Measles seroepidemiology among adolescents and young adults: Response to revaccination [SARI; 2003]

Despite a high coverage with measles vaccine, outbreaks of measles occur with an increasing proportion in older children and adults who have been vaccinated. The aim of this study was to determine the anti- measles seroepidemiology in adolescents and young adults, and the responses of subjects to revaccination. Five hundred and ninty adolescents and young adults 15 to 25 years old previously received one or two doses of measles vaccine [15-19 years old subjects; 2 doses at 9 and 15 months of age and 20-25 years old subjects; one dose after 12 months of age] with no history of physician diagnosed measles were redcruited to determine the seroprevalence of IgG measles antibody. Two to six weeks after revaccination, anti measles IgM and IgG antibodies titers were assessed by ELISA methods, to differentiate between the primary and secondary vaccine failure. The results were compared and analyzed. From 590 subjects, 263 were serologically negative or susceptible. Of 105 susceptible revaccinated subjects 75 showed anamnestic IgG and 11 of them also showed IgM responses [probably primary vaccine failure]. No significant responses were observed in 39 seroprotected subjects to revaccination except one subject. The results showed that 44.6% of vaccinated adolescents and young adults were serologically susceptible to measles. The rates of primary and secondary vaccine failure, herd immunity with 95% coverage were 4.7%, 27.1% and 83%, respectively. The study showed that vaccination- induced anti-measles antibody decline overtime especially in the absence of natural boosting. Catch-up vaccination or third dose of measles vaccination is recommended

[Clinical and Para clinical Findings of leptospirosis in Mazandaran, June-September 2004]

Leptospirosis is an uncommon widespread spirochetal zoonoses caused by the members of the genus leptospira. Human disease is acquired by coming into contact with urine or tissues of infected animals, or through contaminated water and soil, thus is an occupational disease particularly in farmers, slaughterhouse workers and fishermen. The goal of this study was to evaluate the clinical and Paraclinical findings of leptospirosis cases in Mazandaran. In this cross-sectional descriptive study, patients with high suspicion to leptospirosis presenting to Imam Khomeini and Razi hospitals of Sari and Qaemshahr from June to September 2004 with positive serology finding [MAT] were enrolled. Demographic, clinical and Paraclinical data for each patient were recorded. From 63 patients suspicious for leptospirosis, 36 had positive serologic test. The mean age of the positive patients [25 male, 11 female] was 34.2 +/- 13.77 [range 14-64 years old]. Most cases [86.1%] were farmers and 83.4% villagers. 55.6% of the patients presented in July. Fever and chills were the main complaints in 42.9% of the cases and fever, weakness, headache, anorexia and mialgia were seen in 96.6%, 96.6%, 93.1%, 89.7% and 85% respectively. Thrombocytopenia and leucopenia were noticed in 45.7% and 33.4% of the patients respectively. AST and ALT in 51.7% and 55.2% of patients were above the normal upper limit. Weil's syndrome and ileus occurred in 7 [19.5%] and one [2.8%] cases respectively. The classic history of fever, weakness, headache, anorexia and mialgia in villagers and farmers in warm months should raise the possibility of leptospirosis