Hiromi Yoshikawa

Five Cases of Measles Secondary Vaccine Failure with Confirmed Seroconversion after Live Measles Vaccination

We report 5 patients with secondary vaccine failure (SVF) who were infected with natural measles 2, 5, 5, 7 and 12 years, respectively, after vaccination with further attenuated live measles vaccine during infancy. Their seroconversion had been confirmed after vaccination. Three of the 5 patients had mild (modified) measles, while the remaining 2 patients had typical measles. The hemagglutination inhibition antibody titers to measles virus in paired acute and convalescent sera showed a secondary response pattern in 4/5 patients, and a primary response pattern was present in the remaining patient. Measles IgM antibodies were present in all patients during the convalescent stage. The patient with the primary response pattern may have had a decrease in the B cell memory during the 5-year period between vaccination and infection. This may be the first SVF case report that confirms the existence of completely waning immunity in recipients of the further attenuated live measles vaccines.

Pharyngoconjunctival fever caused by adenovirus type 11.

Among a group of hospitalized children in Fukuoka, southern Japan, an epidemic of pharyngoconjunctival fever-like disease caused by adenovirus type 11 was observed in the autumn of 1988. Of the 47 children studied 38 were seronegative in neutralizing antibody for adenovirus type 11 before the epidemic, and sero-conversion occurred in 16 (42%) including 5 subclinical cases. Of the 11 symptomatic patients the incidences of conjunctivitis, pharyngitis and fever were 91, 64 and 46%, respectively. Four patients (36%) had all three symptoms. Fifteen patients (94%) were boys. The sex predominance and high incidence of conjunctivitis suggested that infection may have been transmitted in the large bathroom where boys took baths together.

Suppression of Tuberculin Reactivity During Natural Rubella Observations with 54 Patients

Fifty-four patients with previously positive tuberculin reactions were fol lowed for tuberculin sensitivity, between the incubation period of natural rubella and the 40th day after the onset of rash. In many instances, tuberculin sensitivity was partially or completely depressed beginning in the incubation period and extending for up to 4 weeks after rash onset. Two of 3 cases of subclinical rubella infection also showed this phenomenon. The highest inci dence of negative reactions was 83 per cent in the first 3 days after rash onset. A few subjects had a larger skin reaction to tuberculin than the baseline reading during the 2 to 5 weeks after rash onset.

Clinical Experience with a Live Attenuated Rubella Virus Vaccine, Matsuba Strain GMK3SK60RK6, in Special Reference to 6-Year Follow-up of Rubella Antibodies and Prevention of Rubella Infection during an Epidemic

A live attenuated rubella virus vaccine, Matsuba strain GMK3SK60RK6 was the vaccine attenuated by 60 passages in swine kidney cell cultures and propagated in rabbit kidney cell cultures. This vaccine was inoculated to 46 children and 47 young adults in closed populations and to 340 young women in open populations. As contact control 32 cases were observed in closed populations. Rash occurred in one case and arthritis‐arthralgia did in 5 cases among young women. There was not any evidence of communicability although vaccinees shedded the virus in pharynx. Seroconversion rate was 99 per cent and relatively stable rubella HI antibody titers were demonstrated in a follow‐up study for 6 years. Thirty‐two vaccinees experienced rubella epidemic in a high school in 1976 and were protected from natural rubella virus infection.