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Measles encephalomyelitis in a patient with a history of vaccination

Y Matsuzono1, M Narita, A Satake

  • 1Department of Pediatrics, Hokkaido University, School of Medicine, Sapporo, Japan.

Acta Paediatrica Japonica : Overseas Edition
|June 1, 1995
PubMed

Insights

Measles secondary vaccine failure (SVF) can cause severe neurological illness like encephalomyelitis, even without typical measles symptoms. This case highlights the potential for measles virus to cause encephalitis in vaccinated individuals with waning immunity.

Area of Science:

  • Neurology
  • Immunology
  • Virology

Background:

  • Secondary vaccine failure (SVF) in measles is typically associated with milder illness.
  • Severe complications, particularly central nervous system involvement, are rarely reported following SVF.

Observation:

  • A 12-year-old girl with a history of measles vaccination developed encephalomyelitis.
  • She presented without characteristic symptoms of ordinary measles, such as Koplik spots.
  • Extremely high anti-measles antibody titers (hemagglutination inhibition and IgG) and detectable measles virus genomic sequence were found in acute-phase serum and cerebrospinal fluid.

Findings:

  • The patient's clinical presentation and immunological profile indicated encephalomyelitis due to SVF of measles.
  • Measles virus was confirmed as the causative agent via polymerase chain reaction in cerebrospinal fluid.
  • High antibody titers at the early stage of illness were observed despite prior vaccination.

Implications:

  • Measles virus can act as a pathogen causing encephalitis in vaccinated individuals with SVF.
  • This case underscores the importance of considering measles virus in neurological presentations, even in the absence of typical exanthem.
  • Further research is needed to understand the mechanisms and prevalence of measles-induced encephalitis in the context of SVF.

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