- Paul A. Gastañaduy
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Susan B. Redd
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Amy Parker Fiebelkorn
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Jennifer S. Rota
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Paul A. Rota
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - William J. Bellini
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Jane F. Seward
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Gregory S. Wallace
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
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15
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Latner DR, McGrew M, Williams NJ, Sowers SB, Bellini WJ, Hickman CJ. Estimates of mumps seroprevalence may be influenced by antibody specificity and serologic method. Clin Vaccine Immunol 2014; 21:286-97. [PMID: 24371258 PMCID: PMC3957677 DOI: 10.1128/cvi.00621-13] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/20/2013] [Indexed: 01/21/2023]
Abstract
Neutralizing antibodies are assumed to be essential for protection against mumps virus infection, but their measurement is labor- and time-intensive. For this reason, enzyme-linked immunosorbent assays (ELISAs) are typically used to measure mumps-specific IgG levels. However, since there is poor correlation between mumps neutralization titers and ELISAs that measure the presence of mumps-specific IgG levels, ELISAs that better correlate with neutralization are needed. To address this issue, we measured mumps antibody levels by plaque reduction neutralization, by a commercial ELISA (whole-virus antigen), and by ELISAs specific for the mumps nucleoprotein and hemagglutinin. The results indicate that differences in the antibody response to the individual mumps proteins could partially explain the lack of correlation among various serologic tests. Furthermore, the data indicate that some seropositive individuals have low levels of neutralizing antibody. If neutralizing antibody is important for protection, this suggests that previous estimates of immunity based on whole-virus ELISAs may be overstated.
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Affiliation(s)
- Donald R Latner
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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16
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Rosen JB, Rota JS, Hickman CJ, Sowers SB, Mercader S, Rota PA, Bellini WJ, Huang AJ, Doll MK, Zucker JR, Zimmerman CM. Outbreak of measles among persons with prior evidence of immunity, New York City, 2011. Clin Infect Dis 2014; 58:1205-10. [PMID: 24585562 DOI: 10.1093/cid/ciu105] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Measles was eliminated in the United States through high vaccination coverage and a public health system able to rapidly respond to measles. Measles may occur among vaccinated individuals, but secondary transmission from such individuals has not been documented. METHODS Suspected patients and contacts exposed during a measles outbreak in New York City in 2011 were investigated. Medical histories and immunization records were obtained. Cases were confirmed by detection of measles-specific immunoglobulin M and/or RNA. Tests for measles immunoglobulin G (IgG), IgG avidity, measurement of measles neutralizing antibody titers, and genotyping were performed to characterize the cases. RESULTS The index patient had 2 doses of measles-containing vaccine; of 88 contacts, 4 secondary patients were confirmed who had either 2 doses of measles-containing vaccine or a past positive measles IgG antibody. All patients had laboratory confirmation of measles infection, clinical symptoms consistent with measles, and high-avidity IgG antibody characteristic of a secondary immune response. Neutralizing antibody titers of secondary patients reached >80 000 mIU/mL 3-4 days after rash onset and that of the index was <500 mIU/mL 9 days after rash onset. No additional cases of measles occurred among 231 contacts of secondary patients. CONCLUSIONS This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. Secondary patients had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts. This outbreak underscores the need for thorough epidemiologic and laboratory investigation of suspected cases of measles regardless of vaccination status.
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Affiliation(s)
- Jennifer B Rosen
- Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York
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17
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Papania MJ, Wallace GS, Rota PA, Icenogle JP, Fiebelkorn AP, Armstrong GL, Reef SE, Redd SB, Abernathy ES, Barskey AE, Hao L, McLean HQ, Rota JS, Bellini WJ, Seward JF. Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience. JAMA Pediatr 2014; 168:148-55. [PMID: 24311021 DOI: 10.1001/jamapediatrics.2013.4342] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE To verify the elimination of endemic measles, rubella, and congenital rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, rubella, and CRS had been sustained. OBJECTIVE To review the evidence for sustained elimination of endemic measles, rubella, and CRS from the United States through 2011. DESIGN, SETTING, AND PARTICIPANTS Review of data for measles from 2001 to 2011 and for rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. MAIN OUTCOMES AND MEASURES Annual numbers of measles, rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and rubella; and measles-mumps-rubella vaccination coverage levels. RESULTS Since 2001, US reported measles incidence has remained below 1 case per 1,000,000 population. Since 2004, rubella incidence has been below 1 case per 10,000,000 population, and CRS incidence has been below 1 case per 5,000,000 births. Eighty-eight percent of measles cases and 54% of rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and rubella. CONCLUSIONS AND RELEVANCE The external expert panel concluded that the elimination of endemic measles, rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
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Affiliation(s)
- Mark J Papania
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gregory S Wallace
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul A Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph P Icenogle
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Parker Fiebelkorn
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gregory L Armstrong
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan E Reef
- Global Immunization Division, Coordinating Office for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan B Redd
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily S Abernathy
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Albert E Barskey
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia4HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, National
| | - Lijuan Hao
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Huong Q McLean
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia5Marshfield Clinic Research Foundation, Marshfield, Wisconsin
| | - Jennifer S Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William J Bellini
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jane F Seward
- Office of the Director, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Goldsmith CS, Ksiazek TG, Rollin PE, Comer JA, Nicholson WL, Peret TCT, Erdman DD, Bellini WJ, Harcourt BH, Rota PA, Bhatnagar J, Bowen MD, Erickson BR, McMullan LK, Nichol ST, Shieh WJ, Paddock CD, Zaki SR. Cell culture and electron microscopy for identifying viruses in diseases of unknown cause. Emerg Infect Dis 2013; 19:886-91. [PMID: 23731788 PMCID: PMC3713842 DOI: 10.3201/eid1906.130173] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During outbreaks of infectious diseases or in cases of severely ill patients, it is imperative to identify the causative agent. This report describes several events in which virus isolation and identification by electron microscopy were critical to initial recognition of the etiologic agent, which was further analyzed by additional laboratory diagnostic assays. Examples include severe acute respiratory syndrome coronavirus, and Nipah, lymphocytic choriomeningitis, West Nile, Cache Valley, and Heartland viruses. These cases illustrate the importance of the techniques of cell culture and electron microscopy in pathogen identification and recognition of emerging diseases.
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Affiliation(s)
- Cynthia S Goldsmith
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G32, Atlanta, GA 30329, USA.
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19
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Xu S, Zhang Y, Zhu Z, Liu C, Mao N, Ji Y, Wang H, Jiang X, Li C, Tang W, Feng D, Wang C, Zheng L, Lei Y, Ling H, Zhao C, Ma Y, He J, Wang Y, Li P, Guan R, Zhou S, Zhou J, Wang S, Zhang H, Zheng H, Liu L, Ma H, Guan J, Lu P, Feng Y, Zhang Y, Zhou S, Xiong Y, Ba Z, Chen H, Yang X, Bo F, Ma Y, Liang Y, Lei Y, Gu S, Liu W, Chen M, Featherstone D, Jee Y, Bellini WJ, Rota PA, Xu W. Genetic characterization of the hemagglutinin genes of wild-type measles virus circulating in china, 1993-2009. PLoS One 2013; 8:e73374. [PMID: 24073194 PMCID: PMC3779233 DOI: 10.1371/journal.pone.0073374] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 07/29/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND China experienced several large measles outbreaks in the past two decades, and a series of enhanced control measures were implemented to achieve the goal of measles elimination. Molecular epidemiologic surveillance of wild-type measles viruses (MeV) provides valuable information about the viral transmission patterns. Since 1993, virologic surveillnace has confirmed that a single endemic genotype H1 viruses have been predominantly circulating in China. A component of molecular surveillance is to monitor the genetic characteristics of the hemagglutinin (H) gene of MeV, the major target for virus neutralizing antibodies. PRINCIPAL FINDINGS Analysis of the sequences of the complete H gene from 56 representative wild-type MeV strains circulating in China during 1993-2009 showed that the H gene sequences were clustered into 2 groups, cluster 1 and cluster 2. Cluster1 strains were the most frequently detected cluster and had a widespread distribution in China after 2000. The predicted amino acid sequences of the H protein were relatively conserved at most of the functionally significant amino acid positions. However, most of the genotype H1 cluster1 viruses had an amino acid substitution (Ser240Asn), which removed a predicted N-linked glycosylation site. In addition, the substitution of Pro397Leu in the hemagglutinin noose epitope (HNE) was identified in 23 of 56 strains. The evolutionary rate of the H gene of the genotype H1 viruses was estimated to be approximately 0.76×10(-3) substitutions per site per year, and the ratio of dN to dS (dN/dS) was <1 indicating the absence of selective pressure. CONCLUSIONS Although H genes of the genotype H1 strains were conserved and not subjected to selective pressure, several amino acid substitutions were observed in functionally important positions. Therefore the antigenic and genetic properties of H genes of wild-type MeVs should be monitored as part of routine molecular surveillance for measles in China.
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Affiliation(s)
- Songtao Xu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Chunyu Liu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Naiying Mao
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Yixin Ji
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Huiling Wang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Xiaohong Jiang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Chongshan Li
- Shanghai Center for Disease Control and Prevention, Shanghai City, China
| | - Wei Tang
- Shanghai Center for Disease Control and Prevention, Shanghai City, China
| | - Daxing Feng
- Henan Center for Disease Control and Prevention, Zhengzhou City, Henan Province, China
| | - Changyin Wang
- Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, China
| | - Lei Zheng
- Shanxi Center for Disease Control and Prevention, Taiyuan City, Shanxi Province, China
| | - Yue Lei
- Tianjin Center for Disease Control and Prevention, Tianjin City, China
| | - Hua Ling
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Chunfang Zhao
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Yan Ma
- Hainan Center for Disease Control and Prevention, Haikou City, Hainan Province, China
| | - Jilan He
- Sichuan Center for Disease Control and Prevention, Chengdu City, Sichuan Province, China
| | - Yan Wang
- Liaoning Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China
| | - Ping Li
- Shaanxi Center for Disease Control and Prevention, Xian City, Shannxi Province, China
| | - Ronghui Guan
- Shaanxi Center for Disease Control and Prevention, Xian City, Shannxi Province, China
| | - Shujie Zhou
- Anhui Center for Disease Control and Prevention, Hefei City, Anhui Province, China
| | - Jianhui Zhou
- Jilin Center for Disease Control and Prevention, Changchun City, Jilin Province, China
| | - Shuang Wang
- Jilin Center for Disease Control and Prevention, Changchun City, Jilin Province, China
| | - Hong Zhang
- Hunan Center for Disease Control and Prevention, Changsha City, Hunan Province, China
| | - Huanying Zheng
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangzhou Province, China
| | - Leng Liu
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangzhou Province, China
| | - Hemuti Ma
- Xinjiang Center for Disease Control and Prevention, Urumchi City, Xinjiang Province, China
| | - Jing Guan
- Xinjiang Center for Disease Control and Prevention, Urumchi City, Xinjiang Province, China
| | - Peishan Lu
- Jiangsu Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China
| | - Yan Feng
- Zhejiang Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China
| | - Yanjun Zhang
- Zhejiang Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China
| | - Shunde Zhou
- Jiangxi Center for Disease Control and Prevention, Nanchang City, Jiangxi Province, China
| | - Ying Xiong
- Jiangxi Center for Disease Control and Prevention, Nanchang City, Jiangxi Province, China
| | - Zhuoma Ba
- Qinghai Center for Disease Control and Prevention, Xining City, Qinghai Province, China
| | - Hui Chen
- Ningxia Center for Disease Control and Prevention, Yinchuan City, Ningxia Province, China
| | - Xiuhui Yang
- Fujian Center for Disease Control and Prevention, Fuzhou City, Fujian Province, China
| | - Fang Bo
- Heilongjiang Center for Disease Control and Prevention, Harbin City, Heilongjiang Province, China
| | - Yujie Ma
- Heilongjiang Center for Disease Control and Prevention, Harbin City, Heilongjiang Province, China
| | - Yong Liang
- Hebei Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, China
| | - Yake Lei
- Hubei Center for Disease Control and Prevention, Wuhan City, Hubei Province, China
| | - Suyi Gu
- Inner Mongolia Center for Disease Control and Prevention, Hohhot City, Inner Mongolia Province, China
| | - Wei Liu
- Guangxi Center for Disease Control and Prevention, Nanning City, Guangxi Province, China
| | - Meng Chen
- Beijing Center for Disease Control and Prevention, Beijing City, China
| | - David Featherstone
- Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Youngmee Jee
- Expanded Programme on Immunization, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - William J. Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Paul A. Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Wenbo Xu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
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Mahamud A, Masunu-Faleafaga Y, Walls L, Williams N, Garcia P, Teshale E, Williams R, Dulski T, Bellini WJ, Kutty PK. Seroprevalence of measles, mumps and rubella among children in American Samoa, 2011, and progress towards West Pacific Region goals of elimination. Vaccine 2013; 31:3683-7. [DOI: 10.1016/j.vaccine.2013.05.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/15/2013] [Accepted: 05/30/2013] [Indexed: 11/27/2022]
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21
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Coughlin MM, Bellini WJ, Rota PA. Contribution of dendritic cells to measles virus induced immunosuppression. Rev Med Virol 2012; 23:126-38. [DOI: 10.1002/rmv.1735] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/29/2012] [Accepted: 10/30/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Melissa M. Coughlin
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
| | - William J. Bellini
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
| | - Paul A. Rota
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
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22
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Barskey AE, Schulte C, Rosen JB, Handschur EF, Rausch-Phung E, Doll MK, Cummings KP, Alleyne EO, High P, Lawler J, Apostolou A, Blog D, Zimmerman CM, Montana B, Harpaz R, Hickman CJ, Rota PA, Rota JS, Bellini WJ, Gallagher KM. Mumps outbreak in Orthodox Jewish communities in the United States. N Engl J Med 2012; 367:1704-13. [PMID: 23113481 DOI: 10.1056/nejmoa1202865] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND By 2005, vaccination had reduced the annual incidence of mumps in the United States by more than 99%, with few outbreaks reported. However, in 2006, a large outbreak occurred among highly vaccinated populations in the United States, and similar outbreaks have been reported worldwide. The outbreak described in this report occurred among U.S. Orthodox Jewish communities during 2009 and 2010. METHODS Cases of salivary-gland swelling and other symptoms clinically compatible with mumps were investigated, and demographic, clinical, laboratory, and vaccination data were evaluated. RESULTS From June 28, 2009, through June 27, 2010, a total of 3502 outbreak-related cases of mumps were reported in New York City, two upstate New York counties, and one New Jersey county. Of the 1648 cases for which clinical specimens were available, 50% were laboratory-confirmed. Orthodox Jewish persons accounted for 97% of case patients. Adolescents 13 to 17 years of age (27% of all patients) and males (78% of patients in that age group) were disproportionately affected. Among case patients 13 to 17 years of age with documented vaccination status, 89% had previously received two doses of a mumps-containing vaccine, and 8% had received one dose. Transmission was focused within Jewish schools for boys, where students spend many hours daily in intense, face-to-face interaction. Orchitis was the most common complication (120 cases, 7% of male patients ≥12 years of age), with rates significantly higher among unvaccinated persons than among persons who had received two doses of vaccine. CONCLUSIONS The epidemiologic features of this outbreak suggest that intense exposures, particularly among boys in schools, facilitated transmission and overcame vaccine-induced protection in these patients. High rates of two-dose coverage reduced the severity of the disease and the transmission to persons in settings of less intense exposure.
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Affiliation(s)
- Albert E Barskey
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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23
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Lo MK, Peeples ME, Bellini WJ, Nichol ST, Rota PA, Spiropoulou CF. Distinct and overlapping roles of Nipah virus P gene products in modulating the human endothelial cell antiviral response. PLoS One 2012; 7:e47790. [PMID: 23094089 PMCID: PMC3477106 DOI: 10.1371/journal.pone.0047790] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/17/2012] [Indexed: 12/15/2022] Open
Abstract
Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus that causes fatal encephalitis in up to 75% of infected humans. Like other paramyxoviruses, NiV employs co-transcriptional mRNA editing during transcription of the phosphoprotein (P) gene to generate additional mRNAs encoding the V and W proteins. The C protein is translated from the P mRNA, but in an alternative reading frame. There is evidence from both in vitro and in vivo studies to show that the P gene products play a role in NiV pathogenesis. We have developed a reverse genetic system to dissect the individual roles of the NiV P gene products in limiting the antiviral response in primary human microvascular lung endothelial cells, which represent important targets in human NiV infection. By characterizing growth curves and early antiviral responses against a number of recombinant NiVs with genetic modifications altering expression of the proteins encoded by the P gene, we observed that multiple elements encoded by the P gene have both distinct and overlapping roles in modulating virus replication as well as in limiting expression of antiviral mediators such as IFN-β, CXCL10, and CCL5. Our findings corroborate observations from in vivo hamster infection studies, and provide molecular insights into the attenuation and the histopathology observed in hamsters infected with C, V, and W-deficient NiVs. The results of this study also provide an opportunity to verify the results of earlier artificial plasmid expression studies in the context of authentic viral infection.
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Affiliation(s)
- Michael K Lo
- Centers for Disease Control & Prevention, Viral Special Pathogens Branch, Atlanta, Georgia, United States of America.
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24
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Abzug MJ, Qin M, Levin MJ, Fenton T, Beeler JA, Bellini WJ, Audet S, Sowers SB, Borkowsky W, Nachman SA, Pelton SI, Rosenblatt HM. Immunogenicity, immunologic memory, and safety following measles revaccination in HIV-infected children receiving highly active antiretroviral therapy. J Infect Dis 2012; 206:512-22. [PMID: 22693229 DOI: 10.1093/infdis/jis386] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Response rates and immunologic memory following measles vaccination are reduced in human immunodeficiency virus (HIV)-infected children in the absence of highly active antiretroviral therapy (HAART). METHODS HIV-infected children 2 to <19 years old receiving HAART and with HIV loads <30,000 copies/mL, CD4% ≥15, and ≥1 prior measles-mumps-rubella vaccination (MMR) were given another MMR. Measles antibody concentrations before and 8, 32, and 80 weeks postvaccination were determined by plaque reduction neutralization (PRN). A subset was given another MMR 4-5 years later, and PRN antibody was measured before and 7 and 28 days later. RESULTS At entry, 52% of 193 subjects were seroprotected (PRN ≥120 mIU/mL). Seroprotection increased to 89% 8 weeks postvaccination, and remained at 80% 80 weeks postvaccination. Of 65 subjects revaccinated 4-5 years later, 85% demonstrated memory based on seroprotection before or 7 days after vaccination. HIV load ≤400 copies/mL at initial study vaccination was associated with higher seroprotection rates, greater antibody concentrations, and memory. Grade 3 fever or fatigue occurred in 2% of subjects. CONCLUSIONS Measles revaccination induced high rates of seroprotection and memory in children receiving HAART. Both endpoints were associated with HIV viral load suppression. CLINICAL TRIALS REGISTRATION NCT00013871 (www.clinicaltrials.gov).
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Affiliation(s)
- Mark J Abzug
- Pediatric Infectious Diseases, Box B055, Children’s Hospital Colorado, 13123 East 16th Ave, Aurora, CO 80045, USA.
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25
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Lo MK, Lowe L, Hummel KB, Sazzad HMS, Gurley ES, Hossain MJ, Luby SP, Miller DM, Comer JA, Rollin PE, Bellini WJ, Rota PA. Characterization of Nipah virus from outbreaks in Bangladesh, 2008-2010. Emerg Infect Dis 2012; 18:248-55. [PMID: 22304936 PMCID: PMC3310473 DOI: 10.3201/eid1802.111492] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
New genotyping scheme facilitates classification of virus sequences. Nipah virus (NiV) is a highly pathogenic paramyxovirus that causes fatal encephalitis in humans. The initial outbreak of NiV infection occurred in Malaysia and Singapore in 1998–1999; relatively small, sporadic outbreaks among humans have occurred in Bangladesh since 2001. We characterized the complete genomic sequences of identical NiV isolates from 2 patients in 2008 and partial genomic sequences of throat swab samples from 3 patients in 2010, all from Bangladesh. All sequences from patients in Bangladesh comprised a distinct genetic group. However, the detection of 3 genetically distinct sequences from patients in the districts of Faridpur and Gopalganj indicated multiple co-circulating lineages in a localized region over a short time (January–March 2010). Sequence comparisons between the open reading frames of all available NiV genes led us to propose a standardized protocol for genotyping NiV; this protcol provides a simple and accurate way to classify current and future NiV sequences.
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Affiliation(s)
- Michael K Lo
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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26
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Zhang Y, Xu S, Wang H, Zhu Z, Ji Y, Liu C, Zhang X, Sun L, Zhou J, Lu P, Hu Y, Feng D, Zhang Z, Wang C, Fang X, Zheng H, Liu L, Sun X, Tang W, Wang Y, Liu Y, Gao H, Tian H, Ma J, Gu S, Wang S, Feng Y, Bo F, Liu J, Si Y, Zhou S, Ma Y, Wu S, Zhou S, Li F, Ding Z, Yang Z, Rota PA, Featherstone D, Jee Y, Bellini WJ, Xu W. Single endemic genotype of measles virus continuously circulating in China for at least 16 years. PLoS One 2012; 7:e34401. [PMID: 22532829 PMCID: PMC3332093 DOI: 10.1371/journal.pone.0034401] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/27/2012] [Indexed: 11/18/2022] Open
Abstract
The incidence of measles in China from 1991 to 2008 was reviewed, and the nucleotide sequences from 1507 measles viruses (MeV) isolated during 1993 to 2008 were phylogenetically analyzed. The results showed that measles epidemics peaked approximately every 3 to 5 years with the range of measles cases detected between 56,850 and 140,048 per year. The Chinese MeV strains represented three genotypes; 1501 H1, 1 H2 and 5 A. Genotype H1 was the predominant genotype throughout China continuously circulating for at least 16 years. Genotype H1 sequences could be divided into two distinct clusters, H1a and H1b. A 4.2% average nucleotide divergence was found between the H1a and H1b clusters, and the nucleotide sequence and predicted amino acid homologies of H1a viruses were 92.3%-100% and 84.7%-100%, H1b were 97.1%-100% and 95.3%-100%, respectively. Viruses from both clusters were distributed throughout China with no apparent geographic restriction and multiple co-circulating lineages were present in many provinces. Cluster H1a and H1b viruses were co-circulating during 1993 to 2005, while no H1b viruses were detected after 2005 and the transmission of that cluster has presumably been interrupted. Analysis of the nucleotide and predicted amino acid changes in the N proteins of H1a and H1b viruses showed no evidence of selective pressure. This study investigated the genotype and cluster distribution of MeV in China over a 16-year period to establish a genetic baseline before MeV elimination in Western Pacific Region (WPR). Continuous and extensive MeV surveillance and the ability to quickly identify imported cases of measles will become more critical as measles elimination goals are achieved in China in the near future. This is the first report that a single endemic genotype of measles virus has been found to be continuously circulating in one country for at least 16 years.
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Affiliation(s)
- Yan Zhang
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
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Cortese MM, Barskey AE, Tegtmeier GE, Zhang C, Ngo L, Kyaw MH, Baughman AL, Menitove JE, Hickman CJ, Bellini WJ, Dayan GH, Hansen GR, Rubin S. Mumps antibody levels among students before a mumps outbreak: in search of a correlate of immunity. J Infect Dis 2011; 204:1413-22. [PMID: 21933874 DOI: 10.1093/infdis/jir526] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In 2006, a mumps outbreak occurred on a university campus despite ≥ 95% coverage of students with 2 doses of measles-mumps-rubella (MMR) vaccine. Using plasma samples from a blood drive held on campus before identification of mumps cases, we compared vaccine-induced preoutbreak mumps antibody levels between individuals who developed mumps (case patients) and those who did not develop mumps (nonpatients). METHODS Preoutbreak samples were available from 11 case patients, 22 nonpatients who reported mumps exposure but no mumps symptoms, and 103 nonpatients who reported no known exposure and no symptoms. Antibody titers were measured by plaque reduction neutralization assay using Jeryl Lynn vaccine virus and the outbreak virus Iowa-G/USA-06 and by enzyme immunoassay (EIA). RESULTS Preoutbreak Jeryl Lynn virus neutralization titers were significantly lower among case patients than unexposed nonpatients (P = .023), and EIA results were significantly lower among case patients than exposed nonpatients (P = .007) and unexposed nonpatients (P = .009). Proportionately more case patients than exposed nonpatients had a preoutbreak anti-Jeryl Lynn titer < 31 (64% vs 27%, respectively; P = .065), an anti-Iowa-G/USA-06 titer < 8 (55% vs 14%; P = .033), and EIA index standard ratio < 1.40 (64% vs 9%; P = .002) and < 1.71 (73% vs 14%, P = .001). DISCUSSION Case patients generally had lower preoutbreak mumps antibody levels than nonpatients. However, titers overlapped and no cutoff points separated all mumps case patients from all nonpatients.
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Affiliation(s)
- Margaret M Cortese
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia, USA.
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28
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Fowlkes A, Witte D, Beeler J, Audet S, Garcia P, Curns A, Yang C, Fudzulani R, Broadhead R, Bellini WJ, Cutts F, Helfand RF. Persistence of vaccine-induced measles antibody beyond age 12 months: a comparison of response to one and two doses of Edmonston-Zagreb measles vaccine among HIV-infected and uninfected children in Malawi. J Infect Dis 2011; 204 Suppl 1:S149-57. [PMID: 21666156 DOI: 10.1093/infdis/jir135] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previously, we demonstrated that measles antibody prevalence was lower at age 12 months among children infected with human immunodeficiency virus (HIV) than uninfected children following measles vaccination (MV) at ages 6 and 9 months. Among HIV-uninfected children, measles antibody prevalence was lower among 1- than 2-dose MV recipients. Here, we report results through age 24 months. METHODS Children born to HIV-infected mothers received MV at 6 and 9 months, and children of HIV-uninfected mothers were randomized to MV at 6 and 9 months or MV at 9 months. We followed children through age 24 months. The child's HIV status was determined and measles immunoglobulin G (IgG) level was measured by enzyme immunoassay (EIA) and by plaque reduction neutralization (PRN) on a subset. RESULTS Among HIV-uninfected children, the difference in measles antibody prevalence at age 12 months between one- and two-dose recipients reported previously by EIA was shown to be smaller by PRN. By age 24 months, 84% and 87% of HIV-uninfected children receiving 1 or 2 doses, respectively, were seroprotected. Only 41% of 22 HIV-infected children were measles seroprotected at age 20 months. DISCUSSION Measles seroprotection persisted through age 24 months among HIV-uninfected children who received 1 or 2 doses of MV. HIV-infected children demonstrated seroprotection through age 12 months, but this was not sustained.
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Affiliation(s)
- Ashley Fowlkes
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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29
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Hickman CJ, Hyde TB, Sowers SB, Mercader S, McGrew M, Williams NJ, Beeler JA, Audet S, Kiehl B, Nandy R, Tamin A, Bellini WJ. Laboratory characterization of measles virus infection in previously vaccinated and unvaccinated individuals. J Infect Dis 2011; 204 Suppl 1:S549-58. [PMID: 21666212 DOI: 10.1093/infdis/jir106] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Waning immunity or secondary vaccine failure (SVF) has been anticipated by some as a challenge to global measles elimination efforts. Although such cases are infrequent, measles virus (MeV) infection can occur in vaccinated individuals following intense and/or prolonged exposure to an infected individual and may present as a modified illness that is unrecognizable as measles outside of the context of a measles outbreak. The immunoglobulin M response in previously vaccinated individuals may be nominal or fleeting, and viral replication may be limited. As global elimination proceeds, additional methods for confirming modified measles cases may be needed to understand whether SVF cases contribute to continued measles virus (MeV) transmission. In this report, we describe clinical symptoms and laboratory results for unvaccinated individuals with acute measles and individuals with SVF identified during MeV outbreaks. SVF cases were characterized by the serological parameters of high-avidity antibodies and distinctively high levels of neutralizing antibody. These parameters may represent useful biomarkers for classification of SVF cases that previously could not be confirmed as such using routine laboratory diagnostic techniques.
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Affiliation(s)
- Carole J Hickman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Featherstone DA, Rota PA, Icenogle J, Mulders MN, Jee Y, Ahmed H, de Filippis AMB, Ramamurty N, Gavrilin E, Byabamazima C, Dosseh A, Xu W, Komase K, Tashiro M, Brown D, Bellini WJ, Strebel P. Expansion of the global measles and rubella laboratory network 2005-09. J Infect Dis 2011; 204 Suppl 1:S491-8. [PMID: 21666205 DOI: 10.1093/infdis/jir107] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Enhancing measles surveillance with integration of epidemiologic and laboratory information is one of the key strategies for accelerated measles control and elimination. The World Health Organization (WHO) Global Measles and Rubella Laboratory Network (LabNet) has been developed since 2000 to currently include 690 laboratories serving 183 countries. The LabNet testing strategy follows well-validated, standardized procedures for confirming suspected cases and for monitoring measles and rubella virus transmission patterns. The strength of the LabNet is a strong quality assurance program that monitors the performance of all laboratories through annual proficiency testing and continuous assessment. In the 5-year period 2005-2009, the results of >1 million measles immunoglobulin M (IgM) tests have been reported by the LabNet and, in addition, sequence information on >7000 measles and 600 rubella viruses has been shared. Progress with the development of the LabNet during 2005-2009 is discussed.
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Affiliation(s)
- David A Featherstone
- Department of Immunization, Vaccines and Biologicals, Family and Community Health Cluster, World Health Organization (WHO), Geneva, Switzerland.
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31
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Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ. Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission. J Infect Dis 2011; 204 Suppl 1:S559-63. [PMID: 21666213 DOI: 10.1093/infdis/jir098] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In 2009, measles outbreaks in Pennsylvania and Virginia resulted in the exposure and apparent infection of 2 physicians, both of whom had a documented history of vaccination with >2 doses of measles-mumps-rubella vaccine. These physicians were suspected of having been infected with measles after treating patients who subsequently received a diagnosis of measles. The clinical presentation was nonclassical in regard to progression, duration, and severity. It is hypothesized that the 2 physicians mounted vigorous secondary immune responses typified by high avidity measles immunoglobulin G antibody and remarkably high neutralizing titers in response to intense and prolonged exposure to a primary measles case patient. Both of the physicians continued to see patients, because neither considered that they could have measles. Despite surveillance for cases among contacts, including unvaccinated persons, no additional cases were identified.
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Affiliation(s)
- Jennifer S Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Affiliation(s)
- Peter M Strebel
- Accelerated Disease Control, Expanded Programme on Immunization, Dept of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia, CH-1211, Geneva 27, Switzerland.
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Rota PA, Brown KE, Hübschen JM, Muller CP, Icenogle J, Chen MH, Bankamp B, Kessler JR, Brown DW, Bellini WJ, Featherstone D. Improving Global Virologic Surveillance for Measles and Rubella. J Infect Dis 2011; 204 Suppl 1:S506-13. [DOI: 10.1093/infdis/jir117] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rota PA, Brown K, Mankertz A, Santibanez S, Shulga S, Muller CP, Hübschen JM, Siqueira M, Beirnes J, Ahmed H, Triki H, Al-Busaidy S, Dosseh A, Byabamazima C, Smit S, Akoua-Koffi C, Bwogi J, Bukenya H, Wairagkar N, Ramamurty N, Incomserb P, Pattamadilok S, Jee Y, Lim W, Xu W, Komase K, Takeda M, Tran T, Castillo-Solorzano C, Chenoweth P, Brown D, Mulders MN, Bellini WJ, Featherstone D. Global Distribution of Measles Genotypes and Measles Molecular Epidemiology. J Infect Dis 2011; 204 Suppl 1:S514-23. [DOI: 10.1093/infdis/jir118] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Birlea M, Arendt G, Orhan E, Schmid DS, Bellini WJ, Schmidt C, Gilden D, Cohrs RJ. Subclinical reactivation of varicella zoster virus in all stages of HIV infection. J Neurol Sci 2011; 304:22-4. [PMID: 21419427 PMCID: PMC3176733 DOI: 10.1016/j.jns.2011.02.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 02/17/2011] [Accepted: 02/23/2011] [Indexed: 12/30/2022]
Abstract
Analysis of 200 paired serum and cerebrospinal fluid (CSF) samples from 180 HIV-positive individuals, 136 of whom had AIDS, revealed intrathecal synthesis of antibodies specific for varicella zoster virus (VZV) in 28 (16%) individuals, measles virus in 15 (8%), herpes simplex virus-1 (HSV-1) in 1 (0.6%), and HSV-2 in none. Of the 28 subjects with a positive VZV antibody specificity index, only 1 had zoster rash at the time of serum and CSF sampling; of the total 180 HIV-positive subjects, 146 (81%) had no history of zoster. Based on an estimated 33.4 million HIV-positive individuals worldwide, subclinical reactivation of VZV in even less than 16% of HIV-positive people suggests the possibility that millions of people have active VZV infection of the central nervous system. In cases of VZV vasculopathy, myelopathy and even zoster sine herpete, the CSF is often positive for anti-VZV antibody, but negative for VZV DNA. To rule out VZV infection of the nervous system, CSF must be tested for VZV DNA and anti-VZV IgG and IgM antibody.
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Affiliation(s)
- Marius Birlea
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gabriele Arendt
- Department of Neurology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Eser Orhan
- Department of Neurology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - D. Scott Schmid
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Christian Schmidt
- Department of Neurology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Don Gilden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Microbiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Randall J. Cohrs
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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Kutty PK, Kruszon-Moran DM, Dayan GH, Alexander JP, Williams NJ, Garcia PE, Hickman CJ, McQuillan GM, Bellini WJ. Seroprevalence of antibody to mumps virus in the US population, 1999-2004. J Infect Dis 2010; 202:667-74. [PMID: 20662720 DOI: 10.1086/655394] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In 2006, the largest mumps outbreak in the United States in 20 years occurred. To understand prior mumps seroprevalence and factors associated with the presence of antibody to mumps virus, data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed. METHODS A mumps virus-specific enzyme immunoassay was used to measure the seroprevalence of serum immunoglobulin G (IgG) antibody among NHANES participants aged 6-49 years. Participants were grouped on the basis of 10-year birth cohorts, 95% confidence intervals (CIs) were calculated using SUDAAN software, and logistic regression was used to identify independent predictors. RESULTS The overall age-adjusted seroprevalence of IgG antibody to mumps virus during 1999-2004 was 90.0% (95% CI, 88.8%-91.1%). Seroprevalence was higher among US-born non-Hispanic blacks (96.4% [95% CI, 95.5%-97.2%]) and non-US-born Mexican Americans (93.7% [95% CI, 92.0%-95.2%]). Seroprevalence was significantly lower in the 1967-1976 birth cohort (85.7% [95% CI, 83.5%-87.8%]). The variables sex, education, and race/ethnicity/birthplace were independent predictors in at least 1 of the birth cohorts. CONCLUSIONS The overall estimate of 90.0% is at the lower end of the estimated population immunity (90%-92%) needed to achieve herd immunity. Lower seroprevalence among groups suggest that they represent populations at an increased risk. For mumps control, high vaccine coverage and high population immunity must be achieved and maintained.
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Affiliation(s)
- Preeta K Kutty
- Division of Viral Diseases and 2Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
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Kutty PK, Kyaw MH, Dayan GH, Brady MT, Bocchini JA, Reef SE, Bellini WJ, Seward JF. Guidance for isolation precautions for mumps in the United States: a review of the scientific basis for policy change. Clin Infect Dis 2010; 50:1619-28. [PMID: 20455692 DOI: 10.1086/652770] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The 2006 mumps resurgence in the United States raised questions about the appropriate isolation period for people with mumps. To determine the scientific basis for isolation recommendations, we conducted a literature review and considered isolation of virus and virus load in saliva and respiratory secretions as factors that were related to mumps transmission risk. Although mumps virus has been isolated from 7 days before through 8 days after parotitis onset, the highest percentage of positive isolations and the highest virus loads occur closest to parotitis onset and decrease rapidly thereafter. Most transmission likely occurs before and within 5 days of parotitis onset. Transmission can occur during the prodromal phase and with subclinical infections. Updated guidance, released in 2007-2008, changed the mumps isolation period from 9 to 5 days. It is now recommended that mumps patients be isolated and standard and droplet precautions be followed for 5 days after parotitis onset.
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Affiliation(s)
- Preeta K Kutty
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, Georgia, USA.
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Lo MK, Miller D, Aljofan M, Mungall BA, Rollin PE, Bellini WJ, Rota PA. Characterization of the antiviral and inflammatory responses against Nipah virus in endothelial cells and neurons. Virology 2010; 404:78-88. [PMID: 20552729 DOI: 10.1016/j.virol.2010.05.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Nipah virus (NiV) is a highly pathogenic paramyxovirus which causes fatal encephalitis in up to 75% of infected humans. Endothelial cells and neurons are important cellular targets in the pathogenesis of this disease. In this study, viral replication and the innate immune responses to NiV in these cell types were measured. NiV infected endothelial cells generated a functionally robust IFN-beta response, which correlated with localization of the NiV W protein to the cytoplasm. There was no antiviral response detected in infected neuronal cells. NiV infection of endothelial cells induced a significant increase in secreted inflammatory chemokines, which corresponded with the increased ability of infected cell supernatants to induce monocyte and T-lymphocyte chemotaxis. These results suggest that pro-inflammatory chemokines produced by NiV infected primary endothelial cells in vitro is consistent with the prominent vasculitis observed in infections, and provide initial molecular insights into the pathogenesis of NiV in physiologically relevant cells types.
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Affiliation(s)
- Michael K Lo
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Ji Y, Xu S, Zhang Y, Zhu Z, Mao N, Jiang X, Ma C, Lu P, Wang C, Liang Y, Zheng H, Liu Y, Dai D, Zheng L, Zhou J, Wang S, Zhang Z, Wu S, Nan L, Li L, Liang X, Featherstone DA, Rota PA, Bellini WJ, Xu W. Genetic characterization of wild-type measles viruses isolated in China, 2006-2007. Virol J 2010; 7:105. [PMID: 20500809 PMCID: PMC2887432 DOI: 10.1186/1743-422x-7-105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 05/25/2010] [Indexed: 11/10/2022] Open
Abstract
Molecular characterization of wild-type measles viruses in China during 1995-2004 demonstrated that genotype H1 was endemic and widely distributed throughout the country. H1-associated cases and outbreaks caused a resurgence of measles beginning in 2005. A total of 210,094 measles cases and 101 deaths were reported by National Notifiable Diseases Reporting System (NNDRS) and Chinese Measles Laboratory Network (LabNet) from 2006 to 2007, and the incidences of measles were 6.8/100,000 population and 7.2/100,000 population in 2006 and 2007, respectively. Five hundred and sixty-five wild-type measles viruses were isolated from 24 of 31 provinces in mainland China during 2006 and 2007, and all of the wild type virus isolates belonged to cluster 1 of genotype H1. These results indicated that H1-cluster 1 viruses were the predominant viruses circulating in China from 2006 to 2007. This study contributes to previous efforts to generate critical baseline data about circulating wild-type measles viruses in China that will allow molecular epidemiologic studies to help measure the progress made toward China's goal of measles elimination by 2012.
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Affiliation(s)
- Yixin Ji
- WHO WPRO Regional Reference Measles Lab and State Key Laboratory for Molecular Virology & Genetic Engineering, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
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Rota JS, Turner JC, Yost-Daljev MK, Freeman M, Toney DM, Meisel E, Williams N, Sowers SB, Lowe L, Rota PA, Nicolai LA, Peake L, Bellini WJ. Investigation of a mumps outbreak among university students with two measles-mumps-rubella (MMR) vaccinations, Virginia, September-December 2006. J Med Virol 2009; 81:1819-25. [PMID: 19697404 DOI: 10.1002/jmv.21557] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Following the clinical diagnosis of the first case of mumps on September 22, 2006 at the University of Virginia (UVA), 52 suspected cases were identified through active surveillance for mumps by the end of December 2006. Samples were collected from 47 students who presented with parotitis despite a documented history of two doses of measles, mumps, and rubella (MMR) vaccine. Six of 47 serum samples (13%) were positive for mumps IgM, and 46/47 specimens were positive for mumps IgG. Endpoint titration of acute phase serum samples from laboratory-confirmed cases did not provide evidence that elevated serum IgG is a consistent marker for infection among cases due to secondary vaccine failure. Buccal swab samples from 39 of the 47 students were tested by real-time reverse transcription-polymerase chain reaction (RT-PCR) and/or viral culture. Mumps virus or mumps RNA was detected in 12 of 39 buccal samples (31%). Genetic analysis of the virus from the outbreak at UVA indicated that the outbreak was not linked to the large mumps outbreak in the Midwestern US that occurred earlier in 2006. Our findings support the use of viral detection to improve laboratory diagnosis of mumps among persons who have received two doses of MMR.
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Affiliation(s)
- J S Rota
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Ji Y, Zhang Y, Xu S, Zhu Z, Zuo S, Jiang X, Lu P, Wang C, Liang Y, Zheng H, Liu Y, Mao N, Liang X, Featherstone DA, Rota PA, Bellini WJ, Xu W. Measles resurgence associated with continued circulation of genotype H1 viruses in China, 2005. Virol J 2009; 6:135. [PMID: 19737391 PMCID: PMC2759936 DOI: 10.1186/1743-422x-6-135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 09/08/2009] [Indexed: 11/15/2022] Open
Abstract
Measles morbidity and mortality decreased significantly after measles vaccine was introduced into China in 1965. From 1995 to 2004, average annual measles incidence decreased to 5.6 cases per 100,000 population following the establishment of a national two-dose regimen. Molecular characterization of wild-type measles viruses demonstrated that genotype H1 was endemic and widely distributed throughout the country in China during 1995-2004. A total of 124,865 cases and 55 deaths were reported from the National Notifiable Diseases Reporting System (NNDRS) in 2005, which represented a 69.05% increase compared with 2004. Over 16,000 serum samples obtained from 914 measles outbreaks and the measles IgM positive rate was 81%. 213 wild-type measles viruses were isolated from 18 of 31 provinces in China during 2005, and all of the isolates belonged to genotype H1. The ranges of the nucleotide sequence and predicted amino acid sequence homologies of the 213 genotype H1 strains were 93.4%-100% and 90.0%-100%, respectively. H1-associated cases and outbreaks caused the measles resurgence in China in 2005. H1 genotype has the most inner variation within genotype, it could be divided into 2 clusters, and cluster 1 viruses were predominant in China throughout 2005.
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Affiliation(s)
- Yixin Ji
- WHO WPRO Regional Reference Measles Lab and State Key Laboratory for Molecular Virology & Genetic Engineering, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, PR China.
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Zhang Y, Zhou J, Bellini WJ, Xu W, Rota PA. Genetic characterization of Chinese measles vaccines by analysis of complete genomic sequences. J Med Virol 2009; 81:1477-83. [PMID: 19551837 DOI: 10.1002/jmv.21535] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complete genomic sequences of two Chinese measles vaccine viruses, Shanghai-191 (S-191) and Changchun-47 (C-47), were determined and compared to the sequences of other measles vaccine strains as well as the prototype measles strain, Edmonston wild-type (Edwt). Compared to Edwt, S-191 and C-47 had 49 and 43 nucleotide changes, respectively. These differences were found at 52 nucleotide positions that were not found in other vaccine strains. Phylogenetic analysis of the all of the available genomic sequences for measles vaccines showed that S-191 and C-47 were most closely related to the Leningrad-4 strain. S-191 and C-47 shared conserved vaccine virus-specific amino acid changes in the phosphoprotein (P), V, C, matrix (M), and hemagglutinin (H) that could represent important targets for future studies aimed at understanding the molecular basis of attenuation. In addition, S-191 and C-47 had several unique amino acid changes including 13 positions that differed from Edwt. This is the first comparison of the complete genomic sequences of Chinese measles vaccines to the sequences of other vaccine strains.
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Affiliation(s)
- Yan Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention, Beijing, China
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43
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Hyde TB, Nandy R, Hickman CJ, Langidrik JR, Strebel PM, Papania MJ, Seward JF, Bellini WJ. Laboratory confirmation of measles in elimination settings: experience from the Republic of the Marshall Islands, 2003. Bull World Health Organ 2009; 87:93-8. [PMID: 19274360 DOI: 10.2471/blt.07.045484] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 05/26/2008] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To highlight the complications involved in interpreting laboratory tests of measles immunoglobulin M (IgM) for confirmation of infection during a measles outbreak in a highly vaccinated population after conducting a mass immunization campaign as a control measure. METHODS This case study was undertaken in the Republic of the Marshall Islands during a measles outbreak in 2003, when response immunization was conducted. A measles case was defined as fever and rash and one or more of cough, coryza or conjunctivitis. Between 13 July and 7 November 2003, serum samples were obtained from suspected measles cases for serologic testing and nasopharyngeal swabs were taken for viral isolation by reverse transcriptase polymerase chain reaction (RT-PCR). FINDINGS Specimens were collected from 201 suspected measles cases (19% of total): of the ones that satisfied the clinical case definition, 45% were IgM positive (IgM+) and, of these, 24% had received measles vaccination within the previous 45 days (up to 45 days after vaccination an IgM+ result could be due to either vaccination or wild-type measles infection). The proportion of IgM+ results varied with clinical presentation, the timing of specimen collection and vaccination status. Positive results on RT-PCR occurred in specimens from eight IgM-negative and four IgM+ individuals who had recently been vaccinated. CONCLUSION During measles outbreaks, limiting IgM testing to individuals who meet the clinical case definition and have not been recently vaccinated allows for measles to be confirmed while conserving resources.
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Affiliation(s)
- Terri B Hyde
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
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44
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Lo MK, Harcourt BH, Mungall BA, Tamin A, Peeples ME, Bellini WJ, Rota PA. Determination of the henipavirus phosphoprotein gene mRNA editing frequencies and detection of the C, V and W proteins of Nipah virus in virus-infected cells. J Gen Virol 2009; 90:398-404. [PMID: 19141449 DOI: 10.1099/vir.0.007294-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The henipaviruses, Nipah virus (NiV) and Hendra virus (HeV), are highly pathogenic zoonotic paramyxoviruses. Like many other paramyxoviruses, henipaviruses employ a process of co-transcriptional mRNA editing during transcription of the phosphoprotein (P) gene to generate additional mRNAs encoding the V and W proteins. The C protein is translated from the P mRNA, but in an alternate reading frame. Sequence analysis of multiple, cloned mRNAs showed that the mRNA editing frequencies of the P genes of the henipaviruses are higher than those reported for other paramyxoviruses. Antisera to synthetic peptides from the P, V, W and C proteins of NiV were generated to study their expression in infected cells. All proteins were detected in both infected cells and purified virions. In infected cells, the W protein was detected in the nucleus while P, V and C were found in the cytoplasm.
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Affiliation(s)
- Michael K Lo
- The Research Institute at Nationwide Children's Hospital, Center for Vaccines and Immunity, 700 Children's Drive, Columbus, OH 43205, USA.,The Ohio State University, College of Medicine, Department of Pediatrics, Columbus, OH 43205, USA.,Emory University School of Medicine, Department of Microbiology and Immunology, 1510 Clifton Road, Atlanta, GA 30322, USA.,Measles, Mumps, Rubella and Herpesviruses Laboratory Branch, 1600 Clifton Road, MS-C-22, Atlanta, GA 30333, USA
| | - Brian H Harcourt
- Measles, Mumps, Rubella and Herpesviruses Laboratory Branch, 1600 Clifton Road, MS-C-22, Atlanta, GA 30333, USA
| | - Bruce A Mungall
- Commonwealth Scientific Industrial Research Organization, Australian Animal Health Laboratory, 5 Portarlington Road, East Geelong, Victoria, Australia
| | - Azaibi Tamin
- Measles, Mumps, Rubella and Herpesviruses Laboratory Branch, 1600 Clifton Road, MS-C-22, Atlanta, GA 30333, USA
| | - Mark E Peeples
- The Ohio State University, College of Medicine, Department of Pediatrics, Columbus, OH 43205, USA.,The Research Institute at Nationwide Children's Hospital, Center for Vaccines and Immunity, 700 Children's Drive, Columbus, OH 43205, USA
| | - William J Bellini
- Measles, Mumps, Rubella and Herpesviruses Laboratory Branch, 1600 Clifton Road, MS-C-22, Atlanta, GA 30333, USA
| | - Paul A Rota
- Measles, Mumps, Rubella and Herpesviruses Laboratory Branch, 1600 Clifton Road, MS-C-22, Atlanta, GA 30333, USA
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45
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Tamin A, Harcourt BH, Lo MK, Roth JA, Wolf MC, Lee B, Weingartl H, Audonnet JC, Bellini WJ, Rota PA. Development of a neutralization assay for Nipah virus using pseudotype particles. J Virol Methods 2009; 160:1-6. [PMID: 19559943 DOI: 10.1016/j.jviromet.2009.02.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 02/22/2009] [Accepted: 02/24/2009] [Indexed: 01/25/2023]
Abstract
Nipah virus (NiV) and Hendra virus (HeV) are zoonotic paramyxoviruses capable of causing severe disease in humans and animals. These viruses require biosafety level 4 (BSL-4) containment. Like other paramyxoviruses, the plaque reduction neutralization test (PRNT) can be used to detect antibodies to the surface glycoproteins, fusion (F) and attachment (G), and PRNT titers give an indication of protective immunity. Unfortunately, for NiV and HeV, the PRNT must be performed in BSL-4 containment and takes several days to complete. Thus, we have developed a neutralization assay using VSV pseudotype particles expressing the F and G proteins of NiV (pVSV-NiV-F/G) as target antigens. This rapid assay, which can be performed at BSL-2, was evaluated using serum samples from outbreak investigations and more than 300 serum samples from an experimental NiV vaccination study in swine. The results of the neutralization assays with pVSV-NiV-F/G as antigen showed a good correlation with those of standard PRNT. Therefore, this new method has the potential to be a rapid and cost-effective diagnostic method, especially in locations that lack high containment facilities, and will provide a valuable tool for basic research and vaccine development.
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Affiliation(s)
- Azaibi Tamin
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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Abstract
Genetic characterization of wild-type measles viruses provides a means to study the transmission pathways of the virus and is an essential component of laboratory-based surveillance. Laboratory-based surveillance for measles and rubella, including genetic characterization of wild-type viruses, is performed throughout the world by the WHO Measles and Rubella Laboratory Network, which serves 166 countries in all WHO regions. In particular, the genetic data can help confirm the sources of virus or suggest a source for unknown-source cases as well as to establish links, or lack thereof, between various cases and outbreaks. Virologic surveillance has helped to document the interruption of transmission of endemic measles in some regions. Thus, molecular characterization of measles viruses has provided a valuable tool for measuring the effectiveness of measles control programs, and virologic surveillance needs to be expanded in all areas of the world and conducted during all phases of measles control.
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Affiliation(s)
- P A Rota
- Measles, Mumps, Rubella and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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47
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Sui J, Aird DR, Tamin A, Murakami A, Yan M, Yammanuru A, Jing H, Kan B, Liu X, Zhu Q, Yuan QA, Adams GP, Bellini WJ, Xu J, Anderson LJ, Marasco WA. Broadening of neutralization activity to directly block a dominant antibody-driven SARS-coronavirus evolution pathway. PLoS Pathog 2008; 4:e1000197. [PMID: 18989460 PMCID: PMC2572002 DOI: 10.1371/journal.ppat.1000197] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/09/2008] [Indexed: 01/01/2023] Open
Abstract
Phylogenetic analyses have provided strong evidence that amino acid changes in spike (S) protein of animal and human SARS coronaviruses (SARS-CoVs) during and between two zoonotic transfers (2002/03 and 2003/04) are the result of positive selection. While several studies support that some amino acid changes between animal and human viruses are the result of inter-species adaptation, the role of neutralizing antibodies (nAbs) in driving SARS-CoV evolution, particularly during intra-species transmission, is unknown. A detailed examination of SARS-CoV infected animal and human convalescent sera could provide evidence of nAb pressure which, if found, may lead to strategies to effectively block virus evolution pathways by broadening the activity of nAbs. Here we show, by focusing on a dominant neutralization epitope, that contemporaneous- and cross-strain nAb responses against SARS-CoV spike protein exist during natural infection. In vitro immune pressure on this epitope using 2002/03 strain-specific nAb 80R recapitulated a dominant escape mutation that was present in all 2003/04 animal and human viruses. Strategies to block this nAb escape/naturally occurring evolution pathway by generating broad nAbs (BnAbs) with activity against 80R escape mutants and both 2002/03 and 2003/04 strains were explored. Structure-based amino acid changes in an activation-induced cytidine deaminase (AID) “hot spot” in a light chain CDR (complementarity determining region) alone, introduced through shuffling of naturally occurring non-immune human VL chain repertoire or by targeted mutagenesis, were successful in generating these BnAbs. These results demonstrate that nAb-mediated immune pressure is likely a driving force for positive selection during intra-species transmission of SARS-CoV. Somatic hypermutation (SHM) of a single VL CDR can markedly broaden the activity of a strain-specific nAb. The strategies investigated in this study, in particular the use of structural information in combination of chain-shuffling as well as hot-spot CDR mutagenesis, can be exploited to broaden neutralization activity, to improve anti-viral nAb therapies, and directly manipulate virus evolution. The SARS-CoV caused a worldwide epidemic of SARS in 2002/03 and was responsible for this zoonotic infectious disease. The role of neutralizing antibody (nAb) mediated immune pressure in the evolution of SARS-CoV during the 2002/03 outbreak and a second 2003/04 zoonotic transmission is unknown. Here we demonstrate nAb responses elicited during natural infection clearly have strain-specific components which could have been the driving force for virus evolution in spike protein during intra-species transmission. In vitro immune pressure using 2002/03 strain-specific nAb 80R recapitulate a dominant escape mutation that was present in all 2003/04 animal and human viruses. We investigated how to generate a single broad nAb (BnAb) with activity against various natural viral variants of the 2002/03 and 2003/04 outbreaks as well as nAb escape mutants. Remarkably, amino acid changes in an activation-induced cytidine deaminase (AID) “hot spot” of somatic hypermutation and localized to a single VL CDR were successful in generating BnAbs. These results provide an effective strategy for generating BnAbs that should be generally useful for improving immune based anti-viral therapies as well as providing a foundation to directly manipulate virus evolution by blocking escape pathways.
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Affiliation(s)
- Jianhua Sui
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (JS); (WAM)
| | - Daniel R. Aird
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Azaibi Tamin
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Akikazu Murakami
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Meiying Yan
- State Key Laboratory for Infectious Disease Prevention and Control and National Institute for Communicable Disease Control and Prevention; Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Anuradha Yammanuru
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Huaiqi Jing
- State Key Laboratory for Infectious Disease Prevention and Control and National Institute for Communicable Disease Control and Prevention; Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Biao Kan
- State Key Laboratory for Infectious Disease Prevention and Control and National Institute for Communicable Disease Control and Prevention; Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Xin Liu
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Quan Zhu
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Qing-an Yuan
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - Gregory P. Adams
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - William J. Bellini
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jianguo Xu
- State Key Laboratory for Infectious Disease Prevention and Control and National Institute for Communicable Disease Control and Prevention; Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Larry J. Anderson
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Wayne A. Marasco
- Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (JS); (WAM)
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Bankamp B, Fontana JM, Bellini WJ, Rota PA. Adaptation to cell culture induces functional differences in measles virus proteins. Virol J 2008; 5:129. [PMID: 18954437 PMCID: PMC2582235 DOI: 10.1186/1743-422x-5-129] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 10/27/2008] [Indexed: 11/10/2022] Open
Abstract
Background Live, attenuated measles virus (MeV) vaccine strains were generated by adaptation to cell culture. The genetic basis for the attenuation of the vaccine strains is unknown. We previously reported that adaptation of a pathogenic, wild-type MeV to Vero cells or primary chicken embryo fibroblasts (CEFs) resulted in a loss of pathogenicity in rhesus macaques. The CEF-adapted virus (D-CEF) contained single amino acid changes in the C and matrix (M) proteins and two substitutions in the shared amino terminal domain of the phosphoprotein (P) and V protein. The Vero-adapted virus (D-VI) had a mutation in the cytoplasmic tail of the hemagglutinin (H) protein. Results In vitro assays were used to test the functions of the wild-type and mutant proteins. The substitution in the C protein of D-CEF decreased its ability to inhibit mini-genome replication, while the wild-type and mutant M proteins inhibited replication to the same extent. The substitution in the cytoplasmic tail of the D-VI H protein resulted in reduced fusion in a quantitative fusion assay. Co-expression of M proteins with wild-type fusion and H proteins decreased fusion activity, but the mutation in the M protein of D-CEF did not affect this function. Both mutations in the P and V proteins of D-CEF reduced the ability of these proteins to inhibit type I and II interferon signaling. Conclusion Adaptation of a wild-type MeV to cell culture selected for genetic changes that caused measurable functional differences in viral proteins.
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Affiliation(s)
- Bettina Bankamp
- Measles, Mumps, Rubella and Herpesvirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, MS C-22, 1600 Clifton Road, Atlanta, Georgia 30333, USA.
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Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, Siemetzki U, Hummel K, Rota PA, Bellini WJ, O'Leary JJ, Sheils O, Alden E, Pickering L, Lipkin WI. Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLoS One 2008; 3:e3140. [PMID: 18769550 PMCID: PMC2526159 DOI: 10.1371/journal.pone.0003140] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Accepted: 08/08/2008] [Indexed: 11/18/2022] Open
Abstract
Background The presence of measles virus (MV) RNA in bowel tissue from children with autism spectrum disorders (ASD) and gastrointestinal (GI) disturbances was reported in 1998. Subsequent investigations found no associations between MV exposure and ASD but did not test for the presence of MV RNA in bowel or focus on children with ASD and GI disturbances. Failure to replicate the original study design may contribute to continued public concern with respect to the safety of the measles, mumps, and rubella (MMR) vaccine. Methodology/Principal Findings The objective of this case-control study was to determine whether children with GI disturbances and autism are more likely than children with GI disturbances alone to have MV RNA and/or inflammation in bowel tissues and if autism and/or GI episode onset relate temporally to receipt of MMR. The sample was an age-matched group of US children undergoing clinically-indicated ileocolonoscopy. Ileal and cecal tissues from 25 children with autism and GI disturbances and 13 children with GI disturbances alone (controls) were evaluated by real-time reverse transcription (RT)-PCR for presence of MV RNA in three laboratories blinded to diagnosis, including one wherein the original findings suggesting a link between MV and ASD were reported. The temporal order of onset of GI episodes and autism relative to timing of MMR administration was examined. We found no differences between case and control groups in the presence of MV RNA in ileum and cecum. Results were consistent across the three laboratory sites. GI symptom and autism onset were unrelated to MMR timing. Eighty-eight percent of ASD cases had behavioral regression. Conclusions/Significance This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Autism with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.
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Affiliation(s)
- Mady Hornig
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- * E-mail: (MH); (WIL)
| | - Thomas Briese
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Timothy Buie
- Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Margaret L. Bauman
- Department of Neurology, Harvard Medical School and Departments of Neurology and Pediatrics and Learning and Developmental Disabilities Evaluation and Rehabilitation Services (LADDERS), Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Gregory Lauwers
- Department of Pathology of Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Ulrike Siemetzki
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Kimberly Hummel
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Paul A. Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - William J. Bellini
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - John J. O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Orla Sheils
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Errol Alden
- American Academy of Pediatrics, Elk Grove Village, Illinois, United States of America
| | - Larry Pickering
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - W. Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- * E-mail: (MH); (WIL)
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Date AA, Kyaw MH, Rue AM, Klahn J, Obrecht L, Krohn T, Rowland J, Rubin S, Safranek TJ, Bellini WJ, Dayan GH. Long-term persistence of mumps antibody after receipt of 2 measles-mumps-rubella (MMR) vaccinations and antibody response after a third MMR vaccination among a university population. J Infect Dis 2008; 197:1662-8. [PMID: 18419346 DOI: 10.1086/588197] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND High attack rates among vaccinated young adults reported during the 2006 mumps outbreak in the United States heightened concerns regarding mumps vaccine failure. METHODS Serum specimens from university students and staff were tested for mumps immunoglobulin (Ig) G by enzyme immunoassay (EIA). A subset of participants vaccinated for < or =5 years and > or =15 years were tested by neutralizing antibody (NA) assay. Persons seronegative by EIA were offered a third dose of measles-mumps-rubella vaccine (MMR3), and serum specimens were obtained 7-10 days and 2-3 months after its administration. RESULTS Overall, 94% (95% confidence interval [CI], 91%-96%) of the 440 participants were seropositive. No differences existed in seropositivity rates by sex, age, age at receipt of the second dose of MMR vaccine (MMR2), or time since receipt of MMR2 (P = .568). The geometric mean titer (GMT) of NA among persons vaccinated with MMR2 during the previous 1-5 years was 97 (95% CI, 64-148), whereas, among those vaccinated > or =15 years before blood collection, the GMT was 58 (95% CI, 44-76) (P = .065). After MMR3, 82% (14/17) and 91% (10/11) seroconverted in 7-10 days and 2-3 months, respectively. CONCLUSIONS Lower levels of NA observed among persons who received MMR2 > or =15 years ago demonstrates antibody decay over time. MMR3 vaccination of most seronegative persons marked the capacity to mount an anamnestic response.
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Affiliation(s)
- Anand A Date
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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