A measles outbreak in Kansai International Airport, Japan, 2016: Analysis of the quantitative difference and infectivity of measles virus between patients who are immunologically naive versus those with secondary vaccine failure
A measles outbreak in Kansai International Airport, Japan, 2016: Analysis of the quantitative difference and infectivity of measles virus between patients who are immunologically naive versus those with secondary vaccine failure
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DOI：
10.1002/jmv.26733
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发表时间：
2020-12-29
影响因子：
12.7
通讯作者：
Kinoshita, Masaru
中科院分区：
文献类型：
--
作者：
Kurata, Takako;Yamamoto, Seiji P.;Kinoshita, Masaru
自消除麻疹病毒以来，日本有接种麻疹疫苗记录的患者有所增加。根据多项研究，以前接种过疫苗的患者，特别是那些继发性疫苗失败(SVF)的患者的传播风险低于那些患有初发麻疹感染的患者。通过高亲和力和高空斑减少中和抗体浓度的特异性免疫球蛋白G(IgG)诱导，鉴定SVF的免疫学特征。然而，SVF的病毒学特征还没有得到很好的研究。为了不仅检查SVF和免疫幼稚患者之间的免疫学和病毒学差异，我们分析了2016年关西国际机场爆发后确诊的25名麻疹感染患者的咽拭子和血液和尿液样本。根据麻疹特异性抗体的浓度和亲和力，患者被分为幼稚(n=3)或SVF(n=22)。用病毒分离和实时定量聚合酶链式反应对临床标本中的病毒载量进行定量，并估计每个标本中的传染性。SVF患者血液样本中的病毒基因组拷贝数有显著差异，约为免疫未成熟患者的1/100。然而，咽拭子和尿液样本中的基因组拷贝数在两组之间没有显著差异。病毒只从幼稚组的人身上分离出来。我们的研究表明病毒在SVF患者中的传播风险很低。
Since the elimination of the measles virus, patients with vaccination records for the measles-containing vaccine have increased in Japan. According to several studies, the transmission risk from previously immunized patients, especially those with secondary vaccine failure (SVF), is lower than that from those with primary measles infections. Immunological features of SVF were identified per specific immunoglobulin G (IgG) induction with high avidity and high plaque reduction neutralization antibody concentration. However, the virological features of SVF have not been well investigated. To examine not only immunological but also virological differences between SVF and immunologically naive patients, throat swabs and blood and urine specimens of 25 patients with confirmed measles infection after an outbreak at the Kansai International Airport in 2016 were analyzed. Patients were categorized as naive (n = 3) or with SVF (n = 22) based on measles-specific IgG antibody concentrations and their avidity. Virus isolation and quantitative real-time polymerase chain reaction were performed to quantify the viral load in clinical specimens and estimate the infectivity in each specimen. The number of viral genome copies in the blood specimens of those with SVF was significantly different and approximately 1 out of 100 of that in immunologically naive patients. However, genome copy numbers in throat swabs and urine specimens were not significantly different between the groups. The virus was isolated only from those in the naive group. Our study indicated low transmission risk of the virus in patients with SVF.