title: Girls may have lower levels of maternal measles antibodies and higher risk of subclinical measles infection before the age of measles vaccination.
abstract: BACKGROUND
  Previous studies have suggested that girls may have lower maternal measles antibody levels than boys. Girls might therefore be more likely to contract measles infection before the normal age of measles vaccination at 9 months of age.
  
  
  METHODS
  In connection with a clinical trial of different measles vaccination strategies, we collected pre-measles vaccination blood samples at 4.5 months of age from two subgroups of children. Samples from these children were used to assess possible differences in maternal antibody levels for boys and girls. At 9 months of age another subgroup of children was sampled before the normal measles vaccination; these samples were used to assess the frequency of subclinical measles infection among boys and girls.
  
  
  RESULTS
  We determined measles-specific antibody levels for 812 children at 4.5 months of age and for 896 children at 9 months of age. At 4.5 months of age girls were less likely to have protective maternal antibody levels, the male-female ratio for protective antibody level being 1.23 (1.00-1.51). Among children sampled at 9 months of age, girls were more likely to have protective levels, the female-male ratio for having protective antibody levels being 1.65 (0.98-2.78) (p=0.054) and the geometric mean titre was significantly higher for girls (p=0.007). Children who lived in houses with known measles cases were more likely to have protective levels at 9 months of age even though they had not reported measles infection. Since we had excluded children with known measles infection, girls may have been more likely to have had subclinical measles infection. Combining clinical and possible subclinical measles infection, girls tended to be more likely than boys to contract measles infection before 9 months of age, the RR being 1.36 (0.97-1.90).
  
  
  CONCLUSIONS
  Girls lost maternal measles antibodies more rapidly than boys and well before 9 months of age. They may be more likely to contract subclinical measles infection before the current age of measles vaccination.
authors: Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau. c.martins@bandim.org
authors: Cesario
authors: C
authors: Martins
authors: Carlitos
authors: C
authors: Bale
authors: May-Lill
authors: ML
authors: Garly
authors: Amabelia
authors: A
authors: Rodrigues
authors: Ida M
authors: IM
authors: Lisse
authors: Andreas
authors: A
authors: Andersen
authors: Mia
authors: M
authors: Eriksson
authors: Christine S
authors: CS
authors: Benn
authors: Hilton
authors: H
authors: Whittle
authors: Peter
authors: P
authors: Aaby
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood*; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007112:Immunity, Maternally-Acquired; D017589:Immunization Programs; D007223:Infant; D008297:Male; D008457:Measles / Q000276:immunology*; D008458:Measles Vaccine / Q000276:immunology; D011159:Population Surveillance; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000914:Antibodies, Viral; D008458:Measles Vaccine