Measles mumps rubella varicella
Download
1 / 32

Measles - PowerPoint PPT Presentation


  • 800 Views
  • Updated On :

Measles, Mumps, Rubella, Varicella. MedCh 401 Lecture 6. Measles, Mumps, Rubella. Common childhood diseases May be associated with severe complications/death More often in adults Measles - pneumonia, encephalitis Mumps - aseptic meningitis, deafness, orchitis

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Measles' - Olivia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Measles mumps rubella varicella l.jpg

Measles, Mumps, Rubella, Varicella

MedCh 401

Lecture 6

KL Vadheim Lecture 6


Measles mumps rubella l.jpg
Measles, Mumps, Rubella

  • Common childhood diseases

  • May be associated with severe complications/death

    • More often in adults

    • Measles - pneumonia, encephalitis

    • Mumps - aseptic meningitis, deafness, orchitis

    • Rubella - congenital rubella syndrome

  • Respiratory transmission

KL Vadheim Lecture 6


Measles l.jpg
Measles

  • 14-day incubation period for respiratory-acquired infections

  • 6-10 days if acquired parenterally

  • remains the leading cause of vaccine-preventable death in children

KL Vadheim Lecture 6


Measles virus attenuation l.jpg
Measles virus attenuation

  • Start with attenuated Enders’attenuated Edmonston strain

  • Propagate in chick embryo cell culture

KL Vadheim Lecture 6


Measles vaccine efficacy l.jpg
Measles vaccine efficacy

  • 1941 - 894,134 U.S. cases

  • 1995 - 288 U.S. cases

KL Vadheim Lecture 6


Vaccine failure l.jpg
Vaccine failure

  • Infants vaccinated at <12m who were born to naturally-infected mothers may not develop sustained antibody levels when later revaccinated

  • Primary failure

    • No seroconversion

  • Secondary failure

    • Loss of protection after seroconversion

KL Vadheim Lecture 6


Mumps pathogenesis l.jpg
Mumps Pathogenesis

  • Viremia common, leading to organ involvement

    • salivary glands (parotitis), meningitis, orchitis, endolymph infection leading to deafness

  • A major cause of permanent, bilateral, sensorineural deafness in children

  • Virus shed in saliva and urine for long periods after infection

KL Vadheim Lecture 6


Mumps pathogenesis8 l.jpg
Mumps Pathogenesis

  • Reinfection occurs

    • usually asymptomatic

KL Vadheim Lecture 6


Mumps virus attenuation l.jpg
Mumps virus attenuation

  • Jeryl Lynn (B level) strain

  • Cultured from Jeryl Lynn Hilleman’s throat

  • Attenuated by serial passage in

    • embryonated hen’s eggs

    • chick embryo cell culture

KL Vadheim Lecture 6


Passive immunization against mumps l.jpg
Passive immunization against mumps

  • Immune globulin ineffective for postexposure prophylaxis

    • does not prevent disease or reduce complications

  • Transplacental maternal antibody appears to protect infants for first year of life

KL Vadheim Lecture 6


Mumps vaccine efficacy l.jpg
Mumps vaccine efficacy

  • 1968 - 152,209 U.S. cases

  • 1995 - 840 U.S. cases

KL Vadheim Lecture 6


Recent mumps outbreaks l.jpg
Recent mumps outbreaks

  • Started in Dec. 2005 in Iowa

  • 2,597 cases Jan. 1- May 2, 2006

  • 11 states, all ages affected

  • Vaccination clinics initiated

KL Vadheim Lecture 6


Theories on outbreak l.jpg
Theories on outbreak

  • College campuses are the perfect environment for spreading a disease transmitted through oral secretions

  • Only 25 states and DC require two doses of MMR for college admission

KL Vadheim Lecture 6


More theories l.jpg
More theories

  • Delayed recognition and diagnosis of disease:

    • few younger MDs have seen the disease

    • Many would not consider the diagnosis in a vaccinated individual

KL Vadheim Lecture 6


Uk mumps epidemic 2004 2005 l.jpg
UK Mumps epidemic, 2004-2005

  • >70,000 cases in England and Wales

  • Increased susceptibility of unvaccinated cohorts who have less exposure to mumps because of a decrease in disease circulation after implementation of a childhood immunization program

KL Vadheim Lecture 6


Uk epidemic l.jpg
UK Epidemic

  • Importance of ensuring high levels of immunity among other age groups when mumps vaccination is added to the routine immunization schedule for children.

KL Vadheim Lecture 6


Rubella l.jpg
Rubella

  • Aka ‘German’ measles

  • Discovered in 1841

  • Virus isolated in 1941 by German scientists

  • Sudden pandemic in 1962-65

  • Vaccine developed in 1960s

  • Vaccine licensed in 1970 (U.S.)

KL Vadheim Lecture 6


Congenital rubella syndrome l.jpg
Congenital Rubella Syndrome

  • Infection in first trimester most dangerous

    • 90% of fetuses likely to have some type of abnormality

  • Virus disrupts organogenesis

    • plus more destructive on brain, cochlea, lens, etc.

  • Virus establishes chronic infection in many cells/organs

    • virus secretion may persist for years

KL Vadheim Lecture 6


Congenital rubella syndrome19 l.jpg
Congenital Rubella Syndrome

  • Cataracts

  • Deafness

  • Heart malformation

  • Also:

    • microcephaly

    • autism

    • mental retardation

    • Diabetes

    • etc.

KL Vadheim Lecture 6


Mumps pandemic 1962 65 europe and u s l.jpg
Mumps Pandemic 1962-65, Europe and U.S.

  • 12.5 million mumps cases

  • 20,000 cases CRS

    • 11,600 deaf

    • 3,580 blind

    • 1,800 mental retardation

  • 6,250 spontaneous abortions

  • 5,000 surgical abortions

  • 2,100 stillborn/neonatal deaths

KL Vadheim Lecture 6


Rubella vaccine l.jpg
Rubella vaccine

  • Mumps virus RA-27/3 isolated from an infected fetus in 1965

  • Culture fluid passaged directly into WI-38 cells

    • 8 serial passages at 37C

  • Seven additional passages at 30C

    • human volunteer studies showed attenuation

  • Ten additional passages to further decrease pathogenicity

KL Vadheim Lecture 6


Rubella ra27 3 vaccine strain l.jpg
Rubella RA27/3 vaccine strain

  • Produced between 25th and 30th passage in human diploid cells

  • Relatively rapid attenuation due to:

    • cold adaptation (30C)

  • Retention of high immunogenicity due to:

    • relatively low passage number required for attenuation

KL Vadheim Lecture 6


Rubella points to remember l.jpg
Rubella points to remember

  • Clinical rubella has been demostrated in vaccinees and naturally infected, immune persons

  • Reinfection with fetal transmission of wild virus in presence of both natural and vaccine-induced immunity

    • can result in CRS

KL Vadheim Lecture 6


Rubella vaccine efficacy l.jpg
Rubella vaccine efficacy

  • 1969 - 57,686 U.S. cases

  • 1995 - 200 U.S. cases

KL Vadheim Lecture 6


Mmr vaccines l.jpg
MMR Vaccines

  • Live

  • Attenuated

  • Subcutaneous administration

  • Lyophilized presentation

  • Licensed 1971

KL Vadheim Lecture 6


Mmr vaccines26 l.jpg
MMR Vaccines

KL Vadheim Lecture 6


Varicella zoster l.jpg
Varicella zoster

  • Causes two separate diseases

    • chickenpox (varicella)

    • shingles (herpes zoster)

  • Generally a benign, self-limiting disease

  • Herpes virus

  • Highly communicable disease of all ages

KL Vadheim Lecture 6


Varicella transmission l.jpg
Varicella Transmission

  • Airborne

  • Skin, Respiratory droplets through conjunctivae or mucosa of upper respiratory tract

  • Can transmit chickenpox to a susceptible person from a person with shingles

KL Vadheim Lecture 6


Varicella pathogenicity l.jpg
Varicella Pathogenicity

  • Usually a mild disease

    • can cause severe, life-threatening complications

    • 1st trimester infection can cause permanent CNS (and other) damage to fetus, or death

    • 3rd trimester infectionmay cause severe maternal infection,

  • Host range limited to humans and some primates

KL Vadheim Lecture 6


Varicella pathogenicity30 l.jpg
Varicella Pathogenicity

  • Latent infection of sensory nerve ganglia common

    • Some viral infection during latent stage

    • Suppression of VZV reactivation partially under immunological control

KL Vadheim Lecture 6


Varicella vaccine l.jpg
Varicella Vaccine

  • Lyophilized

  • Requires storage at +5F or below

  • Live, attenuated virus

KL Vadheim Lecture 6


Varicella attenuation process l.jpg
Varicella attenuation process

  • Initial viral isolation from a child with varicella

  • Adapted to human embryonic lung cell cultures

  • Adapted to and propagated in embryonic guinea pig cell cultures

  • Propagated in human diploid cell cultures (WI-38)

  • Further passage in human diploid cell cultures (MRC-5) that are free of adventitious agents

KL Vadheim Lecture 6


ad