measles mumps rubella varicella
Download
Skip this Video
Download Presentation
Measles, Mumps, Rubella, Varicella

Loading in 2 Seconds...

play fullscreen
1 / 32

Measles - PowerPoint PPT Presentation


  • 810 Views
  • Uploaded 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

Measles, Mumps, Rubella, Varicella

MedCh 401

Lecture 6

KL Vadheim Lecture 6

measles mumps rubella
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
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
Measles virus attenuation
  • Start with attenuated Enders’attenuated Edmonston strain
  • Propagate in chick embryo cell culture

KL Vadheim Lecture 6

measles vaccine efficacy
Measles vaccine efficacy
  • 1941 - 894,134 U.S. cases
  • 1995 - 288 U.S. cases

KL Vadheim Lecture 6

vaccine failure
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
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
Mumps Pathogenesis
  • Reinfection occurs
    • usually asymptomatic

KL Vadheim Lecture 6

mumps virus attenuation
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
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
Mumps vaccine efficacy
  • 1968 - 152,209 U.S. cases
  • 1995 - 840 U.S. cases

KL Vadheim Lecture 6

recent mumps outbreaks
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
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
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
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
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
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
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
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
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
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
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
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
Rubella vaccine efficacy
  • 1969 - 57,686 U.S. cases
  • 1995 - 200 U.S. cases

KL Vadheim Lecture 6

mmr vaccines
MMR Vaccines
  • Live
  • Attenuated
  • Subcutaneous administration
  • Lyophilized presentation
  • Licensed 1971

KL Vadheim Lecture 6

mmr vaccines26
MMR Vaccines

KL Vadheim Lecture 6

varicella zoster
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
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
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
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
Varicella Vaccine
  • Lyophilized
  • Requires storage at +5F or below
  • Live, attenuated virus

KL Vadheim Lecture 6

varicella attenuation process
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