Measles

During the early 1900s, vaccines against major human epidemic diseases such as pertussis, diphtheria, tetanus, and tuberculosis were developed. Vaccines for many animal diseases were also available. In the early 1950s, the development of cell culture techniques byj. E. Enders at Harvard was followed by another series of major advances in vaccine development. Vaccines against poHo, mumps, measles, and mbeUa were Hcensed during the 1960s. 

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. 

Varicella. The varicella (chicken pox) vacciae was approved ia April 1995 for immunisation of children. A single dose at one year of age is recommended. In the future it may be combiaed with measles, mumps, and mbeUa. 

The worldwide market is approximately 3.0 bHHon in sales, with the pediatric portion accounting for about 35%. Basic, required childhood vaccines (DTP, poHo, measles /MMR, BCG, and TT) account for 3640 x 10 doses of this global market. In the United States doses distributed in the pediatric sector have risen from around 45 x 10 in 1982, covering basic, childhood vaccines, to around 75 x 10 in 1993 due primarily to the addition of vaccines for Haemophilus disease, hepatitis B, and a second dose of MMR to the recommended childhood series (144). The majority of vaccines for the U.S. market are... 

The synthesis of adamantane (15), tricyclo[3.3.1.1 ]decane [281-23-2] by heating tetrahydrodicyclopentadiene (14) [6004-38-2] in the presence of aluminum trichloride illustrates another aspect of the synthetic utiHty of DCPD (80). Adamantane is the base for dmgs that control German measles and influenza (80-81) (see ANTIVIRAL AGENTS). 

Flecken, m. spot, speck, stain, flaw, t unt. — m.pl. measles, -bildung, /. spotting, staining,... 

Maser, /. speckle, spot, mark grain (of wood) pi.) measles. 

Rfitel, m., Rotelerde, /. ruddle, red ocher. RiUeln, /.pi. German measles, rubella. 

Viruses are small infectious agents composed of a nucleic acid genome (DNA or RNA) encased by structural proteins and in some cases a lipid envelope. They are the causative agents of a number of human infectious diseases, the most important for public health today being acquired immunodeficiency syndrome (AIDS), hepatitis, influenza, measles, and vituses causing diarrhoea (e.g., rotavirus). In addition, certain viruses contribute to the development of cancer. Antiviral drugs inhibit viral replication by specifically targeting viral enzymes or functions and are used to treat specific virus-associated diseases. 

For the pathogenesis of multiple sklerosis, autoimmune T-lymphocy tes play a predominant role, which are directed against components of the neural myelin sheath. T-lymphocy tes by secreting cytokines such as interferon y maintain the chronic inflammation which destructs the myelin sheath. Also cytotoxic T-lymphocytes may participate directly. The cause of multiple sklerosis is unknown. Significantly increased antibody titers against several vitusses, mostly the measles virus, point to a (latent) virus infection initiating the disease. 

The nurse informsthe primary health care provider immediately if a skin rash occurs. The use of phenytoin is usually discontinued if a skin rash occurs. If the rash is exfoliative (red rash with scaling of the skin), purpuric (small hemorrhages or bruising on the skin), or bullous (skin vesicle filled with fluid, ie, blister) use of the drug is not resumed. If the rash is milder (eg, measles-like), therapy may be resumed after the rash has completely disappeared. 

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. 

The measles vaccine is considered an immunization. Immunization is a form of artificial active immunity and an important metiiod of controlling some of the infectious diseases tiiat are capable of causing serious and sometimes fatal consequences. The immunization schedule for children is given in Figure 54-2. Currentiy, many infectious diseases may be prevented by vaccine... 

Virus vaccines against measles, rubella, and mumps should not be given to pregnant women. 

Antibodies in the immune globulin preparations may interfere with the immune response to live virus vaccines, particularly measles, but also others, such as mumps and rubella It is recommended that the live virus vaccines be administered 14 to 30 days before or 6 to 12 weeks after administration of immune globulins. No known interactions have been reported with antivenins. 

Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4-6 years but may be administered during any visit, provided at least 4 weeks have elapsed since the first dose and that both doses are administered beginning at or after age 12 months. Those who have not previously received the second dose should complete the schedule by the 11-12-year-old visit. 

In recent years concerns have been raised in the popular press about possible side effects from the MMR vaccine, which is given to infants to guard against measles, mumps and rubella. Although this has led to a drop in the levels of vaccination, the advice from health professionals continues to be in favour of vaccination, because even if the claimed side effects were shown to be true, failure to vaccinate would still statistically pose the greater health risk due to the detrimental effects of the diseases themselves. 

Many enveloped viruses share a common mechanism of fusion, mediated by a virus-encoded glycoprotein that contains heptad repeats in its extraceUnlar domain. Dnring the fnsion process, these domains rearrange to form highly structured and thermodynamically stable coiled-coils. Viruses encoding fusion proteins that have these domains inclnde members of the paramyxovirus family (e.g., respiratory syncytial virus, metapneumovirus, and measles virus), ebola virus, influenza, and members of the retroviridae (e.g., human T cell lenkemia virus type-1 and human immunodeficiency virus type-1, HlV-1). Peptide inhibitors of fusion that disrupt the... 

Measles virus Enveloped particles variable in size, 120-250nm in diameter, helical capsids Very common childhood fever, immunity is life-long and second attacks are very rare... 

Togaviruses Rubella Spherical particles 70 nm in diameter, a tightly adherent envelope surrounds an icosahedral capsid Causes German measles in children. An infection contracted in the early stages of pregnancy can induce severe multiple congenital abnormalities, e.g. deafness, blindness, heart disease and mental retardation... 

The single-component viral vaccines are listed in Table 15.2 with notes similar to those provided with the bacterial vaccines. The only eombined viral vaeeine that is widely used is the measles, mumps and rubella vaccine (MMR Vac). In a sense, however, both the inactivated (Salk) poliovaccine (PoWac (inactivated)) and the live (Sabin) poliovaccine (PolWac (oral)) are combined vaccines in that they are both mixtures of vims of each of the three serotypes of poliovims. Influenza vaeeines, too, are eombined vaccines in that many contain components fiom as many as three vims strains, usually fiom two strains of influenza A and one strain of influenza B. 

Measles Chick embryo cell cultures infected with attenuated measles virus 1 Clarification 2 Freeze-drying Infectivity titration in cell cultures Tests to exclude presence of extraneous viruses... 

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