• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.133-139
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• 1997

Purpose : To determine the age-specific seropositivity and the level of measles specific IgG in vaccinated adolescents, the measles specific IgG titers were measured from the sera of junior & senior high school students in Seoul, Korea. Methods : From May to July in 1996, 216 sera were collected from junior & senior high school students(male : 110, female : 106) aged 12 to 17 years who were vaccinated and had no history of natural measles. Measles specific IgG titers were measured using ELISA method($SIA^{TM}$ Measles IgG Kit, Sigma Co. St. Louis, Mo). Results : The seropositivity of measles specific IgG in vaccinated adolescents aged 12 to 17 years was 91.2%. There were no significant correlations between age and seropositivity as well as between age and measles specific IgG level. Conclusions : We consider that our data suggest the necessity of revaccination of measles in adolescents. Further considerations should be required to establish an appropriate revaccination method and to evaluate the efficacy of revaccination of previously vaccinated adolescents.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.245-252
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• 1999

Purpose : The aim of this study is to determine the age-specific seropositivity and the level of measles specific IgG in adults and to evaluate herd immunity to measles in Korea, the measles specific IgG were measured from the sera of adults over ages of 20 in Korea. Methods : 156 sera were collected from 156 out-patients over ages 20, who had visited clinical laboratory from June to July in 1997 at Korea University Ansan Hospital. The histories of natural measles or vaccination were not undertaken. Measles specific IgG titers were measured using ELISA method($SIA^{TM}$ Measles IgG Kit Co. St. Louis. Mo). Results : The results obtained from this study were as follows. 1) The seropositivity of measles specific IgG in adults was 94.9%. And there were no significant differences in their age and gender. 2) The mean measles-specific IgG titer was $238{\pm}84AU/mL$. And there were no significant differences in age and gender, except significant lower in 4th decades than other age groups. And there were no significant correlations between age and measles specific IgG level. Conclusion : In conclusion, a seropositivity of in adults was 94.9% which was higher than that of adolescents(91.2% in previous study), and antibody level was similar with adolescents. The herd immunity of the adults were considered to enough for protecting the transmission of measles in the community. For the eradication of measles in Korea, more efforts will be required to increase the vaccine coverage rate in children and adolescents.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.126-132
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• 1997

Measles outbreak in the world was decreased since measles vaccine had been introduced. Although vaccination rate is high, measles was not eradicated and measles reappeared among vaccinated children. We measured measles-specific antibody from the vaccinated and unvaccinated groups who had experienced apparent measles in the Seongnam city in 1993. The results were as follows. 1) The data included total 126 children (M:F=1 : 1). Age distribution of measles outbreak revealed 6 children in 5yr, 11 in 6yr, 20 in 7yr, 39 in 8yr, 22 in 9yr, 11 in 10yr, 11 in 11yr, and 6 in 12yr. 2) MMR vaccination rate was 78.6%(99/126) in the children who had experienced measles. Positive rate of measles-specific IgM Ab was 80.8% (80/99) among the vaccinated group and among 9E.6.% (25/27) the unvaccinated. 3) Positive rate of measles-specific IgG Ab was 90.9% (90/99) among MMR-vaccinated group, and 85.2% (23/27) in unvaccinated group. In conclusion, measles-specific IgM antibody have been detected more than 1 month in most patients. The relatively high proportion of measles-specific IgM positivity may mean primary vaccine failure. To booster the antibody titers and to prevent measles epidemic in school-aged children, revaccination of measles should be considered.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.185-193
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• 1996

Purpose : The incidence of measles was gradually decreased since 1963 when measles vaccination was firstly developed and liscenced in the world. But, recently the outbreaks of measles in infants and school children have been reported despite of wide spread use of measles vaccination. This study was performed to evaluate the efficacy of measles vaccination and the necessity of revaccination in Korean infants and children. Methods : 168 subjects of mothers and neonates, infants and children were enrolled in this study during the periods of 10 months from March to December in 1995. Measles specific IgG in the sera of mothers and children was measured using EIA kit (Sigma Co., MO, USA). Antibody titer of over or equal to 110 AU/ml was considered positive. Results : The results obtained were as follows. 1) Values of measles specific IgG in the sera of mother and neonate were 82.9 AU/ml and 89.3 AU/ml respectively and were rapidly decreased within 6 month after birth. Positive antibody levels (${\geq}$ 110 AU/ml) were observed in only 25 % of neonates. 2) In vaccinated children, values of measles specific IgG were 117.4 AU/ml in 9~15 month group, 76.9 AU/ml in 3~6 year group and 79.5 AU/ml in 10~15 year group after either one or two times of measles vaccination. Positive antibody levels in vaccinated children were observed in 57.7% of 9~15 month group, 38.4% of 3~6 year group and 34.7% of 10~15 year group. Conclusion : These results suggest that primary measles vaccination before 6 months of age can be considered and revaccination of measles should be recommended before 3~6 years of age. Further studies will be needed to clarify the reasons of high proportion of primary measles vaccination failure and to established the appropriate schedule of measles vaccination in korean infants and children.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.67-73
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• 2002

Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.980-986
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• 2002

Purpose : Although the number of patients with measles have dramatically decreased since the introduction of measles vaccines in 1965, measles outbreaks have occurred periodically every 4-6 years during the 1990s(1989-1990 and 1993-1994). During 2000-2001, measles prevailed all over the country again. A characteristic of current epidemics is that the majority of affected population was infants and school-aged children. This study was designed to analyze the epidemic and clinical features of measles prevalence during 2000-2001 and to find ways to overcome vaccination failure. Methods : We reviewed the records of 59 patients with mealses admitted in the Pediatric Department of Pusan National University Hospital from January 2000 to October 2001 for patient's age, month of admission, history of vaccination, clinical features and complications. Antibody titers of measles-specific IgM and IgG were measured by enzyme immunoassay. Results : The epidemic show two peaks in the age distribution. Forty three patients(72.9%) were under 2-years of age and 14 patients(23.7%) were over 5-years of age. Outbreaks had high incidence in July to August, 2000 and March to April, 2001, then faded away after July, 2001. Vaccinated group comprised 30.5% and unvaccinated group comprised 69.5% and their mean age was $9.25{\pm}4.27$ years old and $0.95{\pm}0.30$ years old respectively. Positive rate of IgM was 86.7% in vaccinated group and 90.3% in unvaccinated group. This means there was primary vaccine failure; 13 cases of 15 vaccinated patients were positive in IgM antibody. During the prevalence, two patients died with mealses complication. One of them was immunocompromised. Conclusion : To prevent another prevalence of measles in the future, we must enhance revaccination at ages 4-6 and check vaccination status when children enter elementary school. These will produce over 95% of herd immunity, with catch-up MMR vaccination which has been completed already.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.215-221
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• 2002

Purpose : This study was done to compare the vitamin A levels between hospitalized patients of measles symptoms and of the other infectious diseases common in childhood (bronchiolitis, penumonia, gastroenteritis and etc.). Methods : We have set up a population of 133 hospitalized patients of measles symptoms in the pediatric department of Kangnam Sacred Heart Hospital between Nov. 2000~Apr. 2001 and compared them to a group of 30 hospitalized patients of other infectious diseases between Dec. 2001~Feb. 2002. The whole patients were divided into three groups by diagnosing measles-specific IgM antibody positive as measles group(n=104), negative as measles-susepcted group(n=29) and other infectious disease group. And we compared the vitamin A levels, clinical symptoms, and general hematological and biochemical results. Results : Among the 104 measles patients, the concentrated age groups were 10 12 months(n=24, 23.1%), 13~15 months(n=16, 15.3%) and 16 months~4 years of age(n=24, 23.1%). The mean levels of vitamin A of measles and measles-susepcted groups were $69.6{\pm}28.6{\mu}g/dL$ and $75.2{\pm}34.4{\mu}g/dL$, respectively, and that of other infectious disease group was $28.1{\pm}17.5{\mu}g/dL$. Conclusion : The mean levels of vitamin A of both measles and measles-suspected groups were significantly higher than that of other infectious disease group(P<0.05) and showed no significant correlations with clinical symptoms and hospitalization duration.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1219-1226
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• 2002

Purpose : To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. Methods : Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. Results : Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. Conclusion : Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.