Should women be treated with testosterone?

BACKGROUND: This study was done to determine antibodies to measles, mumps, and rubella within the first 2 weeks of life and 3 months of age in premature infants. METHODS: All premature infants (< 32 weeks' gestation) weighing less than 1,000 g and admitted to the neonatal intensive care unit were eligible for inclusion in the study. Measles, mumps, and rubella titers were obtained from the mother and from the infant during the first 2 weeks of life and at 3 months of age. RESULTS: A total of 44 maternal-infant pairs were enrolled. At birth, 45% of the infants were seronegative for measles, 55% for mumps, and 48% for rubella. Maternal samples revealed seronegativity in 14%, 3%, and 17%, respectively. By 3 months of age, 100% of infants were seronegative for mumps and rubella, and 94% were seronegative for measles. CONCLUSIONS: The majority of prematurely born infants are seronegative for measles, mumps, and rubella by 3 months of age and therefore are presumably susceptible to infection during the first year of life.     

The synaptology of 2 types of neurons in the sympathetic ganglia of the frog

In 1996 the immunization of children against measles, mumps and rubella with combined vaccine Trimovax ("Pasteur Mérieux Connaught", France) was carried out in the Republic of Belarus. The reactogenicity of the vaccine was studied in 372 children. To evaluate immunological effectiveness, the sera of 324 children were used. Postvaccinal reactions of different intensity were registered in 5.6% of the children; of these, 1.3% exhibited severe reactions. Among the vaccinees, protective titers of antibodies to measles were found in 97.6% to mumps, in 93.8% and to rubella, in 96.0% of the children. Antibodies to all three components of the vaccine were present mainly in high and moderate titers. The results thus obtained indicate that, Trimovax was well tolerated and proved to be immunologically active.     

The risk of measles, mumps, and varicella among young adults: a serosurvey of US Navy and Marine Corps recruits

OBJECTIVES: To assess the risk of epidemic transmission and to guide immunization policy, the seroprevalence of antibody to measles, mumps, and varicella was determined in a group of young adults. METHODS: A cross-sectional study of 1533 US Navy and Marine Corps recruits was conducted in June 1989. Antibody status was determined with commercially available enzyme-linked immunosorbent assays. RESULTS: Direct sex and race adjustment to the 15- to 29-year-old US population resulted in seronegativity rates of 17.8% for measles, 12.3% for mumps, and 6.7% for varicella. Measles and mumps seronegativity rates were higher among Whites whereas varicella seronegativity was higher among non-Whites. Recruits enlisting from outside the 50 US states, especially those from island territories, were more likely to lack varicella antibody. The sensitivity of a positive history of vaccination or disease in predicting antibody status was less than 90% for all diseases. CONCLUSIONS: These results suggest a continued potential for epidemics, especially of measles, and the need for mandatory immunization policies. Immigrants to the United States, especially those from island territories, may be a high-risk group that could benefit from varicella vaccination.     

Mumps epidemic in vaccinated children in West Switzerland

Since 1991, 6 years after the recommendation of universal childhood vaccination against measles, mumps, and rubella (MMR triple vaccine), Switzerland is confronted with a large number of mumps cases affecting both vaccinated and unvaccinated children. Up to 80% of the children suffering from mumps between 1991 and 1995 had previously been vaccinated, the majority with the Rubini vaccine strain. On the basis of a case-control study including 102 patients and 92 controls from the same pediatric population, a study of the humoral immune-response following vaccination with the Rubini vaccine in 6 young adult volunteers, and two different genetic studies, we investigated the complex problem of large scale vaccine failure in Switzerland. We conclude that the recently reported large number of Swiss mumps cases was caused by at least four interacting factors: 1. A vaccine coverage of 90-95% at the age of 2 years is necessary to interrupt mumps wild virus circulation. The nationwide vaccine coverage in Switzerland of some 80% in 27-36 month-old children is too low. 2. Primary vaccine failures (absence of seroconversion or unprotective low levels of neutralizing antibodies), as well as secondary vaccine failures due to the rapid decline of antibodies to mumps virus in our volunteers and controls, seem to be frequent after vaccination with the Rubini strain. 3. Despite its reported Swiss origin, the Rubini strain does not belong to the mumps virus lineages recently circulating in this area but is closely related to American mumps virus strains. 4. Differences in protein structure between the vaccine strain and the circulating wild type strains, and in particular a different neutralization epitope in the hemagglutinin neuraminidase protein, may additionally contribute to the lack of protection in vaccinated individuals.     

Age-related seroprevalence of measles, mumps and rubella antibodies in 1996

In 1996 the effects on the immunity profile of a Swiss population exposed to MMR vaccination, which has been recommended since 1985, were evaluated with an age-stratified seroprevalence study for measles, mumps and rubella (MMR). At the age of 1.5-2.5 years, seroprevalence attained 76% for measles and rubella, which is respectively 17% and 24% above the values observed in 1992. The seroprevalence for mumps attained only 55% at the same age, which could reflect the poor immunogenicity of this component of the MMR vaccine. The seroprevalence for measles IgG showed a slow but steady increase from vaccination age to adulthood, attaining nearly 100%. The concentrations of measles IgG were about 700 IU/l into adolescence and rose to a plateau at about 1500 IU/l during young adulthood. These observations are compatible with low endemic activity of measles in the last 20 years and a predominance of vaccine-induced immunity up to about 20 years of age. This corresponds to the time period when measles vaccines--single or as MMR--have been in use. In 1992, at the peak of epidemic activity, seroprevalence for mumps rose substantially faster than in 1996. In addition, the rapid increase in quantitative values during preschool age mirrors the ongoing wild virus circulation with minimal vaccine effect. In the vaccine cohort (2-12 years of age) the seroprevalence of rubella IgG reached 70-80%. That there is no rise in the curve during school age shows that the recommended catch-up vaccinations before or during school age have been neglected. The median concentrations of rubella IgG were about 65 IU/ml at vaccination, declined to 40-50 IU/ml during preschool age, and rose again during school age, suggesting wild virus circulation. These data show that the MMR vaccine cover in Swiss children is insufficient to interrupt virus circulation, and administration of a second dose of MMR for catch-up immunisation has been omitted. The poor efficacy of the mumps component of the MMR vaccine that has mainly been used in Switzerland is also evident. The average age at infection is therefore expected to rise, thus involving a risk of increasing age-dependent complications. Efforts to implement the MMR vaccination program in Switzerland should be improved.     

Seroepidemiology of measles, mumps and rubella virus infections in normal children and adults in southern Granada, Spain: response to a vaccination programme

A seroepidemiological study of measles, mumps and rubella virus infection in normal children and adults in southern Granada, Spain, and the response to a vaccination programme was carried out. Protection from the mumps and rubella virus was reduced in the group of 3 to 7 year-old children vaccinated at age 15 months indicating the need for revaccination against rubella as well as the mumps virus.     

Routine immunization of infants in the Canton of Zurich

At present there is a shortage of data regarding the rate of routine immunization in Swiss children. To address this deficit, a representative cross sectional study was conducted in the Canton of Zurich with 210 children aged between 24 and 36 months. Data was taken from the individual official vaccination certificates. 178 vaccination certificates (55.1% female and 44.9% male) were evaluated, corresponding to a response rate of 84.8%. With children of foreign nationalities, the response rate was 66.7%, whereas the response rate of Swiss children was 90.6% (p < 0.001). The response rate of children of a European nationality outside the European Union was especially poor (33.3%). The immunization rate with three doses of diphtheria, tetanus and poliomyelitis vaccines was 99.4%, and that of the pertussis vaccine was 93.3%. With the vaccines for measles, mumps and rubella the rates were 80.3%, 78.1% and 77.5% respectively. Vaccination rate against Haemophilus influenzae type B was 74.7% with two doses, and 61.2% with three doses. The timing and the number of doses of the vaccines used for infants in the Canton of Zurich were satisfactory. However, the vaccination rate for measles, mumps and rubella is inadequate. Attention should be paid to this problem and also to possible insufficient care of foreign children.     

Seroconversion of a trivalent measles, mumps, and rubella vaccine in children aged 9 and 15 months

The serological response to MMR vaccine was evaluated in 109 9-month-old infants having no history of measles vaccination, and in 98 15-month-old children who had received monocomponent measles immunisation at 9 months. The combined vaccine contained Schwarz, Urabe Am9, and Wistar RA 27/3 live attenuated virus strains. Preimmunisation antibody levels were extremely low for the 9-month-old children, indicating that maternally-transmitted antibodies do not persist at this age. In the case of mumps, preimmunisation antibody levels were significantly higher in the 15-month-old than in the 9-month-old group. A difference between groups in terms of postimmunisation antibody titres was observed only for rubella, with titres being significantly higher in the older group. Seroconversion rates were high in both groups and no serious events attributable to vaccination were observed. The MMR vaccine can thus be administered to children as young as 9 months of age. Evidence for the efficacy of a two-dose schedule, i.e. at 9 and 15 months, is presented.     

Persistence of anti-mumps virus antibodies after a two-dose MMR vaccination. A nine-year follow-up

A two-dose vaccination program against measles, mumps, and rubella (MMR) viruses was started in Finland in 1982. In this program the trivalent MMR-II vaccine (MSD, USA) was offered to children at the ages of 14-18 months and 6 years followed by revaccination 4-5 years later. The vaccination coverage has been high (97%) and MMR infections have practically been eliminated in the Finnish population. In a serological follow-up program sequential serum samples were obtained from 254 children (127 14-18-month-old vaccinees and 127 6-year-old vaccinees) during a 9-year follow-up period. Anti-mumps virus antibody titers were determined by enzyme immunoassay using purified whole mumps viruses as the antigen. In seronegative (n = 120) 14-18-month-old vaccinees the seroconversion rate was 86% (geometric mean titer 1/1670 +/- 1/270). The antibody levels fell rapidly (significance p < 0.01) within the first year of follow-up (mean titer 1/1080 +/- 1/190), but remained relatively stable in subsequent years. After revaccination the seropositivity rate was 95% (mean titer 1/2310 +/- 1/260) and declined more slowly thereafter to 86% (mean titer 1/1510 +/- 1/210) at year 9 of follow-up. The mean antibody titer was significantly (p < 0.05) higher 4 years after the second MMR vaccination when compared with the corresponding time point after the first vaccination. In 6-year-old seronegative vaccinees the increase and decay of anti-mumps virus antibodies after the first MMR vaccination was similar to that seen in the group of younger vaccinees. A two-dose MMR vaccination protocol resulted in a high mumps immunity level in the vaccinated population.     

Two monoclonal antibodies from the platelet panel recognize sheep plasma fibrinogen

PCR techniques were applied for the detection of mycoplasma DNA and pestivirus RNA to 43 lots of live viral vaccines (measles, mumps, rubella, and oral poliomyelitis) produced by six manufacturers in Japan. Although mycoplasma DNA was not detected in any of the vaccines tested, pestivirus RNA was detected in 12 lots (28%). The incidence of contamination among the four viral vaccines was in the range of 20 to 37%, and the incidence among the six manufacturers varied from 0 to 56%.     

The modification in measles vaccination age as a consequence of the earlier decline of transplacentally transferred antimeasles antibodies in Turkish infants

The maternal antibodies are gradually decreased at 9 to 12 months in infants. We determined the elimination period of maternal measles antibodies in 34 infants whose mothers had had a history of natural measles previously. Seropositivity rates at sixth and nine months of age were found to be 61.8% and 3.4%, respectively. The very low passive antibody at nine months of age may suggest the measles vaccination could be carried out earlier than just before the critical age of antibody level.     

Osteopetrosis in the IA rat cured by spleen cells from a normal littermate

The Clausen modification of the peripheral blood buffy coat leukocyte migration test was used to test patients with multiple sclerosis, normal subjects and patients with other neurologic diseases for cell-mediated immunity to commercial measles virus, purified nuclear core material from a human neurotropic strain of measles virus, as well as to commercial preparations of rubella, mumps and parainfluenza HA2. Leukocytes of multiple sclerosis patients showed significantly less mean inhibition of migration in the presence of both measles antigens, mumps and parainfluenza but no difference from controls when incubated with rubella. No correlation could be found between the degree of migration inhibition and concomitant serum anti-measles neutralization antibody titers to the same strain of virus. The use of purified viral antigens might result in more meaningful studies of the status of cellmediated immunity to viral antigens in multiple sclerosis. The relationship of our findings to other studies in this area and to the pathogenesis of multiple sclerosis is discussed.     

Antibodies against the measles matrix polypeptide after clinical infection and vaccination

Sera from patients exposed to measles virus were investigated for the presence of antibodies against each of the viral antigens. All sera with measurable neutralizing titers contained antibodies against the two surface proteins (the glycoprotein and fusion protein), the nucleocapsid protein, and one of the internal proteins (P2). However, only sera from individuals with clinical symptoms of measles infection (natural measles and atypical measles) contained antibodies against the measles virus matrix protein. Levels of matrix-specific antibodies were highest in patients with atypical measles infection.     

Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP)

These revised recommendations of the Advisory Committee on Immunization Practices (ACIP) on measles, mumps, and rubella prevention supersede recommendations published in 1989 and 1990. This statement summarizes the goals and current strategies for measles, rubella, and congenital rubella syndrome (CRS) elimination and for mumps reduction in the United States. Changes from previous recommendations include: Emphasis on the use of combined MMR vaccine for most indications; A change in the recommended age for routine vaccination to 12-15 months for the first dose of MMR, and to 4-6 years for the second dose of MMR; A recommendation that all states take immediate steps to implement a two dose MMR requirement for school entry and any additional measures needed to ensure that all school-aged children are vaccinated with two doses of MMR by 2001; A clarification of the role of serologic screening to determine immunity; A change in the criteria for determining acceptable evidence of rubella immunity; A recommendation that all persons who work in health-care facilities have acceptable evidence of measles and rubella immunity; Changes in the recommended interval between administration of immune globulin and measles vaccination; and Updated information on adverse events and contraindications, particularly for persons with severe HIV infection, persons with a history of egg allergy or gelatin allergy, persons with a history of thrombocytopenia, and persons receiving steroid therapy.     

Antisense-mediated resistance to measles virus infection in HeLa cells

Endogenous expression of antisense RNA in transfected cells has been explored for use in blocking cellular gene expression and for its antiviral potential. Antisense strategies were used with the goal of blocking measles virus (MV) infection. A recombinant expression plasmid was designed to produce antisense oligonucleotides targeted to the 5' end of the MV nucleocapsid protein mRNA. This construct was transfected into HeLa cells. The transfected cell line and a control cell line expressing a random RNA comprising the same nucleotides were infected with MV and assessed for viral resistance by observation of cytopathic effect (CPE); infectious virus was quantified by viral plaque assay. Both cell lines were also infected with a related paramyxovirus, mumps virus, as a specificity control. Both CPE and infectious virus were reduced by approximately 90% in the antisense-expressing line compared with that in control cells or transfectant cells expressing random RNA. There was no evidence of resistance to infection with mumps virus in any cell line.     

Vaccination status of children in the Vienna area (author's transl)

The vaccination status was investigated in 1482 patients between the ages of 1 and 14 years admitted to hospital with scarlet fever. Most of the patients were vaccinated against tuberculosis (97.7%), diphtheria, tetanus and whooping-cough (95.3%) and poliomyelitis (94.1%), relatively few against measles (21.1%) and very few indeed against mumps (0.7%) and tick-borne encephalitis (1.9%). The booster vaccination against tetanus and diphtheria had been omitted in more than 40%. Although the beneficial results of vaccination against tuberculosis, diphtheria-pertussis-tetanus and poliomyelitis remained more or less the same, the tendency towards vaccination did not spread as might have been anticipated. On the contrary, the extent of vaccination decreased, especially during the past years. In the same way the tendency towards vaccination against measles showed a sudden slowing down after a period of rapid increase. This implies that vaccination of children does not tend towards perfection. The vaccination rates differ widely between foreign children living in Vienna and natives. Although the foreigners show a similar vaccination distribution pattern as the natives, the numbers of unvaccinated children are much higher.     

Oligoclonal measles virus-specific IgG antibodies isolated from cerebrospinal fluids, brain extracts, and sera from patients with subacute sclerosing panencephalitis and multiple sclerosis

Measles virus-specific antibodies were isolated from sera, cerebrospinal fluids (CSF), and brain extracts of patients with subacute sclerosing panencephalitis (SSPE) and multiple sclerosis (MS) by absorption with measles antigens and subsequent acid elution of the antigen-antibody precipitates. Electrophoretically homogeneous measles antibodies were isolated from CSF or brain extracts in five patients with SSPE and in five out of seven patients with MS. Homogeneous IgG antibodies were also demonstrated in the sera from all SSPE patients and from three of the MS patients. The antibodies isolated from various control sera and from pooled CSF were electrophoretically heterogeneous. The results support the concept of a local synthesis in the nervous system of oligoclonal IgG antibodies to measles virus in all patients with SSPE and in some patients with MS. In SSPE, most or all oligoclonal IgG proteins of the CSF or brain carry measles antibody activities. In MS, only part of the oligoclonal IgG appears to be associated with measles antibody activity.     

Susceptibility to measles, rubella and parotitis in young adults

BACKGROUND: The aim of this study was to know the prevalence of antibodies against measles, rubella and parotiditis in young adults. METHODS: The study was carried out in health care students during the academic year of 1992-1993. Demographic and geographic variables were obtained as were vaccination and history of diseases. Antibodies against measles, rubella, and parotiditis were determined by ELISA techniques with commercial reagents. RESULTS: Three hundred and six individuals of 21.3 +/- 2.2 years (range 17-36 years) with 27.5% being males were studied. Past history of measles, rubella and parotiditis was reported in 43.5, 30.7 and 37.3%, respectively, with vaccination being 23.2, 43.8 and 20.6%, respectively. The prevalence of antibodies was 93.1% (measles), 96.4% (rubella) and 92.1% (parotiditis). CONCLUSIONS: The prevalence of infection of measles, rubella and parotiditis in the young population studied is mainly due to infection by wild type virus. The foreseeable growth of susceptibility groups in this population which should be adequately evaluated by extensive seroepidemiologic questionnaires, favors the appearance of epidemic outbreaks. The use of the triple viral vaccine is suggested as an alternative to rubella vaccination in presumable susceptible young women.     

Identification of paramyxovirus-specific haemolysis-inhibiting antibodies separate from haemagglutinating-inhibiting and neuraminidase-inhibiting antibodies. 2. NDV and mumps virus haemolysis-inhibiting antibodies

Egg-grown Newcastle disease (NDV) and mumps virus were used for preparation of rabbit hyperimmune sera against purified whole virus and projectionless virus particles. These sera and convalescent sera after natural NDV and mumps infections in chickens and human subjects, respectively, were studied in haemolysis-inhibition (HLI), haemagglutination-inhibition (HI) and neuraminidase-inhibition (NI) tests both before and after absorption with Tween 80-ether (TE) treated virus preparations. In addition, neutralization tests using the different sera were carried out. HI and NI antibodies and the major population of neutralizing antibodies in convalescent sera were removed by absorption with TE treated virus material without changing the titre of non-HI HLI antibodies. Rabbit hyperimmune sera directed against projectionless virus particles exhibited HLI antibody titres in marked excess of HI and NI antibody titres, whereas this was not found in sera against whole virus. Absorption with TE treated virus material resulted in removal of all demonstrable antibody activities in sera against whole virus. The corresponding absorption of sera against projectionless particles eliminated HI antibodies without changing the titre of non-Hi HLI antibodies. In rabbit hyperimmune sera, HI antibodies were of primary importance in neutralization tests. After addition of anti-gamma globulin to the test, an efficient neutralization was observed if mumps non-HI HLI antibodies were used whereas this was not found if NDV non-HI HLI antibodies were used.     

New systemic drugs in the treatment of gastrointestinal cancer

Our objective was to study the antibody response to the parotiditis, rubella, measles and tetanus vaccines in HIV infected children. Forty-four children of HIV positive mothers, of which 14 were infected (SG) and 33 HIV negative (CG) were studied when they were between 2 and 3 years of age. Their response to vaccinations of four doses of tetanus toxoid and one dose of measles, rubella and parotiditis vaccines was assessed. Children in the SG were tested at the age of 5-6 years to study the evolution of the response. At the age of 2-3 years, all children had optimal protection against tetanus toxoid. The response to measles, parotiditis and rubella was poor (adequate levels of antibodies in 50%, 25% and 21%, respectively) in infected children and good (93%, 75% and 90%, respectively) in the CG. At 5-6 years of age, a decreased level of antitetanus antibodies were found in the SG, maintaining low protection levels. There was no evidence of any changes in the response to measles, while the number of cases with a good response to parotiditis and rubella increased. Further results are necessary to know the effectiveness of the booster. We conclude that: 1) The immunological response to vaccination is poor in HIV infected children. 2) There was no evidence of side effects or changes in the HIV symptoms after vaccination.