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We report a 14-month-male child, who developed Hemophilus infl uenzae meningitis after three primary doses of the vaccine. The child presented with fever and seizures. H. infl uenzae was isolated from both cerebrospinal fl uid (CSF) and blood. The child also had features of septicaemia. Procalcitonin (104 ng/ml) and C-reactive protein (CRP - 42.6 mg/dl) were high. Appropriate antibiotics were given. The child made an uneventful recovery. This case highlights vaccine failure, especially after primary immunisation alone.
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<b>Objectives</b> : To investigate the prevalence of rubella HI antibody among pregnant women in relation to changes in the recommended age for rubella-containing vaccination.<br><b>Methods</b> : A total of 659 primiparous women were included in this study. All subjects were ≥20 years old at the time of delivery in our hospital during the 5-year period from January 2008 to December 2012. Rubella HI antibody titers were measured. Subjects were divided into four groups according to their date of birth and retrospectively analyzed : i) single-dose mass vaccination in junior high school generation ; ii) “interim measures generation” ; iii) single-dose vaccination in infancy generation ; and iv) infancy plus catch-up MR two-dose vaccination generation. HI antibody titers ≤1 : 16 was defined as a low antibody titer.<br><b>Results</b> : The percentage of cases with low antibody titers in the total study population was 20.2%. The percentages of cases with low antibody titers in each group were : i) 20.4%, ii) 18.2%, iii) 30.6%, and iv) 31.6%.<br><b>Conclusion</b> : The percentage of low antibody titers among all cases was comparable to other reports. The results suggested that rubella seroprevalence was low among those in the generation including and subsequent to the single-dose vaccination in infancy generation.
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Objective To analyze the failure ratio and the causes of the inoculation failure of hepatitis B virus(HBV)-vaccine in children and relevant the remedial measures. Methods One thousand three hundred and sixty cases treated in Suzhou Wuzhong people′s hospital during Jan.2007 to Jul.2008 were chosen,of whom 286 children from 1-5 years old to be anti-HBs negative or anti-HBs titre to be 0-10 IU/L were screened,and specific failure reasons for the vaccination were analyzed,also the timely treatment measures were taken.Then 286 children were divided into 5 groups randomly.Apart from one group was set up as blank control,the other 4 groups were arranged to accept different immunization methods with 0,1,2 month schedule,group A simply got revaccinated with HB vaccine(10 ?g) 3 times;group B revaccinated with double dosage of HB vaccine(20 ?g) 3 times;group C besides being revaccinated 3 times,the immune regulatory agent was jointly used;group D revaccinated 3 times with genetically engineered CHO hepatitis B vaccine. Results The ratio of failure of HBV-vaccine was 21.03%,what caused failure of hepatitis B vaccine included immunologic inadequacy 218(76.22%),repeated respiratory infection 192 cases(67.13%),abuse hormone 140 cases(48.95%),zinc deficiency 129 cases(45.10%),anaemia 108 cases(37.76%),passive smoking 80 cases(27.97%),the mother being chronic parenchymatous nephritis or HBV carrier 63 cases(22.03%),premature 54 cases(18.88%),adiposity 38 cases(13.29%),dystrophy 29 cases(10.14%).There were 4 methods of revaccination,the positive rate for group A,B,C,D were 90.00%,96.47%,99.08%,95.83%,respectively.Group C had the highest positive rate,compared with the other 3 groups,which were statistically significant(P a
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BACKGROUND: Nation-wide measles outbreaks occurred from 2000 to 2001 in Korea. Since, mass vaccination campaign for measles eradication among children and adolescents was implemented in May-August of 2001. Even in a highly vaccinated community, measles cases occur among vaccinees and there might be different serological responses among unvaccinees. In addition, the primary and secondary vaccine failures are not rare in the mass-vaccination era. Therefore, this study was undertaken to evaluate the effectiveness of serologic method for diagnosis of measles among the vaccinees and to estimate the vaccine failure rate among students with relatively high vaccination rate during the measles outbreak in a primary school. METHODS: In March 2000, the measles outbreak occurred in a primary school in Youngduk county, Kyung-sang-buk Do. Questionnaires about clinical manifestations of measles and history of measles vaccination were given out to in 209 3rd and 5th grade students among whom many measles cases occurred. The paired sera, which were taken from all students during March and May 2000, were tested for IgM and IgG measles antibody by using Enzygnost Anti-Measles IgG and IgM (Dade Behring, Germany). RESULTS: The questionnaires and serum samples were obtained from 145(69.4%) out of 209 cases. The immunization rate of measles vaccine was 80.7% (117/145). During the measles outbreak, 25 (17.2%) out of 145 cases with previous history of measles vaccination were diagnosed as measles, based on clinical definition. Among 17 cases (17/25, 68.0%) with paired samples out of 25 measles cases, 4 cases (4/17, 23.5%) were diagnosed by seroconversion of IgG, but negative IgM antibody, and they all had received measles vaccination previously. Among 117 cases with previous history of measles vaccination, 47 (40.2%) cases without measles symptoms showed four-fold increment of IgG titer. The primary and secondary failure rates of measles vaccine were 6.0% (7/117) and 1.7% (2/117), respectively. CONCLUSION: Among symptomatic measles cases with previous history of measles vaccination, 23.5% were diagnosed only by seroconversion of IgG measles antibody. In a highly vaccinated country, the accuracy of measles serodiagnosis can be increased with the IgG test of convalescent serum sample in addition to IgM antibody test. Among vaccinees, secondary immune response was 40.2%, suggesting that non-specific measles symptoms might occur among them. Therefore, further studies on the clinical definition of measles cases, vaccine failure rate and protective antibody titers should be continued in order to effectively conduct measles eradication campaign.
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Adolescent , Child , Humans , Diagnosis , Disease Outbreaks , Immunization , Immunoglobulin G , Immunoglobulin M , Korea , Mass Vaccination , Measles Vaccine , Measles , Seroepidemiologic Studies , Serologic Tests , Vaccination , Surveys and QuestionnairesABSTRACT
BACKGROUND: Nation-wide measles outbreaks occurred from 2000 to 2001 in Korea. Since, mass vaccination campaign for measles eradication among children and adolescents was implemented in May-August of 2001. Even in a highly vaccinated community, measles cases occur among vaccinees and there might be different serological responses among unvaccinees. In addition, the primary and secondary vaccine failures are not rare in the mass-vaccination era. Therefore, this study was undertaken to evaluate the effectiveness of serologic method for diagnosis of measles among the vaccinees and to estimate the vaccine failure rate among students with relatively high vaccination rate during the measles outbreak in a primary school. METHODS: In March 2000, the measles outbreak occurred in a primary school in Youngduk county, Kyung-sang-buk Do. Questionnaires about clinical manifestations of measles and history of measles vaccination were given out to in 209 3rd and 5th grade students among whom many measles cases occurred. The paired sera, which were taken from all students during March and May 2000, were tested for IgM and IgG measles antibody by using Enzygnost Anti-Measles IgG and IgM (Dade Behring, Germany). RESULTS: The questionnaires and serum samples were obtained from 145(69.4%) out of 209 cases. The immunization rate of measles vaccine was 80.7% (117/145). During the measles outbreak, 25 (17.2%) out of 145 cases with previous history of measles vaccination were diagnosed as measles, based on clinical definition. Among 17 cases (17/25, 68.0%) with paired samples out of 25 measles cases, 4 cases (4/17, 23.5%) were diagnosed by seroconversion of IgG, but negative IgM antibody, and they all had received measles vaccination previously. Among 117 cases with previous history of measles vaccination, 47 (40.2%) cases without measles symptoms showed four-fold increment of IgG titer. The primary and secondary failure rates of measles vaccine were 6.0% (7/117) and 1.7% (2/117), respectively. CONCLUSION: Among symptomatic measles cases with previous history of measles vaccination, 23.5% were diagnosed only by seroconversion of IgG measles antibody. In a highly vaccinated country, the accuracy of measles serodiagnosis can be increased with the IgG test of convalescent serum sample in addition to IgM antibody test. Among vaccinees, secondary immune response was 40.2%, suggesting that non-specific measles symptoms might occur among them. Therefore, further studies on the clinical definition of measles cases, vaccine failure rate and protective antibody titers should be continued in order to effectively conduct measles eradication campaign.
Subject(s)
Adolescent , Child , Humans , Diagnosis , Disease Outbreaks , Immunization , Immunoglobulin G , Immunoglobulin M , Korea , Mass Vaccination , Measles Vaccine , Measles , Seroepidemiologic Studies , Serologic Tests , Vaccination , Surveys and QuestionnairesABSTRACT
PURPOSE: To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. METHODS: Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. RESULTS: Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/ 180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. CONCLUSION: Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.