Measles, immunization against

Measles, Mumps, Rubella. Live, attenuated vaccines are used for simultaneous or separate immunization against measles, mumps, and mbeUa Hi children from around 15 months of age to puberty. Two doses, one at 12—15 months of age and the second at 4—6 or 11—12 years are recommended Hi the United States. 

Immune Globulin (IG) IG is a sterile solution containing antibodies from human blood. It is obtained by cold ethanol fractionation of large pools of blood plasma and contains 15-18 percent protein. Intended for intramuscular administration, IG is primarily indicated for routine maintenance of immunity of certain immunodeficient persons and for passive immunity against measles and hepatitis. IG does not transmit hepatitis B virus, human immunodeficiency virus (HIV), or other infectious diseases. 

Measles vaccines Live attenuated strains of measles virus Active immunization against measles... 

Selective induciiiin of active immunity against measles virus. 

Active immunization does not always result in permanent protection. Primary immunization against measles, mumps, poliomyelitis, and rubella appears to be permanent, and in each case... 

An example of the use of an attenuated virus is the administration of the measles vaccine to an individual who has not had measles. The m easles (rubeola) vaccine contains the live, attenuated measles virus. The individual receiving the vaccine develops a mild or modified measles infection, which then produces immunity against the rubeola virus. The measles vaccine protects 95% of the recipients for several years or, for some individuals, for life. An example of a killed virus used for immunization is the cholera vaccine. This vaccine protects those who receive the vacdne for about 3 to 6 months. 

Active immunization against rubella (German measles)... 

Examples of attenuated vaccines are Bacillus Calmette-Guerin (BCG) for immunization against tuberculosis, Sabin vaccine for poliomyelitis, attenuated Paramyxovirus parotitidus against mumps, and attenuated measles virus against measles. 

Polyspecific Response Associated with CNS Autoimmune Diseases. The oligoclonal, intrathecally synthesized IgG contains numerous specific antibodies and autoantibodies. Antibodies are frequently found with specificities against measles, the rubella virus and the varicella-zoster virus, but seldom against the herpes simplex virus. The occurrence of one, two, or three of these antibodies is referred to as the MRZ reaction. The corresponding antigens are not present in these cases. The MRZ reaction is typical of multiple sclerosis as well as cerebral lupus erythematosus and is a chronically evolving immune process (F5, KIO, S16). 

Normal immunoglobulin preparations are purified from pooled material obtained from 1000 or more donors. They will generally contain antibodies against diphtheria, measles, poliomyelitis, hepatitis A, rubella and varicella. Normal immunoglobulin may, therefore, be used to provide passive immunization against these diseases. 

Rubella vaccines Live attenuated strain of rubella virus Active immunization against rubella (German measles)... 

Every adult, whether traveling or not, should be immunized with tetanus toxoid and should also be fully immunized against poliomyelitis, measles (for those bom after 1956), and diphtheria. In addition, every traveler must fulfill the immunization requirements of the health authorities of the countries to be visited. These are listed in Health Information for International Travel, available from the Superintendent of Documents, United States Government Printing Office, Washington, DC 20402. A useful website is http //www.cdc. gov/travel/vaccinat.htm. The Medical Letter on Drugs and Therapeutics also offers periodically updated recommendations for international travelers (see issue of April 15, 2002). Immunizations received in preparation for travel should be recorded on the International Certificate of Immunization. Note Smallpox vaccination is not recommended or required for travel in any country. 

Juntunen-Backman K, Peltola H, Backman A, Salo OP. Safe immunization of allergic children against measles, mumps, and rubella. Am J Dis Child 1987 141(10) 1103-5. 

The reports of the Institute of Medicine, National Academy of Sciences, Washington (on adverse events after pertussis and mbeUa immnnization (SED-12, 817) (SED-12, 825) and on adverse events after immunization against tetanus, diphtheria, measles, mumps, poliomyelitis, H. influenzae type b, and hepatitis B (SEDA-18,325) have provided useful reviews (13,14). The 1996 Update on vaccine side effects, adverse reactions, contraindications,... 

Vaccination against viruses, such as influenza and measles, commonly involves parenteral (subcutaneous or intramuscular) administration of a live, attenuated virus or a killed virus. The inhalation route is being examined as a means of immunizing patients because it circumvents logistical problems associated with parenteral administration, such as needle sterility issues, patient aversion to needles, and the need for administration by a health care professional. In very young children, maternally derived IgG antibodies may prevent successful immunization [118]. The inhalation route may allow vaccination of these children because the immunological response of the airways is less likely to be influenced by maternal antibodies [118], Aerosol immunization has been shown to be effective against measles [119] and, in some respects, is more efficacious than parenteral immunization [120],... 

The historic objective of vaccination has been to induce long-lasting immunity against a disease for which the recipient is at risk. The most successful vaccination campaign eradicated smallpox as a public health problem. Particularly, vaccination against common infectious agents, including poliomyelitis, measles, mumps, and rubella, over the last 50 years has led to effective prevention of many diseases. 

Prophylaxis after exposure to hepatitis A, prevention or modification of measles in one who has not been vaccinated or has not had measles previously, immunoglobulin deficiency, passive immunity against varicella, and rubella... 

Healthcare personnel should meet the Advisory Committee for Immunization Practice (ACIP) guidelines for immunization against mumps, rubella, diphtheria, and measles. Consider the need for the following vaccinations ... 

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