Atypical measles

Haas EJ, et al. Atypical measles 14 years after immunization. JAMA. 1976 Aug 30;236(9):1050. No abstract available. PMID: 989583; UI: 77009302. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=989583&form=6&db=m&Dopt=b

Atypical measles

#The first measles vaccine that came out for use in the 70's (?) was a killed or inactivated vaccine. This vaccine produced atypical measles when a vaccinee was later exposed to the wild virus. Different kind of rash, odd manifestations but with high titres indicative of measles infection.

They stopped using this vaccine because of this. So a lot of the older journal articles explaining atypical measles are talking about it in the context of this old vaccine.

The new live vaccine doesn't have this atypical presentation, at least in the way the old killed vaccine did. These days atypical or non-normal measles cases are defined by a lack of rash, but sign of infection with measles virus, like the abstract I provide below.

Acta Paediatr Jpn 1995 Jun;37(3):374-6

Measles encephalomyelitis in a patient with a history of vaccination.

Matsuzono Y, Narita M, Satake A, Togashi T, Itakura O, Ozutsumi K, Iguchi M

Department of Pediatrics, Hokkaido University, School of Medicine, Sapporo, Japan.

Secondary vaccine failure (SVF) of measles is generally believed to run a milder course of illness than an ordinary course of infection. Severe complications such as central nervous system involvement have rarely been reported. A 12 year old girl, who had received a live attenuated measles vaccine 10 years earlier, developed an encephalomyelitis in the absence of symptoms indicative of ordinary measles such as Koplik spots. Anti-measles hemagglutination inhibition (HI) titer and measles IgM and IgG antibody titers were measured in a commercial laboratory. Measles virus genomic sequence was detected by polymerase chain reaction. Both serum and cerebrospinal fluid (CSF) samples obtained at acute phase already showed extremely high titers
of HI (x8192 in serum and x1024 in CSF, respectively) and IgG antibody along with the presence of IgM antibody.
Polymerase chain reaction detected the measles virus genomic sequence in the acute phase CSF. The patient's definite history of measles vaccination, high titers of HI and IgG antibodies observed at the very early stage of illness and the clinical course indicated that this patient has an encephalomyelitis due to SVF of measles. It is suggested that measles virus can be a pathogen of encephalitis without symptoms indicative of ordinary measles in individuals who received live attenuated measles vaccines.

PMID: 7645392, UI: 95373329

Source--AVN list