Atypical measles and enhanced respiratory syncytial virus disease (ERD) made simple. 2007

Fernando P Polack
Department of Pediatrics, Johns Hopkins University School of Medicine Baltimore, MD 21205, USA. fpolack@jhsph.edu

Atypical measles and enhanced respiratory syncytial virus disease (ERD) were serious diseases that resulted from exposure of children immunized with inactivated vaccines against measles virus (MV) and respiratory syncytial virus (RSV) to the respective wild-type agents in the 1960s. Although the clinical manifestations of both illnesses were different, the immune responses elicited and primed for by the vaccines shared important similarities. Both vaccines failed to elicit long-lived protective antibody and to promote cytotoxic T lymphocyte responses. In both cases, postvaccination exposure to wild type virus during community outbreaks was associated with immune complex deposition in affected tissues, vigorous CD4 T lymphocyte proliferative responses, and a Th2 bias of the immune response. No relapses of atypical measles or ERD were ever reported. In this manuscript, the pathogeneses of both enhanced diseases and the requirements for the generation of protective antibodies against MV and RSV are discussed, to contribute to the development of newer safe and effective vaccines against these important pathogens.

UI MeSH Term Description Entries
D008457 Measles A highly contagious infectious disease caused by MORBILLIVIRUS, common among children but also seen in the nonimmune of any age, in which the virus enters the respiratory tract via droplet nuclei and multiplies in the epithelial cells, spreading throughout the MONONUCLEAR PHAGOCYTE SYSTEM. Rubeola
D008458 Measles Vaccine A live attenuated virus vaccine of chick embryo origin, used for routine immunization of children and for immunization of adolescents and adults who have not had measles or been immunized with live measles vaccine and have no serum antibodies against measles. Children are usually immunized with measles-mumps-rubella combination vaccine. (From Dorland, 28th ed) Vaccine, Measles
D012136 Respiratory Syncytial Viruses A group of viruses in the PNEUMOVIRUS genus causing respiratory infections in various mammals. Humans and cattle are most affected but infections in goats and sheep have also been reported. Chimpanzee Coryza Agent,Orthopneumovirus,RSV Respiratory Syncytial Virus,Chimpanzee Coryza Agents,Coryza Agent, Chimpanzee,Orthopneumoviruses,Respiratory Syncytial Virus,Syncytial Virus, Respiratory,Virus, Respiratory Syncytial
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000914 Antibodies, Viral Immunoglobulins produced in response to VIRAL ANTIGENS. Viral Antibodies
D018357 Respiratory Syncytial Virus Infections Pneumovirus infections caused by the RESPIRATORY SYNCYTIAL VIRUSES. Humans and cattle are most affected but infections in goats and sheep have been reported. RSV Infection,Infections, Respiratory Syncytial Virus,Respiratory Syncytial Virus Infection,Infection, RSV,RSV Infections
D022261 Respiratory Syncytial Virus Vaccines Vaccines or candidate vaccines used to prevent infection with RESPIRATORY SYNCYTIAL VIRUSES. RSV Vaccine,RSV Vaccines,Respiratory Syncytial Virus Vaccine,Vaccine, RSV,Vaccines, RSV

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