title: Deep sequencing reveals persistence of cell-associated mumps vaccine virus in chronic encephalitis.
abstract: Routine childhood vaccination against measles, mumps and rubella has virtually abolished virus-related morbidity and mortality. Notwithstanding this, we describe here devastating neurological complications associated with the detection of live-attenuated mumps virus Jeryl Lynn (MuVJL5) in the brain of a child who had undergone successful allogeneic transplantation for severe combined immunodeficiency (SCID). This is the first confirmed report of MuVJL5associated with chronic encephalitis and highlights the need to exclude immunodeficient individuals from immunisation with live-attenuated vaccines. The diagnosis was only possible by deep sequencing of the brain biopsy. Sequence comparison of the vaccine batch to the MuVJL5isolated from brain identified biased hypermutation, particularly in the matrix gene, similar to those found in measles from cases of SSPE. The findings provide unique insights into the pathogenesis of paramyxovirus brain infections.
authors: Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK. sofia.morfopoulou.10@ucl.ac.uk.
authors: Sofia
authors: 0000-0001-8181-4548
authors: S
authors: Morfopoulou
authors: Virology Division, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK.
authors: Edward T
authors: ET
authors: Mee
authors: Virology Division, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK.
authors: Sarah M
authors: SM
authors: Connaughton
authors: Microbiology, Virology and Infection Control, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Julianne R
authors: JR
authors: Brown
authors: Department of Immunology, Great Ormond Street Hospital, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Kimberly
authors: K
authors: Gilmour
authors: Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: W K 'Kling'
authors: WK
authors: Chong
authors: Department of Microbiology, Boston University School of Medicine, Boston, MA, 02118, USA.
authors: W Paul
authors: WP
authors: Duprex
authors: Virology Division, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK.
authors: Deborah
authors: D
authors: Ferguson
authors: Genetics and Genomics Medicine UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
authors: Mike
authors: M
authors: Hubank
authors: Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Ciaran
authors: C
authors: Hutchinson
authors: Neurosciences Department, Great Ormond Street Hospital, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Marios
authors: M
authors: Kaliakatsos
authors: Molecular Pathology Programme, Centre for Cancer Research and Cell Biology, Queen's University, Belfast, UK.|Tissue Pathology, Belfast Health and Social Care Trust, Belfast City Hospital, Lisburn Road, Belfast, UK.
authors: Stephen
authors: S
authors: McQuaid
authors: Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.|Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
authors: Simon
authors: S
authors: Paine
authors: UCL Genetics Institute, University College London, London, WC1E 6BT, UK.
authors: Vincent
authors: V
authors: Plagnol
authors: Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK.
authors: Christopher
authors: C
authors: Ruis
authors: Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Alex
authors: A
authors: Virasami
authors: Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
authors: Hong
authors: H
authors: Zhan
authors: Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.|Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
authors: Thomas S
authors: TS
authors: Jacques
authors: Virology Division, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK.
authors: Silke
authors: S
authors: Schepelmann
authors: Great Ormond Street Hospital for Children, NHS Foundation Trust, Molecular and Cellular Immunology, London, WC1N 3JH, UK.|UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
authors: Waseem
authors: W
authors: Qasim
authors: Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK.|Microbiology, Virology and Infection Control, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK.
authors: Judith
authors: J
authors: Breuer
mesh_terms: D001706:Biopsy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D002908:Chronic Disease; D018792:Encephalitis, Viral / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology*; D017809:Fatal Outcome; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007223:Infant; D008297:Male; D009108:Mumps Vaccine / Q000009:adverse effects*; D009109:Mumps virus / Q000235:genetics / Q000302:isolation & purification*; D016511:Severe Combined Immunodeficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D009108:Mumps Vaccine