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Immunity, along with the ability to limit pathogen growth to prevent significant body tissue damage, can be gained either by (1) actively developing an immune response within the individual after exposure to a pathogen or after getting vaccinated or (2) passively transferring immune components from an immune individual to one who is nonimmune. Both these forms of immunity can be found naturally and in medical practices.
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Post-exposure passive immunisation for preventing measles.

Megan K Young1, Graeme R Nimmo, Allan W Cripps

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|April 2, 2014
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Summary
This summary is machine-generated.

Passive immunisation with immunoglobulins is effective in preventing measles and reducing measles-related deaths when administered within seven days of exposure. However, a minimum effective dose has not yet been determined.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Public Health

Background:

  • Measles outbreaks persist despite high vaccination rates, highlighting the need for effective post-exposure interventions.
  • Passive immunisation is a potential strategy to prevent measles in exposed, non-immune individuals.
  • Existing estimates of passive immunisation effectiveness vary, with no established minimum effective dose.

Purpose of the Study:

  • To evaluate the effectiveness of immunoglobulins (passive immunisation) in preventing measles.
  • To assess the safety of intramuscular or intravenous immunoglobulin administration in exposed susceptible individuals.
  • To determine effectiveness when administered before symptom onset.

Main Methods:

  • Systematic review and meta-analysis of randomised controlled trials (RCTs), quasi-RCTs, and prospective cohort studies.
  • Searched multiple databases including CENTRAL, MEDLINE, CINAHL, and EMBASE up to August 2013.
  • Included studies involving susceptible, measles-exposed participants receiving polyclonal immunoglobulins; measured subsequent measles cases.

Main Results:

  • Included one RCT, two quasi-RCTs, and 10 cohort studies (3925 participants); overall evidence quality was moderate.
  • Immunoglobulins administered within seven days of exposure were effective in preventing measles (gamma globulin RR 0.17, convalescent serum RR 0.21-0.49, adult serum RR 0.52).
  • Immunoglobulin therapy significantly reduced measles-related deaths (RR 0.24) and reported no serious adverse events, though adverse event reporting was poor.

Conclusions:

  • Passive immunisation within seven days of measles exposure is effective, reducing risk by up to 83%.
  • The dose of immunoglobulin appears to influence effectiveness, but a minimum effective dose could not be identified.
  • Further research is needed on high-risk populations, minimum effective doses, and comparative effectiveness against measles vaccination.