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[Pathophysiology and laboratory findings in measles]

Yoshitsugu Iinuma1

  • 1Department of Clinical Laboratory, Kyoto University Hospital, Kyoto.

Rinsho Byori. the Japanese Journal of Clinical Pathology
|March 6, 2008
PubMed

Insights

Measles outbreaks persist in Japan due to vaccine failures. Promoting vaccination, especially for healthcare workers, is crucial to prevent measles transmission and severe complications.

Area of Science:

  • Virology
  • Immunology
  • Epidemiology

Context:

  • Measles remains a significant public health concern in Japan, causing ongoing outbreaks despite vaccine availability.
  • The disease is highly contagious and can lead to severe complications, including neurological conditions like Acute Disseminated Encephalomyelitis (ADEM), Measles Inclusion Body Encephalitis (MIBE), and Subacute Sclerosing Panencephalitis (SSPE).
  • MIBE and SSPE are particularly concerning due to their poor prognosis, linked to persistent measles virus (MV) mutations in the brain.

Purpose:

  • To analyze the reasons behind persistent measles outbreaks in Japan.
  • To evaluate the effectiveness of current vaccination strategies and antibody titer measurement methods.
  • To provide recommendations for preventing measles, including healthcare-associated infections.

Summary:

  • Despite a safe and effective measles vaccine, outbreaks continue in Japan, potentially due to primary and secondary vaccine failures.
  • Neurological complications such as MIBE and SSPE, associated with persistent MV mutants, have an unfavorable prognosis.
  • Vaccination strategies in Japan include a two-dose regimen since 2006 and supplementary programs. Antibody protection levels vary by measurement method; plaque neutralization (NT) is accurate but complex, while Japan uses particle agglutination (PA) with a threshold of 1:128.
  • All healthcare workers under 35 without adequate immunity should be vaccinated to prevent healthcare-associated MV infections.

Impact:

  • Highlights the need for enhanced measles vaccination coverage and strategies in Japan.
  • Emphasizes the importance of understanding vaccine efficacy and appropriate antibody titer assessment for surveillance.
  • Provides critical guidance for protecting vulnerable populations, including healthcare workers, from measles and its severe neurological sequelae.

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