title: Decline of measles-specific immunoglobulin M antibodies after primary measles, mumps, and rubella vaccination.
abstract: Detection of measles-specific immunoglobulin M (IgM) has become the standard diagnostic method for laboratory confirmation of measles. In outbreaks, the interpretation of an IgM-positive result can be complicated when persons with suspected measles receive a dose of measles vaccine as part of outbreak control measures. This investigation evaluated the decay of measles-specific IgM antibodies 1 to 4 months after primary vaccination with measles, mumps, and rubella vaccine (MMRII). Serum samples were obtained from 536 infants vaccinated when they were 15 months old as part of a study to assess primary and secondary measles vaccine failure. Sixty serum specimens per week were selected from specimens collected between 4 and 9 weeks after MMRII vaccination; all 176 available serum specimens collected between 10 and > or = 16 weeks were included. Specimens were tested for the presence of measles-specific IgM by an antibody-capture enzyme immunoassay. The proportion of IgM-positive specimens dropped from 73% at 4 weeks after vaccination to 52% at 5 weeks after vaccination and then declined to 7% by 8 weeks after vaccination. Less than 10% of children remained IgM positive between 9 and 11 weeks. An IgM-negative result helps rule out the diagnosis of measles in a person with suspected infection and a history of recent vaccination. The interpretation of a positive IgM result from a person with a clinically suspected case of measles and a recent history of measles vaccination (especially within 8 weeks) is problematic, and the diagnosis of measles should be based on epidemiologic linkage to a confirmed case or on detection of wild-type measles virus.
authors.affiliation: Emory University, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. rzh7@cdc.gov
authors.forename: R F
authors.initials: RF
authors.lastname: Helfand
authors.forename: H E
authors.initials: HE
authors.lastname: Gary
authors.forename: W L
authors.initials: WL
authors.lastname: Atkinson
authors.forename: J D
authors.initials: JD
authors.lastname: Nordin
authors.forename: H L
authors.initials: HL
authors.lastname: Keyserling
authors.forename: W J
authors.initials: WJ
authors.lastname: Bellini
mesh_terms: D000914:Antibodies, Viral / Q000097:blood* / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood* / Q000276:immunology; D008457:Measles / Q000175:diagnosis* / Q000276:immunology; D008458:Measles Vaccine / Q000008:administration & dosage / Q000276:immunology*; D009108:Mumps Vaccine / Q000008:administration & dosage / Q000276:immunology*; D012411:Rubella Vaccine / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D008458:Measles Vaccine; D009108:Mumps Vaccine; D012411:Rubella Vaccine