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Subacute sclerosing panencephalitis (SSPE) is a progressive lethal neurological inflammatory disease due to persistent, wild measles virus infection in the central nervous system that is seen most frequently in children and young adolescents. Atypical presentations are seen in up to 10% of cases. Most frequently and severely affected region in the brain is the parieto-occipital region of the brain. Less commonly involved organs are the cerebellum, basal ganglia and corpus callosum. Brainstem involvement is rare and usually occurs when other areas of brain are involved along with it. Here, we describe an unusual male patient of 15 years age, having SSPE with MRI of brain showing extensive involvement of brainstem with no significant involvement of other cortical structures of the brain. It is very rarely described in SSPE, but one should be vigilant about such involvement of brainstem and cerebellum, and SSPE should not be missed when brainstem hyperintensities are seen in MRI brain with or without other region of the brain to avoid misdiagnosis.

The article deals with the history of measles virus discovery, epidemic outbreak of measles over the last 15 years in Ukraine. The paper presents the data on the features of measles clinical picture in children and adults with typical and atypical forms, criteria for diagnosis, as well as possible protection against this dangerous infectious disease.

Background Serological diagnosis of infections due to measles and rubella viruses is done by IgM detection. The aim of this study was to comparatively evaluate commercial systems for detecting IgM against both viruses, including those of ELISA, in indirect and capture formats, chemiluminescence and electrochemiluminescence. Methods Seven (for rubella) and six (for measles) assays were studied. One hundred and sixty two samples were included in the study (from 90 rubella and 72 measles cases), and all were analyzed in all the assays. Results The ranges of sensitivity, specificity and agreement for rubella were 94.8–100%, 52.4–100% and 75.5–98.1%, respectively. The corresponding ranges for measles assays were 87.0–100%, 53.3–100%, and 73.0–99.4%. Conclusion The best-performing assays were chemiluminescence (for measles and rubella IgM), and electrochemiluminescence (for rubella IgM).

Background/Aims: Data on the immunoprotective status against measles, mumps, rubella, varicella zoster virus (VZV), hepatitis A virus (HAV), and Epstein-Barr virus (EBV) infection in patients with inflammatory bowel disease (IBD) are still lacking. Therefore, we investigated the seropositivity rates for viral infectious diseases and the associated factors in Korean patients with IBD.Methods: In this retrospective cohort study, serum immunoglobulin G antibody positivity rates against measles virus, mumps virus, rubella virus, VZV, HAV, and EBV viral capsid antigen (VCA) were measured in patients with Crohn’s disease or ulcerative colitis (UC) who first visited the IBD clinic. Seropositivity rates and their associated factors were analyzed.Results: Between January 2016 and December 2018, 263 patients were enrolled (male, 167 [67.3%]; UC, 134 [50.9%]). The median age at serological test was 30 years (interquartile range, 22 to 46). The seropositivity rates were 84.0%, 85.2%, 66.5%, 87.4%, 50.0%, and 93.7% for measles, mumps, rubella, VZV, HAV, and EBV, respectively. Younger age at serological test was associated with seronegative status for measles (adjusted odds ratio [aOR], 0.92; 95% confidence interval [CI], 0.88 to 0.96), VZV (aOR, 0.83; 95% CI, 0.74 to 0.93), and HAV (aOR, 0.93; 95% CI, 0.91 to 0.95). Furthermore, IBD type-UC was associated with seronegative status against VZV (aOR, 0.33; 95% CI, 0.11 to 0.99).Conclusions: Seropositivity rates for common viral infectious diseases in Korean patients with IBD were similar to those of the general population. In the younger age group, protective immunity against measles, VZV, and HAV is required, with proper vaccination, as necessary.

Background Measles elimination (interruption of endemic measles virus transmission) in the United States was declared in 2000; however, the number of cases and outbreaks have increased in recent years. We characterized the epidemiology of measles outbreaks and measles transmission patterns after elimination to identify potential gaps in the US measles control program. Methods We analyzed national measles notification data from 1 January 2001 to 31 December 2019. We defined measles infection clusters as single cases (isolated cases not linked to additional cases), 2-case clusters, or outbreaks with ≥3 linked cases. We calculated the effective reproduction number (R) to assess changes in transmissibility and reviewed molecular epidemiology data. Results During 2001–2019, a total of 3873 measles cases, including 747 international importations, were reported in the United States; 29% of importations were associated with outbreaks. Among 871 clusters, 69% were single cases and 72% had no spread. Larger and longer clusters were reported since 2013, including 7 outbreaks with >50 cases lasting >2 months, 5 of which occurred in known underimmunized, close-knit communities. No measles lineage circulated in a single transmission chain for >12 months. Higher estimates of R were noted in recent years, although R remained below the epidemic threshold of 1. Conclusions Current epidemiology continues to support the interruption of endemic measles virus transmission in the United States. However, larger and longer outbreaks in recent postelimination years and emerging trends of increased transmission in underimmunized communities emphasize the need for targeted approaches to close existing immunity gaps and maintain measles elimination.

Background: In this study, we used an oncolytic measles virus encoding interleukin 12 (IL-12) to treat colon cancer in vivo and ex vivo to investigate its effect on the viability and apoptosis of c...

Background Subacute sclerosing panencephalitis (SSPE) is a rare, non-treatable and fatal neurological complication of measles , still present due to the return of the epidemic linked to the loosening of vaccination policies. Its mechanism remains unexplained. Objective The main objective was to investigate explanatory variables relating to the risk of developing SSPE and its pathophysiology . Methods Literature analysis was focused on different varieties of SSPE: perinatal forms, short-incubation forms similar to acute measles inclusion body encephalitis (MIBE), rapidly evolving forms, forms occurring in the immunosuppressed, adult forms, and family forms. In addition, several studies on the parameters of innate immunity and interferon responses of patients were analyzed. Results Two main data were highlighted: a relationship between the so-called fulminant forms and the prescription of corticosteroids was established. In familial SSPE, two groups were individualized according to the duration of the latency period, prompting an analysis of patient exomes . Conclusion Treatment with corticosteroids should be banned. Knowledge of the genes involved and epigenetics should be useful for understanding the pathophysiology of SSPE and other late-onset neurological infections with RNA viruses .

The global measles vaccination program has been extraordinarily successful in reducing measles-related disease and deaths worldwide. Eradication of measles is feasible because of several key attributes, including humans as the only reservoir for the virus, broad access to diagnostic tools that can rapidly detect measles-infectious persons, and availability of highly safe and effective measles-containing vaccines (MCVs). All 6 World Health Organization (WHO) regions have established measles elimination goals. Globally, during 2000–2018, measles incidence decreased by 66% (from 145 to 49 cases per million population) and deaths decreased by 73% (from 535 600 to 142 300), drastically reducing global disease burden. Routine immunization with MCV has been the cornerstone for the control and prevention of measles. Two doses of MCV are 97% effective in preventing measles, qualifying MCV as one of the most effective vaccines ever developed. Mild adverse events occur in

The domestic combined measles-mumps-rubella (MMR) vaccine was withdrawn in Japan in 1993 following an outbreak of aseptic meningitis attributed to the mumps component of the cocktail. KM-248 is an MMR vaccine (M-M-R®II), manufactured by Merck & Co., Inc. (Kenilworth, NJ, USA) and registered and approved in 74 countries, but which has not been approved in Japan. This multicenter, randomized, single-blind study, was designed to evaluate the noninferiority of the KM-248 measles component in terms of immunogenicity when compared to the control measles vaccine already approved in Japan and the seroconversion rates for these three viruses following KM-248 administration. Vaccination with KM-248 in children aged 12-90 months (n = 178) induced robust immune responses to measles, mumps, and rubella viruses. The seroconversion rate for the measles virus by the measles component of KM-248 (n = 172) was shown to be non-inferior to that of the control measles vaccine (n = 85). No serious adverse reactions, such as aseptic meningitis or anaphylaxis, were observed. Fever is one of the most common adverse reactions associated with vaccination and was observed in approximately half of the participants. KM-248 administered to healthy Japanese children aged between 12 and 90 months demonstrated a comparable safety and efficacy profile to the control vaccine.

Introduction The Development of the SARS-CoV-2 virus vaccine and its update on an ongoing pandemic is the first subject of the world health agenda. Areas covered First, we will scrutinize the biological features of the measles virus (MV), variola virus (smallpox virus), influenza virus, and their vaccines to compare them with the SARS-CoV-2 virus and vaccine. Next, we will discuss the statistical details of measuring the effectiveness of an improved vaccine. Expert opinion Amidst the pandemic, we ought to acknowledge our prior experiences with respiratory viruses and vaccines. In the planning stage of observational Phase-III vaccine effectiveness studies, the sample size, sampling method, statistical model, and selection of variables are crucial in obtaining high-quality and valid results.

This case-control study was conducted to determine the antibody titer against the measles virus in childhood cancer survivors' post-chemotherapy treatment to determine the patient's immune status against the measles virus.We enrolled 38 children who were in complete remission and whose treatments had been stopped for at least 3 months and 38 age and sex-matched healthy controls. We analyzed the medical records of the cancer survivors, and each study participant's serum sample was analyzed by the ELISA method to determine the antibody titer against measles.The cancer survivors had significantly lower measles antibody titers than the healthy control participants, and 78.9% of cancer survivors were unprotected (seronegative) compared to 7.9% in healthy controls. After multivariate analysis, there was no statistically significant factor associated with loss of protective humoral immunity against measles.These results underline the need for post-chemotherapy measles antibody testing and revaccination of seronegative survivors.

BACKGROUND: Measles (rubella) is a highly contagious disease that is caused by a virus in the Paramyxoviridae family. The measles virus is directly responsible for more than 100,000 deaths each year. Epidemiological studies have linked measles to increased morbidity and mortality many years after infection, but the reasons underlying this phenomenon are poorly understood. The virus attacks immune cells, causing acute suppression of the immune system. The World Health Organization recommends a two-dose vaccination policy, with the first dose administered during the 1st year of life, and coverage should be maintained in at least 90–95% of the population to halt transmission. In many countries, the measles vaccine is included in the immunization program and is freely available to all. Today, despite active immunization of the population, measles still occurs in the Republic of Kazakhstan. AIM: The objective of our study was to analyze the epidemiological characteristics of measles in the Republic of Kazakhstan during the rise of the disease. METHODS: Statistical data were obtained from the Committee on Public Health Protection on the incidence of measles in The Republic of Kazakhstan for the period from November 1, 2018 to December 30, 2019. STUDY DESIGN: Epidemiology survey. RESULTS: The article contains epidemiological data on the incidence of measles in the regions of the Republic of Kazakhstan among children, age, and gender characteristics. CONCLUSION: In the period from November 2018 to December 2019, there was a tendency to increase the incidence of measles in the republic. In terms of morbidity, Nur-Sultan was the leader, where the number of cases was 22.9% (n = 3181). The largest number of registered cases, 58.2% (n = 5745), occurred in children aged 1–14 years. Measles remains an unresolved global problem and groups of undervaccinated and unvaccinated populations remain vulnerable during epidemics.

Background In Japan, measles elimination was confirmed in March 2015. Nevertheless, some outbreaks with cases imported from abroad were reported even after certification. A large rubella outbreak has been occurring since 2017. This study examines measurement of the speed of attenuation of antibody titer for a measles virus comparison with rubella virus. Method Student subjects born from April 2, 1996 through April 1, 2000 were selected at Ibaraki Prefectural University of Health Sciences for this study: 177 for measles and 114 for rubella. They had available dates of additional immunization and antibodies in the following period and were judged as requiring additional immunization. We used enzyme immunoassay for IgG antibody testing. We regressed post-antibody titers of measles or rubella on pre-antibody titers and functions of duration between inoculation to post-evaluation. Functions of duration were selected according to the adjusted coefficient of determination. Results For measles, only a linear term of duration or log of duration was found to be significant without the quadratic terms. For rubella, we selected a five-order linear model which indicated that titer after vaccination would converge to 19.2. Discussion Results demonstrate that measles antibody decreased monotonically. If the pre-antibody titer was 15, vaccination raised titer quickly to 26; then it attenuated by 0.014 per day. Antibody titer is expected to be less than 16, which is the protection level of titer, after 704 days. For rubella, however, when pre-vaccination titer was evaluated at its average, the lower limit was 19.2. Therefore, protection can be maintained for a long time. This difference might reflect some circumstances of outbreaks of the respective diseases. Conclusion. This report describes the speed of attenuation and the epidemiological situation. The speed of attenuation can be expected to rise. Therefore, additional vaccination every several years might be necessary to maintain a protection level if a disease is almost eliminated.

Introduction: Based on its ability to kill tumor cells, the vaccine strain of the measles virus is used for oncolytic virotherapy. However, the dose required for cancer therapy is much higher than that used for vaccination. Therefore, this study was conducted to evaluate the preclinical toxicology of the vaccine strain of measles virus in monkeys. Methods: 16 healthy Macaca mulata monkeys were randomly divided into four groups, of which one was a control. A preclinical safety evaluation of the vaccine strain of the measles virus was performed, and the three experimental groups were intravenously injected with the strain at doses of 105 TCID50, 106 TCID50 and 107 TCID50 respectively. Results: There were no significant abnormalities in the physical, clinical, haematological, and biochemical parameters following the intravenous injection with measles vaccine at doses of 105 TCID50, 106 TCID50 and 107 TCID50. The vaccine strain of measles virus remained in the plasma until the 30th day and disappeared on the 60th, and it did not persist in the tissues on days 30 and 60 post injection. Measles IgG antibody was negative on days 0, 1, 3, and 8 and was positive on days 15, 30, and 60 post administration of the measles virus. The histopathology of target organs was not affected in all groups on days 30 and 60 post injection. Conclusions: The systematic preclinical safety data of the present study confirms the safety of two months of concentrated measles vaccine administration in the Macaca mulata monkey for clinical trials.

Background: Subacute sclersing panencephalitis (SSPE) is a very rare progressive, fatal neurodegenerative disease of the control nervous system of childhood and early adolescence. It is a slow virus disease caused by persistent defective measles virus infection of the brain Objective: To see the clinical andneuro-imaging findings in children with Subacute sclerosing panencephalitis. Methods: This retrospective study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, a tertiary care premier Postgraduate Medical Institution in Bangladesh. Thirty (30) Subacute sclerosing panencephalitis (SSPE) children were evaluated at paediatric neurology ward during the period January 2010 to December 2017. Diagnosis was based on typical clinical characteristic features, the presence of periodic discharges on EEG, demonstration of raised antibody titer against measles in the plasma and cerebrospinal fluid Detected by ELISA in all patients. Results: Total number of studied children were 30. Mean age was 10.2±3.1 year and Male female ratio was 5:1. Most of the patient arrived from poor socio-economic (83.33%) background of rural area (66.67%) of Bangladesh. Among them 46.67% had history of measles infection during early childhood. Progressive deterioration of school performance (50%), gait disturbance (70%), myoclonus (83%) dysarthria (43%) and Ocular manifestations like optic atrophy & papilledema (83.33%) were the main presenting feature of our studied children. All of the patients (100%) showed positive measles specific antibody IgG in CSF and On electroencephalographic findings showed periodic burst suppression in 90.90% cases. Most of the children (56.6%) were in stage II category and other 3.3%, 33.3%,6.6%, were stage I, stage III, stage IV category respectively. Neuroimaging study showed abnormalities in 45.83% cases included periventricular white matter hyper intense signal changes, cortical atrophy and ischaemic change. Conclusion: In our study most of the SSPE patient were in stage II.About half of the patient had history of measles infection during early childhood. Neuroimaging abnormalities found in about half of the cases and majority cases were in stage II. Common neuroimaging abnormalities were periventricular white matter hyper intense signal changes and cortical atrophy.

Advanced pancreatic cancer is characterized by few treatment options and poor outcomes. Oncolytic virotherapy and chemotherapy involve complementary pharmacodynamics and could synergize to improve therapeutic efficacy. Likewise, multimodality treatment may cause additional toxicity, and new agents have to be safe. Balancing both aims, we generated an oncolytic measles virus for 5-fluorouracil-based chemovirotherapy of pancreatic cancer with enhanced tumor specificity through microRNA-regulated vector tropism. The resulting vector encodes a bacterial prodrug convertase, cytosine deaminase-uracil phosphoribosyl transferase, and carries synthetic miR-148a target sites in the viral F gene. Combination of the armed and targeted virus with 5-fluorocytosine, a prodrug of 5-fluorouracil, resulted in cytotoxicity toward both infected and bystander pancreatic cancer cells. In pancreatic cancer xenografts, a single intratumoral injection of the virus induced robust in vivo expression of prodrug convertase. Based on intratumoral transgene expression kinetics, we devised a chemovirotherapy regimen to assess treatment efficacy. Concerted multimodality treatment with intratumoral virus and systemic prodrug administration delayed tumor growth and prolonged survival of xenograft-bearing mice. Our results demonstrate that 5-fluorouracil-based chemovirotherapy with microRNA-sensitive measles virus is an effective strategy against pancreatic cancer at a favorable therapeutic index that warrants future clinical translation., Graphical abstract, This study describes a novel, virus-based therapeutic approach for treatment of pancreatic cancer. Our results demonstrate that 5-fluorouracil-based chemovirotherapy with microRNA-sensitive and prodrug convertase-encoding measles virus is an effective strategy against pancreatic cancer at a favorable therapeutic index.

The aim of the study was to assess the measles immunity level among employees of medical organizations of various specialties, young subjects, and neonates. Materials and Methods. The measles immunity status was assessed for all the employees of St. Petersburg State Budgetary Healthcare Institution Maternity Hospital No. 10 (386 subjects), civilian medical staff of the clinics of the Military Medical Academy named after S.M. Kirov (Military Medical Academy) (1399 subjects), cadets of the Military Medical Academy (304 subjects) and 34 neonates. Laboratory testing was performed by using ELISA with test kits “VektoKor-IgG” (RF). Results. Medical workers displayed high total level of protection against measles virus serologically confirmed in 87.5% of the maternity hospital staff and 81.6% of the employees at the Military Medical Academy clinics. No differences in the immune status between the varying categories of medical personnel from the departments of various specialties were revealed. Lower population immunity was observed in the 20-40-year age group. Among the employees of the maternity hospital, the proportion of measles virus seropositive subjects aged 20—40 years was 75.9% (95%, CI 67.2—82.9%), 40—59 years — 91.5% (95%, CI 86.7—94.7%), 60 year and older subjects were all seropositive (95%, CI 94.6—100%). Dual vaccination did not guarantee emergence of effective measles immunity. The majority of seronegative subjects were dually vaccinated, hence, even in case of previous dual measles vaccination, it is necessary to perform a serological examination prior to recruitment to medical facilities. Females comprised more than 90% of medical workers. Therefore, women of fertile age previously dually vaccinated, but immunologically seronegative, are at risk of measles and intrauterine fetal infection, as well as the risk of its development is increased in vaccination age children. It was confirmed by demonstrating that as few as 70.6±15.3% of neonates were immune to the measles virus. The proportion of seronegative infants (29.4±15.3%) was comparable to that one in seronegative subjects aged 20—40 years (24.1±8.1%) working at the maternity hospital. Among the younger age group (aged 18—23 years) such as cadets of the Military Medical Academy, a significantly higher proportion of seronegative individuals was found — 48.3±5.6%, thereby increasing probability for measles outbreak therein. Conclusions. In order to eradicate measles, it is necessary to develop a screening program for detecting antibodies against measles among young and middle-aged subjects.

Measles (rubeola) is a highly contagious virus. Vaccination has nearly eradicated measles in the United States, yet sporadic outbreaks persist. Although the live-attenuated measles, mumps, rubella vaccine has not been found to cause fetal harm, pregnancy is considered a contraindication for the vaccine and contracting measles during pregnancy can have serious sequelae. Furthermore, lifelong immunity conferred by childhood vaccination is questionable as the vaccine's protection may wane during the childbearing years. Reluctance to vaccinate, or vaccine hesitancy, may leave a proportion of people of childbearing age unprotected. It is unlikely that many clinicians providing preconception, primary, and perinatal care have had occasion to diagnose measles. Susceptibility to infection combined with clinician inexperience may contribute to missed opportunities to halt the spread of this highly contagious, preventable illness. A case of parents' religion-based vaccine hesitancy complicating the pregnancy of their adult daughter is presented. Guidelines for screening for immunity, identifying measles in the clinical setting, and protocols for mitigating spread are reviewed.

BACKGROUND In North America, the first dose of a measles-containing vaccine (MCV1) is administered at ≥12 months of age. However, MCV1 may be given to infants

Responding to measles outbreaks in the United States puts a considerable strain on public health resources, and limited research exists about the effectiveness of containment strategies. In this paper we quantify the impact of isolation, contact tracing, and exclusion in reducing transmission during a measles outbreak in an under-vaccinated community.

Background: In 1861, Hagelloch, an isolated village in Germany, experienced a measles epidemic, which affected nearly all children under 14 years of age. We examined determinants of severe measles. Methods: A contemporary medical thesis by Albert Pfeilsticker had sufficient information on timing of measles cases within all households in the village to make it possible to determine who were index cases, infected outside the household, and who were secondary cases, infected after exposure in the household. Results: The measles case fatality ratio (CFR) was 6.4% (12/187); 10.0% (7/70) for children under five years of age. The youngest class in the local school was the epicentre of the epidemic; all children aged 7-9 years contracted measles at school and became index cases in their own families. The frequency of secondary cases was higher among younger and older children. Overall 44% (82/187) of the children were secondary cases. Secondary cases tended to have higher CFR than index cases (RR=3.03 (95% confidence interval: 0.91-10.07)), whereas there was less difference in the risk of complications (RR=1.34 (0.78-2.28)). The CFR was higher for boys than girls (4.46 (1.03-19.22)), and boys were more likely to suffer severe complications than girls (RR=1.73 (0.97-3.08)). Boys who were infected by a girl had higher CFR than boys infected by other boys (RR=6.30 (1.18-85.64)). Children under five years of age, who survived measles infection, did not have higher mortality in 1862; the 11 children who had not had measles in 1861 had a RR of dying in 1862 of 4.17 (1.22-14.28) compared with those who had measles in 1861. Conclusion: When measles was severe in Europe, the determinants of fatal infection were similar to those observed more recently in low-income countries. Changes in intensity of exposure within the home, due to smaller family size, better housing, and more public childcare, may have been major causes of the mortality decline in the industrialized countries during the 19th and the early 20th centuries. Funding: PA has received support from the Danish Council for Development Research, the Danish Medical Research Council, the Danish National Research Foundation and the Novo Nordisk Foundation. Declaration of Interest: None to declare.

It has been postulated that measles virus infection is associated with remission of idiopathic nephrotic syndrome (INS) in childhood. There are few reports on the correlation of INS remission with other infections. Previously, there have been two case reports suggesting an association between influenza B virus infection and the remission of INS. The patient was an 18-year-old Japanese woman. The onset of steroid-sensitive NS was at 9 years of age, and pathological diagnosis was minimal change nephrotic syndrome (MCNS). Until 10 months prior to visiting our hospital, the patient’s NS was in remission. The patient experienced fever, cough, and malaise and she was diagnosed with type B influenza by a local physician 4 days before visiting our hospital. The patient had vomiting and diarrhea 1 day prior to visiting our hospital. Her weight was 54.7 kg (+5.0 kg) and she had pitting edema of both lower legs. Her serum albumin level was 0.9 g/dL, proteinuria level was 8.73 g/gCr, and urine sediments showed 1–4 red blood cells per high-power field. She was diagnosed with relapse of NS. The level of proteinuria decreased to 0.03 g/gCr with rest alone on day 4 of admission, and a complete remission from NS was observed at approximately 2 weeks after the onset of influenza B infection. We report a rare case wherein spontaneous remission of NS occurred within a short period of 2 weeks after influenza B infection. It is clear that some immunity is involved in the pathogenesis of INS, but there are some cases in which infection improves NS and others in which it recurs.

Fekede W/Kidan,1 Dawit Getachew,1 Besufekad Mekonnen,2 Workineh Woldeselassie Hammeso3 1School of Public Health Department of Epidemiology and Biostatistics, Collage of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 2School of Public Health Department of Public Health, Collage of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3School of Pharmacy, Department Pharmacology and Pharmaceutical Chemistry College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, EthiopiaCorrespondence: Workineh Woldeselassie Hammeso P.o. Box 260, Mizan-Teferi, EthiopiaTel +251912183453Email workinehws@yahoo.comBackground: Measles is a serious respiratory disease that is spread easily through coughing and sneezing of the measles virus for which humans are the only reservoir. Even though prevention and elimination strategies had been implemented, the outbreaks of measles infection quietly occur in different parts of the world. As of November 2019 a suspected measles outbreak was reported from Tepi campus student’s clinic. We investigated the outbreak to determine its possible sources, control measures and identify associated risk factors among students of Mizan-Tepi University.Methods: A facility based unmatched case-control study was conducted. An interviewer administered questionnaire was used to collect the data. Data were cleaned and entered to Epi-info7 and analyzed using SPSS-20. A logistic regression analysis was conducted to identify risk factors associated with measles outbreak at a p-value ≤ 0.05.Results: A total of 40 measles cases were reported during the investigation. The probable source of the outbreak was an index case who had a travel history to a district with the measles epidemic. Five samples were collected for confirmation of the diagnosis. No measles-related deaths were reported. The major risk factors for measles infection in Mizan-Tepi University were being unvaccinated [AOR = 5.21, 95% CI (1.938, 12.058)], being female [AOR = 4.21, 95% CI (1.426, 11.182)], age group of 18– 20 [AOR = 0.123, 95% CI (0.041, 0.37)] and having a contact history [AOR = 0.149, 95% CI (0.041, 0.544)].Conclusion: The findings of the present investigation indicated that being unvaccinated and having a contact history with confirmed or suspected cases increased the risk of measles infection. Reduction in the level of protective antibodies over time may accelerate transmission of measles in the campus. Strengthening case-based surveillance and supplemental measles vaccination are imperative.Keywords: measles outbreak, Mizan-Tepi University, risk factors, students

Thoracic malignancies are associated with high mortality rates. Conventional therapy for many of the patients with thoracic malignancies is obviated by a high incidence of locoregional recurrence and distant metastasis. Fortunately, developments in immunotherapy provide effective strategies for both local and systemic treatments that have rapidly advanced during the last decade. One promising approach to cancer immunotherapy is to use oncolytic viruses, which have the advantages of relatively high tumor specificity, selective replication-mediated oncolysis, enhanced antigen presentation, and potential for delivery of immunogenic payloads such as cytokines, with subsequent elicitation of effective antitumor immunity. Several oncolytic viruses including adenovirus, coxsackievirus B3, herpes virus, measles virus, reovirus, and vaccinia virus have been developed and applied to thoracic cancers in preclinical murine studies and clinical trials. This review discusses the current state of oncolytic virotherapy in lung cancer, esophageal cancer, and metastatic malignant pleural effusions and considers its potential as an emergent therapeutic for these patients.

Background: Over the past few years, measles cases have increased worldwide, despite the availability of a safe and highly effective vaccine. Numerous countries have eliminated measles or have made substantial advancements toward elimination. Materials and Methods: This study investigated the seroprevalence of anti-measles antibodies and vaccination status among 362 men and 81 women in Madinah. All participants were vaccinated or acquired immunity naturally due to infection. We aimed to examine the persistence of anti-measles IgG antibodies, which were qualitatively and quantitatively determined using ELISA. Results: We showed that measles seropositivity (92%, n = 408) was significantly more frequent than negative (5.4%, n = 14) and equivocal results (2.5%, n = 11). Among men, 92.8% were seropositive for the anti-measles IgG antibody, whereas 88.9% of women were seropositive. In addition, a significant relationship was observed between age and measles seropositivity, with a significant positive correlation between age and anti-measles antibody concentration as assessed by Spearman’s correlation analysis (r = 0.405, p

Measles is an acute, highly contagious viral disease caused by measles virus and transmitted primarily by respiratory droplets or airborne spray to mucous membranes in the upper respiratory tract or the conjunctiva. Measles is one of vaccine preventable diseases but the virus usually causes outbreaks especially among unvaccinated population. The aim of this study was to investigate the outbreak and identify associated factors in Basso Liben district in Ethiopia. An unmatched case control study was conducted to investigate measles outbreak from 90 study subjects (30 cases and 60 controls). Face to face interview was conducted using structured questionnaire. Epi info version 7 was used for data entry and analyzed using SPSS version 20 software. Logistic regression was employed to identify factors associated with measles outbreak with 95% confidence level and statistical significance was declared at p-value

Objective: Measles virus is an unsegmented, single-stranded and negative-polarized RNA virus belonging to Morbillivirus genus in Paramyxoviridae family in the order of Mononegavirales. This study aimed to evaluate measles antibody seropositivity proportions in different age groups from different geographical regions within three years. Material and methods: This retrospective study, IgM and IgG antibodies specific to measles were detected in serum samples with enzyme immunoassay method. Measles IgG antibody seroprevalence was calculated by correlating all data with demographic variables. Results: Median age of patients included in the study was 27 years and while 352 (44.4%) were male. Seropositivity rate of measles IgG antibody was 87.1%. Seropositivity in the age group of 0-18 was 77.7% (p = 0.002). IgG seropositivity rates were 82.8%, 88.8% and 90.7% between 2017 and 2019 respectively (p = 0.05). Seropositivity rate of IgM antibody in all cases was 11.1% and the highest rate was detected in the age group of 0-18 (13.5%) (p = 0.09). IgM antibody seropositivity rate was determined most in the winter months (23.8%) (p < 0.001). While measles IgM positivities were 10.6% and 21.1% in Turkish and foreign patients respectively IgG positivities were 86.9% and 92.3% (p = 0.32, p = 1.00 respectively). Measles IgG seropositivity was the highest in patients living in Aegean region (96.8%). Conclusions: In conclusion, measles IgG seropositivity was 87.1% in this study. This rate was lower in pediatric age group. Increasing regional seroprevalence studies may help enhancement efforts on vaccination program to reach and sustain high population immunity.&nbsp

The status of community immunity against measles was evaluated in 480 health professionals (HPs) and 619 students of medical colleges in the Republic of Tatarstan. HPs and students were selected at random taking the vaccination status and age into account. The immunity level was assessed by blood serum (plasma) protective antibody (IgG) titers with an enzyme-linked immunosorbent assay. Three hundred sixty-three (75.63 ± 2.253%) health professionals examined were seropositive to measles virus, and 117 (24.38 ± 3.969%) ones being seronegative. A proportion of medical college students susceptible to measles were 45.07 ± 2.979%. The results obtained suggest that the assessment of community immunity against measles in health professionals and students of medical schools and colleges should be continued and susceptible individuals be vaccinated without age limits.

Introduction Measles has a high transmission rate among susceptible populations. Healthcare facilities can play an important role in measles transmission. The aim of this study is to describe a measles outbreak in a highly immunized community and the implication of healthcare workers in the transmission of the disease. Methods Descriptive study of measles outbreak linked to hospital setting with sociodemographic, clinical, virological and immunization variables studied. Cases were confirmed by RT-PCR in clinical specimens and genotyped by nucleotide sequencing. Association was assessed by chi2, Fisher's exact and z test. Statistical significance at p = 0.05. Results 47 suspected measles cases were reported from March to June 2018 at Terres de l’Ebre, Catalonia. Fourteen cases were confirmed, 8 cases (57%) were men; median age of cases 33y (range 16–46 y). Hospital associated transmission was confirmed in 13 (93%) cases, 8 (61.5%) were hospital staff. Five (38.5%) were healthcare workers (HCW), three (23%) non-healthcare workers (non-HCW) and 6 (46%) were patients attended at the hospital. Four cases (28.5%) were immunized with 2 doses of measles virus containing vaccine (MCV); 3 (75%) were HCW. No statistical difference observed among hospital staff and community cases as to immunization (OR 2.4 95%CI: 0.17–32.88; p = 0.49). Genotype B3 MVs/Dublin.IRL/8.16-variant was obtained from confirmed cases. Conclusion Suspecting measles diagnosis, allows for immediate airborne isolation, and retrieving measles immunity records for healthcare facility employees and contacts. Vaccination of HCW and the adoption of good infection control will minimize nosocomial transmission and spreading of the virus to the community.

SSPE is a neurodegenerative disorder caused by persistent defective or mutant measles virus. The disease has a gradual progressive course leading to death within 1-3 yrs or even early. SSPE is a disease of childhood and early adolescence. The classic age at presentation is 8-11 years and usually occurs after a latent period of average 6 years. Here we report 3 cases of SSPE in toddlers. Diagnosis was made on the basis of clinical presentation, EEG pattern and elevated CSF anti measles antibody titer as described in Dykan criteria for diagnosis of SSPE. Clinical presentation was very early with a relatively shorter latency and fatal progression. Two patients had past history of measles and all patients were immunized against measles. One patient died within 4 months of disease expression and 2 patients went into vegetative state within 3 months of disease onset. Bangladesh J Child Health 2020; VOL 44 (2) :114-117

The study of measles virus (MeV) as a cancer immunotherapeutic was prompted by clinical observations of leukemia and lymphoma regressions in patients following measles virus infection in the 1970s and 1980s. Since then, numerous preclinical studies have confirmed the oncolytic activity of MeV vaccine strains as well as their potential to promote long-lasting tumor-specific immune responses. Early clinical data indicate that some of these effects may translate to the treatment of cancer patients. In this review, we provide a structured summary of current evidence for the anti-tumor immune activity of oncolytic MeV. We start with an overview of MeV oncolysis and MeV-induced immunogenic cell death. Next, we relate findings on MeV-mediated activation of antigen-presenting cells, T cell priming and effector mechanisms to the cancer immunity cycle. We discuss additional factors in the tumor microenvironment which are modulated by MeV treatment as well as the role of anti-viral immunity. Based on these findings, we highlight avenues for rational enhancement of oncolytic MeV immunotherapy by vector engineering. We further point to advantages and drawbacks of experimental models and propose areas warranting promising research. Lastly, we review the available immunomonitoring data from several Phase I clinical trials. While this review presents data for MeV, the concepts and principles introduced herein apply to other oncolytic viruses, providing a framework to assess novel cancer immunotherapies.

In 2017, the WHO registered 23,927 measles cases in 44 out of 53 countries in the European region. In 2018, measles incidence rate increased up to 82,599 cases registered in 48 countries of the region, with a large number of measles-associated deaths. Overall, 72 measles fatalities were registered in 10 European countries, including Serbia (15 cases).Aim of the study: to characterize 2017—2018 epidemiological upsurge of measles incidence rate observed in the Republic of Serbia (RS) and the Northwestern Federal District (NWFD) of the Russian Federation.Materials and methods. During the 2017—2018 season, 944 serum samples were collected from patients with measles, rubella, or exanthematous diseases in the NWFD and tested in the Laboratory of Virology at the St. Petersburg Regional Centre for Measles Surveillance (SPbRC). In 2017—2018, 2,946 serum samples from the Republic of Serbia were analyzed in the SPbRC by using ELISA with IgM measles test system (Vector-Best, Russia; or Siemens, Germany). Urine and swab samples were examined by RT-PCR and used for isolation and genotyping of measles viruses.Results. From 2017 to 2018, 5,798 measles cases were registered in the RS, among which 2,946 were laboratory-confirmed (serological testing and/or PCR). Unvaccinated subjects or those with unknown vaccination status accounted for majority of the cases. Children under 5 years of age and adults aged 30 years and over dominated among measles patients. During this season, 15 deaths were reported. Several genotypes of measles virus circulated in the RS, e.g. В3 Dublin, D8 Gir Somnath, and D8 Herborn. In 2018, 109 measles cases were recorded in the NWFD, 5 of which were imported from abroad. Among patients, adults comprised 64.2%, wherein 74.3% were covered by unvaccinated subjects or those with unknown vaccination status. Rise in measles incidence rate linked to multiple importations of various measles virus genotypes: В3 Kabul; B3 Dublin; D8 Frankfurt; D8 Cambridge; and D8 Gir Somnath.

In 2010—2016, blood serum samples were examined from 5539 patients, aged < 1—60 years, with clinically and laboratory confirmed measles. Primary or secondary type of immune response was determined for all measles cases. Studies were performed with children aged < 1—14 years (2381), adolescents, 15—17 years old (189), and adults aged 18—60 years (2969). Serum measles-specific IgM antibodies were measured by “VektoKor’ IgM” ELISA test system (Russia), concentration and avidity of specific IgG — by using “Anti-Measles Viruses ELISA/IgG” and “Avidity: Anti-Measles Viruses ELISA/ IgG” (Euroimmun, Germany). Primary immune response was identified based on the presence of serum measles-specific low avidity IgM and IgG antibodies, whereas secondary immune response was characterized by detecting high avidity IgM and IgG antibodies at concentration of ≥ 5.0 IU/ml. Analyzing measles-specific IgM antibodies in 2010—2016 demonstrated that measles morbidity was mainly due to children, aged 1—2 years reaching up to 39.9% of the total number of children with measles aged < 1—14 years as well as adults aged 18—40 years old comprising as high as 80.1% total number of patients aged 15—60 years. Serum measles-specific IgG testing showed that in 15.0% of cases they were detected at concentration of ≥ 5.0 IU/ml. Further serum dilution resulted in finding IgG titer ranging within 8.5—45.0 IU/ml (21.4+0.36) and high avidity antibodies in 80—100% (92.5+0.2) cases. The remaining 85.0% cases found low avidity measles-specific IgG antibodies (< 30%) at concentration of 0.2—3.46 IU/ml (1.73+0.03). An age-related analysis of our data demonstrated that all children under 14 with laboratory-confirmed measles developed primary immune response. Moreover, in 73.7% of measles patients aged 15—60 with primary immune response measles might be prevented by timely vaccination, whereas persons with “vaccine failure” comprised 26.3%. In 2010 (0.09 per 100,000 subjects) and 2016 (0.12 per 100,000 subjects), frequency of patients with “vaccine failure” during relative epidemic well-being was 35.3% and 18.2%, respectively, exceeding 9.9% (p < 0.001) serving as a hallmark 2014 high measles incidence rate (3.24 per 100,000 subjects).The data obtained indicate that measles virus circulate among people with “vaccine failure,” which may account for potential to spread and infect unprotected population cohorts as well as cause measles outbreaks during periods of epidemic well-being.

Introduction. Measles remains an urgent problem in Russian healthcare. Despite the ongoing vaccination, there is an increase in the incidence of measles. Prevention of measles is particularly important in high-risk groups, as well as among healthcare professionals to prevent hospital-acquired outbreaks of infection. The duration of post-vaccination immunity during the elimination of measles has not been sufficiently studied, so often people who have had measles in childhood or have 1–2 vaccinations against the disease lose their protective antibodies with age in the absence of natural boosterization. Goals and objectives . To study the intensity of specific immunity to measles in employees of the maternity unit. Material and methods . The study involved 271 employees of the maternity unit aged 21 to 93 years (262 serum samples). The level of IgG antibodies (Ab) to the measles virus in the blood serum was studied by ELISA using a standard set of reagents for the quantitative determination of IgG by «VECTOR-BEST». The result was considered negative if the concentration of IgG to the measles virus in tested sample was ≤ 0.18 IU/ml and positive – if > 0.18 IU/ml. Results . The number of seronegatives ranged from 0% to 30.8% in female employees with its maximum at age of 31–35 years. The lowest proportion of seronegative and the highest proportion of seropositive women were observed among the elderly, > 60 years. Discussion. There is a marked tendency for an increase of the proportion of persons with average Ab levels with age and a decrease of the proportion of persons with low Ab levels. The percentage of seronegative women among employees exceeded the recommended level, which makes it possible for an nosocomial outbreak when an infection is introduced. Conclusion. The authors recommend that serological testing for the intensity of the immune response against measles should be included in the standard of the pre-vaccination screening for adults.

Laboratory information is an important tool for determining indications for preventive measures and evaluating their effectiveness in healthy individuals. In the instructions for some test-systems for IgG to measles virus, the results of the study are interpreted on the basis of analytical characteristics of the reagents and have no connection with the determination of this indicator in the reference group. At the moment, there is no document setting the protective level of anti-measles Ig G. The aim of the study is to establish reference values of IgG to measles virus by immunoenzyme analysis for health care professionals. The reference group was formed of 299 people and divided into two subgroups: older and under 44 years of age. Reference intervals were calculated according to the CLSI C 28-A3 protocol. The set reference intervals were different from the manufacturer’s stated values. The question arises as to whether the values established by the manufacturer, based on the analytical characteristics of a particular test system, should be used when identifying risk groups of persons with a low level of immunity.

International audience; No abstract available

Objective: to evaluate the intensity of measles immunity in students of I–VI courses of the pediatric faculty of St. Petersburg State Medical University.Materials and methods: titers of antibodies to measles virus were determined in 986 students of I–VI courses in May –June 2019. The level of measles antibodies was determined by enzyme-linked immunosorbent assay.Results: positive (protective) titres of measles antibodies were detected in 555 people. (56.4%), the absence of measles immunity was found in 431 people. (43.6%), including 57 people. (5.8%) specific antibodies were not detected. The relationship between the level of collective immunity and the duration of the period after the last vaccination against measles was revealed.Conclusions: in the majority of examined students (96.2%), protective titers of measles antibodies remained for 10 years after the last vaccination. Subsequently, a significant decrease in the level of measles antibodies was noted. All students who do not have a protective IgG titer are shown measles vaccination with live measles vaccine in accordance with the instructions for use.

Subacute sclerosing panencephalitis (SSPE) is a rare and progressive inflammatory disease of central nervous system due to aberrant measles virus with an outcome that is nearly always fatal. In acute fulminant SSPE, the disease rapidly evolves leading to death within 3 months of the diagnosis. We report here four cases of fulminant SSPE with atypical presentations, two of them presented at very early age with history of congenital measles infection in first case and gait abnormality as initial symptom in second case; acute disseminated encephalomyelitis (ADEM) with refractory seizures in third case, unilateral myoclonus with hemiparesis in fourth case at the onset of disease, respectively. The typical periodic electroencephalographic (EEG) complexes, elevated cerebrospinal fluid (CSF), and serum antimeasles antibodies in our patients led to the diagnosis of SSPE. A high index of clinical suspicion in fulminant type with awareness of atypical features, EEG, and CSF studies are of paramount importance in establishing its diagnosis.

Relevance. In recent years, in Russia, against the background of a stable high (no less than 95%) coverage of live measles vaccine (GI) inoculations of decreed groups of the population for almost twenty years, increases in morbidity have been registered, reaching the indicators of 3.3(2014) and 3.1 (2019) per 100 ths population and local outbreaks involving the child population. This situation has raised doubts among a number of researchers about the reliability of high vaccination coverage in children and adults. In this regard, some researchers assumed the loss of post-vaccination immunity and suggested revaccination against measles every 10 years for people up to 50 years old. Others suggested serological examination of certain cohorts of the adult population without taking into account the vaccination history for timely detection and vaccination of individuals with primary post-vaccination failures and who have lost post-vaccination immunity. The purpose of the work: to assess the state of population immunity for some manifestations of the epidemic process of measles infection and the feasibility of changing the tactics of vaccination against measles. Materials and methods. The work uses epidemiological operational and retrospective analysis. The research is based on the analysis of official statistics № 2, № 5, № 6, reports of regional centers, «maps of the surveillance of a case of suspected measles...», information and analytical bulletins of the National scientific and methodological center for the supervision of measles and rubella (NNMC). A total of 18,750 documents were analyzed. The average values, the average standard error, the correlation coefficient of the series, the reliability of the correlation coefficient, and the regression coefficient were calculated. Results and discussion. One of the indirect indicators of the state of population immunity is the ratio of vaccinated and not vaccinated against measles in the structure of patients. The analysis showed a steady trend towards the prevalence of cases not vaccinated against measles in the structure: since 2011, more than 70%, and since 2017 – more than 80%. The percentage of vaccinated people is decreasing from 12.8% to 5.4% (2017) and has stabilized in the last 2.5 years at the level of 5.4–7.2%. Over the past 2 years, there has also been some stabilization of the proportion of people twice vaccinated – 9.4–9.8%. Intensive indicators of morbidity confirmed the General trend of extensive indicators. In addition, over the past 3 years, the intensive incidence rate of those vaccinated is 14 times lower than that of those not vaccinated against measles. All this testifies to the lack of accumulation of susceptible individuals due to the loss of post-vaccination immunity and confirms the adequacy of the strategy and tactics of vaccination against measles in our country. The calculation of the regression coefficient showed that with an increase in vaccination coverage of the entire population by one percent, the incidence of measles among unvaccinated people will increase by 1.34 per one hundred thousand unvaccinated people against measles. The prevalence of foci without infection spread (more than 80%) during the analyzed period, and the restriction of secondary measles spread by the second generation of infection reproduction in foci with two or more cases of measles, multiple circulation of genotypes and subtypes of the measles virus also characterizes a fairly high population immunity. Conclusion. The steady predominance of lesions 1 case, limiting secondary spread of infection in outbreaks, the maintenance of the epidemic process of measles through an unvaccinated population indicate adequate tactics and strategy for measles immunization in our country. At the same time, the achieved 74.1% vaccination coverage of the entire population is clearly not enough to prevent sustained endemic transmission of the measles virus, since the reproductive index R

Relevance. Measles is one of the most contagious infectious viral diseases affecting all age groups and leading to severe complications. There is no specific therapy for measles, but highly effective vaccines are available for specific prevention, both in monoform and in combination. The world is currently experiencing a significant rise in the incidence of measles, which dictates the need to increase coverage with preventive vaccinations. Aims. Show the necessity of using combined drugs for the prevention of measles, rubella, and mumps in non-standard clinical situations and in pregravid preparation. Conclusions. All currently used vaccines, regardless of strain composition, are capable of providing effective protection against wild variants of the measles virus. Combined drugs against measles, rubella, and mumps, have proven their safety and effectiveness for many years of use in the world, including in Russia, and can be used without restrictions. Combined vaccination against measles, rubella, and mumps should be considered as a mandatory measure for additional immunization of citizens who do not have information about revaccination or acceptable confirmation of the immune status, especially as a mandatory element of pre-conceptional preparation of women of childbearing age.

Subacute Sclerosing Panencephalitis (SSPE) is a progressive neurodegenerative disease that attacks the central nervous system, especially in the population of children and early adolescents, due to persistent measles virus infection. The incidence of SSPE is quite rare, and data shows that in developing countries it is still quite high compared to developed countries. Diagnosis is based on clinical, supporting examinations such as EEG, as well as increased antibodies against measles virus in serum and cerebrospinal fluid. Symptoms can include changes in behavior, myoclonus, memory problems, and persistent pyramidal or extrapyramidal movements. Management to date has not provided satisfactory results and is individualized. Most SSPE patients experience a progressive and gradual course, leading to death within 1-3 years. The challenge of SSPE in children is the approach to diagnosis and management. Until now, the approach to treating SSPE in children is still based on the pathophysiological mechanisms from several existing research studies. That why therapy guidelines for children with SSPE are still varied. This paper aims to discuss the topic of SSPE in children with a major focus on diagnostic and therapeutic approaches based on the latest scientific evidence. Keywords: Subacute Sclerosing Panencephalitis (SSPE), children, diagnosis, therapy

In 2017, WHO reported 596 confirmed measles cases in Guinea Republic connected to the 2016–2017 epidemic outbreak that was stopped after additional immunization (SIA) against measles in two provinces of the country. Improving the effectiveness of SIA is associated with the identification of epidemiologically significant groups of the population. The aim of the study was to analyze 2017–2018 measles cases and assess population immunity to measles virus in the Republic of Guinea. Materials and methods. A total of 810 blood serum samples collected from patients with maculo-papular rash and clinical diagnosis “measles?” were tested for measles virus-specific IgM-and IgG antibody level. 445 sera of conditionally healthy individuals aged 7 months to 67 years were examined for anti-measles virus IgG antibody level. Immunoglobulins of classes M and G were detected by ELISA with test systems «Anti-Measles Virus ELISA (IgM)» (Euro immun, Germany) and «Anti-Measles Virus ELISA (IgG)» (Euroimmun, Germany). Results and discussion.In 2017–2018, the epidemic process of the measles in the Republic of Guinea proceeded very intensively, being markedly prevalent in children among age groups. In 2018, more than half of the cases (61.6%) were identified in children aged 1 to 5 years old; the second most abundant age group was children under one year (18.6%), probably due to violated measles vaccination, which in GR are subject to children of nine months of age. It was found that 16.4% of patients (60 out of 366) had documented data on measles vaccination. Potentially, high proportion of measles cases among pre-vaccinated subjects was due to insufficient immune response to a single immunization in children of 9 months of age. Moreover, lowered vaccine-related properties might also be violated “cold chain” during vaccine transportation occurring in tropical climate. Analyzing 445 subjects revealed that total number of measles virus seronegative subjects was 8.3%. However, the vast majority of them were children and young adults aged 7 months to 22 years, where 52.4% of seronegative subjects were identified. Thus, the data obtained indicate that intensive measles virus circulation in human population was continued that necessitate interventions for improving epidemiological surveillance, extend routine measles vaccination coverage and conduct SIAs against measles in GR.

From a long time ago to the present day, measles remains one of the leading health problems in the world. The main reason for this is high mortality from measles – 1/500. Despite the availability of an effective and safe vaccine, which was discovered in 1963, there are still epidemic outbreaks of measles. According to WHO, there were 413,308 confirmed cases in 187 countries and 764 deaths during 2019. Most measles deaths are due to complications associated with the disease.Complications are most common in children under five or in adults over 30 years of age. The most serious complications include blindness, encephalitis leading to cerebral edema, severe diarrhoea and associated dehydration, purulent otitis and severe lower respiratory tract infections such as pneumonia. In a study from 2019, Michael J. Mina and colleagues showed that after measles in the group of unprivileged people, 11 to 73% of previous immune memory is “erased”. Currently, there is no specific etiotropic therapy for measles. One of the pathogenetic links in therapy is the use of interferon replacement therapy. According to the Federal Clinical Recommendations and WHO recommendations, the use of recombinant interferon α-2B and vitamin A is recommended. The effectiveness of interferonotherapy for measles was first shown in 1992 by the Leopardi R team. This study showed that the secretion of measles virus in human peripheral blood mononuclear cells was gradually reduced by increasing the concentrations and blocked at the concentration of interferon α-2B in 1000 units/ml. Moreover, at the XXIV World Congress of Neuroscientists (WCN) it was noted that the safest and most effective method of treatment of subacute sclerosing panencephalitis, one of the severe complications of measles, is recombinant human α-2B interferon.

BACKGROUND Subacute sclerosing panencephalitis (SSPE) is a progressive neurologic disorder caused by the measles virus (MV) and is identified by positive MV-specific antibody titers, detected mainly by hemagglutination inhibition (HI) tests in the cerebrospinal fluid (CSF). However, an alternative method, the enzyme immunoassay (EIA), has increasingly become a preferred method for detecting MV antibodies. To establish the index for SSPE diagnosis using EIA, we investigated the correlation between HI and EIA titers of MV antibodies in SSPE patients. METHODS Data on MV antibody titers and measurement methods at the time of diagnosis in 89 Japanese SSPE cases diagnosed between 1979 and 2006 were obtained by a survey. We also assessed the serum and CSF MV antibody titers in three patients with SSPE and serum MV antibody titers in 38 healthy adults using immunoglobulin G (IgG)-EIA and HI. RESULTS In all cases diagnosed as SSPE, IgG-EIA titers in the CSF were ≥0.49 IU/mL. There was a positive correlation between serum antibody values in the controls measured by IgG-EIA and HI. In patients with SSPE, both serum and CSF antibody values, measured by IgG-EIA, and HI, were positively correlated, and a positive correlation was found between the serum and CSF MV antibody titers as measured by IgG-EIA. The serum/CSF MV antibody titer ratios determined by IgG-EIA were

© The Author(s) 2020.Dental health care workers are in close contact to their patients and are therefore at higher risk for contracting airborne infectious diseases. The transmission rates of airborne pathogens from patient to dental health care workers are unknown. With the outbreaks of infectious diseases, such as seasonal influenza, occasional outbreaks of measles and tuberculosis, and the current pandemic of the coronavirus disease COVID-19, it is important to estimate the risks for dental health care workers. Therefore, the transmission probability of these airborne infectious diseases was estimated via mathematical modeling. The transmission probability was modeled for Mycobacterium tuberculosis, Legionella pneumophila, measles virus, influenza virus, and coronaviruses per a modified version of the Wells-Riley equation. This equation incorporated the indoor air quality by using carbon dioxide as a proxy and added the respiratory protection rate from medical face masks and N95 respirators. Scenario-specific analyses, uncertainty analyses, and sensitivity analyses were run to produce probability rates. A high transmission probability was characterized by high patient infectiousness, the absence of respiratory protection, and poor indoor air quality. The highest transmission probabilities were estimated for measles virus (100%), coronaviruses (99.4%), influenza virus (89.4%), and M. tuberculosis (84.0%). The low-risk scenario leads to transmission probabilities of 4.5% for measles virus and 0% for the other pathogens. From the sensitivity analysis, it shows that the transmission probability is strongly driven by indoor air quality, followed by patient infectiousness, and the least by respiratory protection from medical face mask use. Airborne infection transmission of pathogens such as measles virus and coronaviruses is likely to occur in the dental practice. The risk magnitude, however, is highly dependent on specific conditions in each dental clinic. Improved indoor air quality by ventilation, which reduces carbon dioxide, is the most important factor that will either strongly increase or decrease the probability of the transmission of a pathogen.

Due to COVID-19 outbreaks, entire humanity across the globe is suffering from this deadly disease and searching for novel and more effective antiviral herbal drug for its complete cure. Ayurveda compendia have described herbal medicines which are said to be effective against all microorganisms. Hence in this paper attempt is made to review Krimighna drugs described in Ayurveda compendia and identify its efϑicacy on various viral diseases. Relevant references were searched concerning krimihar drugs described in Brihatrayee viz. Charak Samhita, Sushruta Samhita and Ashtanga Hridaya. Scientiϑic research papers related to pre-clinical and clinical studies showing the antiviral activity of individual krimighna drugs were also searched. In all Samhitas total, 56 drugs were found having Krimighna properties. Out of these only ten drugs are found to have antiviral activity against various type of viruses such as Herpes Simplex virus (HSV type 1 & 2), Dengue virus (DNGV), Newcastle Disease virus (NDV), Sindbis virus(SINV) Measles virus, Poliovirus. Herbal medicinal drugs have great potential to treat viral diseases. Considering the global disease burden caused by COVID-19, there is an urgent need to explore the Krimighna drugs with antiviral activity and to develop novel and useful antiviral agents to combat the COVID -19 menace effectively.