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Human Vaccines Oct 2011Measles is a highly infectious, acute respiratory illness that is caused by a virus of the genus Morbillivirus. The disease infects nearly 30 million children each year,... (Review)
Review
Measles is a highly infectious, acute respiratory illness that is caused by a virus of the genus Morbillivirus. The disease infects nearly 30 million children each year, and deaths usually occur from complications related to pneumonia, diarrhea and malnutrition. A systematic review of published Indian literature depicts the median case fatality ratio (CFR) of measles to be 1.6%. Through immunization, measles deaths dropped a remarkable 78% from 733,000 in 2000 to 164,000 in 2008. As of 2008, 192 of 193 Member States of WHO use 2 doses of measles vaccine in their national immunization programs, India being the only exception. The Millennium Development Goal (MDG) 4 aims to reduce by two-thirds between 1990 and 2015 the under-five mortality rate (U5MR) in the world. Per the draft comprehensive Multi Year Strategic Plan (cMYP, 2010–17) for immunization of India, the country aims to reduce measles-related mortality by 90% by 2013 when compared to 2000. As recommended by the National Technical Advisory Group on Immunization (NTAGI), the implementation strategy of the second dose of measles vaccine at the state level is determined by the underlying performance of the routine immunization program. The second dose in the national immunization schedule gives extra immunity against measles infection that renders children more susceptible to secondary pneumonia and diarrheal diseases, which are the primary causes of under-5 child mortality in India.
Topics: Child, Preschool; Health Policy; Humans; Immunization Programs; Immunization, Secondary; India; Infant; Measles; Measles Vaccine; Vaccination
PubMed: 22238787
DOI: 10.4161/hv.7.10.16890 -
Biomedica : Revista Del Instituto... Mar 2011Thrombocytopenia is a frequent phenomenon in viral infections. Peripheral platelet destruction mediated by anti-platelet antibodies has been one of the proposed causal... (Review)
Review
INTRODUCTION
Thrombocytopenia is a frequent phenomenon in viral infections. Peripheral platelet destruction mediated by anti-platelet antibodies has been one of the proposed causal mechanisms.
OBJECTIVE
Results were collected and analyzed from published studies on associations of human viral infections on anti-platelet antibodies and total platelet counts.
MATERIALS AND METHODS
A PubMed search was conducted using the following terms: Viral infection (OR Virus diseases) AND antiplatelet antibody (OR thrombocytopenia) AND HIV (OR measles OR dengue OR chickenpox OR varicella OR Epistein Barr OR mumps OR rubella). Two hundred eighteen reference hits were obtained, 65 of which were relevant to this review.
RESULTS
Antiplatelet antibody-mediated thrombocytopenia has been documented in cases of HIV, measles, dengue, chickenpox, Epstein-Barr, mumps and rubella. Moreover, the presence of these antibodies has been associated with severity the disease and thrombocytopenia in viral infections.
CONCLUSIONS
Although the presence of antiplatelet antibodies was not the only mechanism for explaining the thrombocytopenia developed in these viral infections, their presence was associated with severity of thrombocytopenia and with the clinical presentation of these patients.
Topics: Antibodies; Blood Platelets; Databases, Factual; Humans; Thrombocytopenia; Virus Diseases
PubMed: 22159482
DOI: 10.1590/S0120-41572011000100006 -
The Cochrane Database of Systematic... Apr 2011Reduced vitamin A concentration increases the risk of blindness in children infected with the measles virus. Promoting vitamin A supplementation in children with measles... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Reduced vitamin A concentration increases the risk of blindness in children infected with the measles virus. Promoting vitamin A supplementation in children with measles contributes to the control of blindness in children, which is a high priority within the World Health Organization (WHO) VISION 2020 The Right to Sight Program.
OBJECTIVES
To assess the efficacy of vitamin A in preventing blindness in children with measles without prior clinical features of vitamin A deficiency.
SEARCH STRATEGY
We searched CENTRAL (2011, issue 1), which includes the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE (1950 to January 2011), EMBASE.com (1974 to January 2011) and LILACS (1985 to January 2011).
SELECTION CRITERIA
Randomised controlled trials (RCTs) assessing the efficacy of vitamin A in preventing blindness in well-nourished children diagnosed with measles but with no prior clinical features of vitamin A deficiency.
DATA COLLECTION AND ANALYSIS
Two review authors independently searched the results for eligible studies and extracted data on reported outcomes. We contacted trial authors of the included studies for additional information on unpublished data. We included two RCTs which were clinically heterogenous. We presented the continuous outcomes reported as the mean difference (MD) with 95% confidence interval (CI). Due to marked clinical heterogeneity we considered it inappropriate to perform a meta-analysis.
MAIN RESULTS
Two RCTs involving 260 children with measles which compared vitamin A with placebo met the inclusion criteria. Neither study reported blindness or other ocular morbidities as end points. One trial of moderate quality suggested evidence of a significant increase in serum retinol levels in the vitamin A group one week after two doses of vitamin A (MD 9.45 µg/dL; 95% CI 2.19 to 16.71, 17 participants) but not six weeks after three doses of vitamin A (MD 2.56 µg/dL; 95% CI -5.28 to 10.40; 39 participants). There was no significant difference in weight gain six weeks (MD 0.39 kg; -0.04 to 0.82; 48 participants) and six months (MD 0.52 kg; 95% CI -0.08 to 1.12; 36 participants) after three doses of vitamin A. The second trial found no significant difference in serum retinol levels two weeks after a single dose of vitamin A (MD 2.67 µg/dL; 95% CI -0.29 to 5.63, 155 participants).
AUTHORS' CONCLUSIONS
We did not find any trials assessing whether or not vitamin A supplementation in children with measles prevents blindness. However, vitamin A use in children should be encouraged for its proven clinical benefits.
Topics: Adolescent; Blindness; Child; Child, Preschool; Humans; Infant; Measles; Randomized Controlled Trials as Topic; Vitamin A; Vitamins
PubMed: 21491401
DOI: 10.1002/14651858.CD007719.pub2 -
Lupus Nov 2009Transverse myelitis is a rare clinical syndrome in which an immune-mediated process causes neural injury to the spinal cord. The pathogenesis of transverse myelitis is... (Review)
Review
Transverse myelitis is a rare clinical syndrome in which an immune-mediated process causes neural injury to the spinal cord. The pathogenesis of transverse myelitis is mostly of an autoimmune nature, triggered by various environmental factors, including vaccination. Our aim here was to search for and analyze reported cases of transverse myelitis following vaccination. A systematic review of PubMed, EMBASE and DynaMed for all English-language journals published between 1970 and 2009 was preformed, utilizing the key words transverse myelitis, myelitis, vaccines, post-vaccination, vaccination and autoimmunity. We have disclosed 37 reported cases of transverse myelitis associated with different vaccines including those against hepatitis B virus, measles-mumps-rubella, diphtheria-tetanus-pertussis and others, given to infants, children and adults. In most of these reported cases the temporal association was between several days and 3 months, although a longer time frame of up to several years was also suggested. Although vaccines harbor a major contribution to public health in the modern era, in rare cases they may be associated with autoimmune phenomena such as transverse myelitis. The associations of different vaccines with a single autoimmune phenomenon allude to the idea that a common denominator of these vaccines, such as an adjuvant, might trigger this syndrome.
Topics: Adolescent; Adult; Autoimmunity; Child; Child, Preschool; Databases, Factual; Humans; Infant; Middle Aged; Myelitis, Transverse; Vaccination; Vaccines; Young Adult
PubMed: 19880568
DOI: 10.1177/0961203309345730 -
The Cochrane Database of Systematic... Oct 2009Measles is an infectious disease caused by the Morbilli virus. Chinese physicians believe that medicinal herbs are effective in alleviating symptoms and preventing... (Review)
Review
BACKGROUND
Measles is an infectious disease caused by the Morbilli virus. Chinese physicians believe that medicinal herbs are effective in alleviating symptoms and preventing complications. Chinese herbal medicines are dispensed according to the particular symptoms. This is an update of a Cochrane review first published in 2006.
OBJECTIVES
To assess the effectiveness and possible adverse effects of Chinese medicinal herbs in treating measles.
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library 2009, issue 1) which contains the Cochrane Acute Respiratory Infection Group's Specialised Register; MEDLINE (1966 to March 2009); EMBASE (1980 to March 2009); the Chinese Biomedical Database (1976 to March 2009); VIP Information (1989 to March 2009); and China National Knowledge Infrastructure (CNKI) (1994 to March 2009). We searched the metaRegister of Controlled Trials for ongoing trials.
SELECTION CRITERIA
Randomised controlled trials (RCTs) in which patients with measles without complications were treated with Chinese medicinal herbs.
DATA COLLECTION AND ANALYSIS
Three review authors (YZ, RG, TW) independently assessed trial quality and extracted data. We telephone interviewed the study authors for missing information regarding participant allocation. Some trials allocated participants according to the sequence they were admitted to the trials, that is to say, by using a pseudo-random allocation method; none of the trials concealed the allocation or blinding method.
MAIN RESULTS
We did not identify any suitable trials for inclusion. In this updated review we identified 61 trials which claimed to use random allocation. We contacted 29 trial authors by telephone and learned that the allocation methods used were not randomised. We excluded 34 studies because the patients experienced complications such as pneumonia. Both reasons excluded 10 studies. Another study was excluded because the trial author had not confirmed the diagnosis of measles. We were unable to contact the remaining seven trials' authors, so that they require further assessment and, meanwhile are allocated to the 'Studies awaiting classification' section.
AUTHORS' CONCLUSIONS
There is no evidence from RCTs for or against Chinese medicinal herbs as a treatment for measles. We hope high quality, robust RCTs in this field will be conducted in the future.
Topics: Adult; Child; Drugs, Chinese Herbal; Humans; Measles
PubMed: 19821347
DOI: 10.1002/14651858.CD005531.pub3 -
The Lancet. Infectious Diseases May 2009Knowledge of the incubation period is essential in the investigation and control of infectious disease, but statements of incubation period are often poorly referenced,... (Review)
Review
Knowledge of the incubation period is essential in the investigation and control of infectious disease, but statements of incubation period are often poorly referenced, inconsistent, or based on limited data. In a systematic review of the literature on nine respiratory viral infections of public-health importance, we identified 436 articles with statements of incubation period and 38 with data for pooled analysis. We fitted a log-normal distribution to pooled data and found the median incubation period to be 5.6 days (95% CI 4.8-6.3) for adenovirus, 3.2 days (95% CI 2.8-3.7) for human coronavirus, 4.0 days (95% CI 3.6-4.4) for severe acute respiratory syndrome coronavirus, 1.4 days (95% CI 1.3-1.5) for influenza A, 0.6 days (95% CI 0.5-0.6) for influenza B, 12.5 days (95% CI 11.8-13.3) for measles, 2.6 days (95% CI 2.1-3.1) for parainfluenza, 4.4 days (95% CI 3.9-4.9) for respiratory syncytial virus, and 1.9 days (95% CI 1.4-2.4) for rhinovirus. When using the incubation period, it is important to consider its full distribution: the right tail for quarantine policy, the central regions for likely times and sources of infection, and the full distribution for models used in pandemic planning. Our estimates combine published data to give the detail necessary for these and other applications.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Humans; Infant; Infectious Disease Incubation Period; Male; Middle Aged; Respiratory Tract Infections; Young Adult
PubMed: 19393959
DOI: 10.1016/S1473-3099(09)70069-6 -
Autoimmunity Reviews Dec 2009To review our current knowledge of the etiopathogenesis of otosclerotic bone remodeling including genetics, viral infection, autoimmunity and inflammation and to discuss... (Review)
Review
OBJECTIVES
To review our current knowledge of the etiopathogenesis of otosclerotic bone remodeling including genetics, viral infection, autoimmunity and inflammation and to discuss disease pathogenesis with relevance for pharmacotherapy.
SYSTEMATIC REVIEW METHODOLOGY
Relevant publications on the etiopathogenesis, molecular biology, genetics and histopathology of otosclerosis from 1984 to 2009 were analyzed.
RESULTS AND CONCLUSIONS
Otosclerosis is a bone remodeling disorder of the human otic capsule, however, the etiopathogenesis remains unclear. Genetic predisposition, disturbed bone metabolism, persistent measles virus infection, autoimmunity, hormonal and environmental factors also may play contributing roles in the pathogenesis of otosclerosis. Since, diagnosis of otosclerosis is still based on histopathological examination of the removed stapes footplate, systemic prospective studies based on comprehensive histopathological and molecular biological analysis are necessary to get further information about the background of disease.
Topics: Animals; Anti-Inflammatory Agents; Autoimmune Diseases; Collagen Type I; Collagen Type I, alpha 1 Chain; Comorbidity; Genetic Predisposition to Disease; Humans; Measles; Measles virus; Otosclerosis; Polymorphism, Genetic; Vitamin D
PubMed: 19318139
DOI: 10.1016/j.autrev.2009.03.009 -
Vaccine Jan 2008Aerosols are the most promising non-injectable method of measles vaccination studied so far and their efficacy is thought to be comparable to injected vaccine. We... (Meta-Analysis)
Meta-Analysis Review
Aerosols are the most promising non-injectable method of measles vaccination studied so far and their efficacy is thought to be comparable to injected vaccine. We conducted a systematic review up to May 2006 to examine the immunogenicity and safety of aerosolized measles vaccine (Edmonston-Zagreb or Schwarz strains) 1 month or more after vaccination. Where possible we estimated pooled serological response rates and odds ratios (with 95% confidence intervals, CI) comparing aerosolized and subcutaneous vaccines in children in three age groups and adults. We included seven randomized trials, four non-randomized trials and six uncontrolled studies providing serological outcome data on 2887 individuals. In children below 10 months, the studies were heterogeneous. In four comparative studies, seroconversion rates were lower with aerosolized than with subcutaneous vaccine and in two of these the difference was unlikely to be due to chance. In children 10-36 months, the pooled seroconversion rate with aerosolized vaccine was 93.5% (89.4-97.7%) and 97.1% (92.4-100%) with subcutaneous vaccine (odds ratio 0.27, 0.04-1.62). In 5-15-year olds the studies were heterogeneous. In all comparative studies aerosolized vaccine was more immunogenic than subcutaneous. Reported side effects were mild. Aerosolized measles vaccine appears to be equally or more immunogenic than subcutaneous vaccine in children aged 10 months and older. Large randomized trials are needed to establish the efficacy and safety of aerosolized measles vaccine as primary and booster doses.
Topics: Adolescent; Adult; Aerosols; Antibodies, Viral; Child; Child, Preschool; Clinical Trials as Topic; Humans; Immunization; Infant; Measles; Measles Vaccine; Measles virus; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 18082295
DOI: 10.1016/j.vaccine.2007.11.010 -
BMJ Clinical Evidence Feb 2007Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding... (Review)
Review
INTRODUCTION
Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding complications in survivors. Mumps can cause neurological problems and hearing loss, orchitis with infertility, and pancreatitis. Rubella infection is usually mild, but can lead to fetal death or severe congenital abnormalities if contracted in early pregnancy. The incidence of all three infections has decreased significantly in countries with routine vaccination programmes targeted at these diseases, but decreased vaccination rates are associated with increased risks of infection.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of measles, mumps, and rubella vaccination? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 94 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: MMR vaccine, monovalent measles vaccine, monovalent mumps vaccine, and monovalent rubella vaccine.
Topics: Deafness; Hearing; Hearing Loss; Humans; Measles; Mumps; Recovery of Function; Risk Factors; Rubella; Treatment Outcome; Virus Diseases
PubMed: 19454052
DOI: No ID Found -
Epidemiologic Reviews 2006Compared with nonindigenous people, indigenous people in first-world countries have experienced much higher rates of many vaccine preventable diseases. This systematic... (Review)
Review
Compared with nonindigenous people, indigenous people in first-world countries have experienced much higher rates of many vaccine preventable diseases. This systematic review of published scientific literature, government reports, and immunization guidelines from Australia, Canada, New Zealand, and the United States compares pre- and postvaccination disease rates and vaccination policy for indigenous people in these four countries. Nationally funded universal vaccination programs are clearly the most effective way of reducing disease in indigenous populations. Most successful have been programs for viral diseases in which strain variations are not important and herd immunity is high, such as measles and hepatitis B. For bacterial infections, strain variations (pneumococcal disease), heavy nasopharyngeal colonization of young infants (pneumococcal and Haemophilus influenzae type b disease), low vaccine effectiveness in adults with a high prevalence of risk factors (polysaccharide pneumococcal vaccine), and waning immunity (pertussis) have been associated with continuing or widening disparities between indigenous and nonindigenous populations. However, universal vaccination programs are not always possible. Geographic targeting of all persons in certain regions with high disease rates has been successful, as has targeting of indigenous populations in regions where they constitute larger proportions of the population. In national programs targeting only indigenous people, it has been difficult to achieve high coverage, particularly in urban areas. Innovative program approaches are particularly needed in these situations.
Topics: Australia; Bacterial Infections; Canada; Communicable Disease Control; Health Policy; Health Services, Indigenous; Humans; Immunity, Herd; Immunization Programs; New Zealand; Practice Guidelines as Topic; United States; Virus Diseases
PubMed: 16763071
DOI: 10.1093/epirev/mxj005