Journal Article

Measles Inclusion-Body Encephalitis Caused by the Vaccine Strain of Measles Virus

Ari Bitnun, Patrick Shannon, Andrew Durward, Paul A. Rota, William J. Bellini, Caroline Graham, Elaine Wang, Elizabeth L. Ford-Jones, Peter Cox, Laurence Becker, Margaret Fearon, Martin Petric and Raymond Tellier

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 4, pages 855-861
Published in print August 1999 | ISSN: 1058-4838
Published online August 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520449
Measles Inclusion-Body Encephalitis Caused by the Vaccine Strain of Measles Virus

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We report a case of measles inclusion-body encephalitis (MIBE) occurring in an apparently healthy 21-month-old boy 8.5 months after measles-mumps-rubella vaccination. He had no prior evidence of immune deficiency and no history of measles exposure or clinical disease. During hospitalization, a primary immunodeficiency characterized by a profoundly depressed CD8 cell count and dysgammaglobulinemia was demonstrated. A brain biopsy revealed histopathologic features consistent with MIBE, and measles antigens were detected by immunohistochemical staining. Electron microscopy revealed inclusions characteristic of paramyxovirus nucleocapsids within neurons, oligodendroglia, and astrocytes. The presence of measles virus in the brain tissue was confirmed by reverse transcription polymerase chain reaction. The nucleotide sequence in the nucleoprotein and fusion gene regions was identical to that of the Moraten and Schwarz vaccine strains; the fusion gene differed from known genotype A wild-type viruses.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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