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Measles antibody titers in early infancy
1Department of Pediatrics, Hektoen Institute for Medical Research, Cook County Children's Hospital, Chicago.
Insights
Many infants in neonatal intensive care units lose measles antibody protection by 4-5 months of age. This highlights the need to consider this vulnerable population in measles control strategies.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Measles antibody levels in infants are crucial for protection against infection.
- Infants admitted to neonatal intensive care units (NICUs) may have unique immunological profiles.
- Understanding measles seronegativity in this population is vital during outbreaks.
Purpose of the Study:
- To determine the prevalence of measles seronegativity in infants under six months old.
- To assess the serologic response to measles vaccination in seronegative infants.
- To identify factors associated with measles antibody loss in NICU infants.
Main Methods:
- A cross-sectional measles antibody survey was conducted during a 1989 measles epidemic in Chicago.
- 203 infants under six months admitted to a NICU were studied.
- Measles IgG antibody levels were measured, and seronegative infants received the measles vaccine.
Main Results:
- At birth, 74% of infants aged 4-5 months were measles seronegative.
- Seronegativity was associated with chronological age, gestational age, packed red blood cell transfusions, and maternal age.
- 79% of vaccinated seronegative infants showed seroconversion.
Conclusions:
- A substantial number of NICU infants lose measles antibodies by 4-5 months of age.
- This population requires specific consideration in measles control and prevention efforts.
- Further research into optimal vaccination timing for high-risk infants is warranted.
Objective:
To determine the prevalence of measles seronegativity among infants younger than 6 months and to ascertain their serologic response to measles vaccine.
Design:
Cross-sectional measles antibody survey during the 1989 measles epidemic in Chicago, Ill.
Setting:
Inner-city perinatal center.
Participants:
Two hundred three infants younger than 6 months who had been admitted to the neonatal intensive care unit at birth; 130 (64%) of these infants were premature. Transplacental antibody transfer was evaluated in a subset of 89 mother-newborn pairs.
Intervention:
Administration of measles monovalent vaccine to seronegative infants.
Measurements/Results:
Measles IgG antibody was measured using indirect fluorescent assay. At birth, 19 (38%) of 50 neonates born at less than 37 weeks' gestation had antibody titers that were twofold to fourfold lower than those of their mothers compared with three (8%) of 39 neonates born at more than 37 weeks' gestation (P < .01). Of the 203 study infants, fewer than 4% were seronegative at birth, while 74% of these infants aged 4 to 5 months were seronegative. Univariate logistic regression analysis indicated that the independent variables related to seronegativity were as follows: gestational age at birth (P = .007), chronological age (P < .001), history of having received three or more packed red blood cell transfusions (P < .001), and maternal age at delivery (P = .001). Multiple logistic regression analysis confirmed the association of seronegativity with chronological age (P < .001), gestational age (P < .02) and maternal age at delivery (P < .001). Seroconversion following administration of the measles vaccine was documented in 11 (79%) of 14 infants.
Conclusion:
A significant proportion of 4- to 5-month-old infants who had been admitted to the neonatal intensive care unit at birth lack measurable measles antibody; this population should be taken into account when strategies to control measles are considered.