Davidkin I, Valle M, Peltola H, Hovi T, Paunio M, Roivainen M, Linnavuori K, Jokinen S, Leinikki P
National Public Health Institute, Helsinki University Central Hospital,Helsinki, Finland.
J Infect Dis. 1998 Dec;178(6):1567-70. doi: 10.1086/314513.
The viral etiology of measles- or rubella-like illnesses after MMR (measles, mumps, and rubella) vaccination was studied prospectively in 993 acutely ill Finnish children with fever and rash in 1983-1995. Their sera were tested for adeno-, entero-, and parvovirus B19 antibodies. Sera of 300 children <4 years old were also tested for human herpesvirus 6 (HHV-6) antibodies. Measles and rubella had been excluded by previous antibody testing. Serologic diagnosis of adeno-, entero-, or parvovirus infection was based on EIA (IgM or IgG antibodies) and that of HHV-6 on indirect immunofluorescence. A viral etiology was verified in 368 cases, most commonly parvovirus (20%), followed by enterovirus (9%) and adenovirus (4%). Among young children, HHV-6 infection was found in 37 (12%). Thirty-eight children (4%) had double infections. This study confirms that measles- or rubella-like illnesses in MMR-vaccinated children are often caused by other viruses. Each suspected vaccine failure requires laboratory confirmation to maintain reliable surveillance and control and to establish the specific etiology of the disease.
1983年至1995年期间，对993名患有发热和皮疹的急性病芬兰儿童进行了前瞻性研究，以探讨麻疹、腮腺炎和风疹（MMR）疫苗接种后出现的麻疹样或风疹样疾病的病毒病因。检测了他们血清中的腺病毒、肠道病毒和细小病毒B19抗体。还检测了300名4岁以下儿童血清中的人类疱疹病毒6型（HHV-6）抗体。通过先前的抗体检测排除了麻疹和风疹。腺病毒、肠道病毒或细小病毒感染的血清学诊断基于酶免疫分析（IgM或IgG抗体），HHV-6的诊断基于间接免疫荧光法。在368例病例中证实了病毒病因，最常见的是细小病毒（20%），其次是肠道病毒（9%）和腺病毒（4%）。在幼儿中，发现37例（12%）感染了HHV-6。38名儿童（4%）有双重感染。这项研究证实，接种MMR疫苗的儿童中出现的麻疹样或风疹样疾病通常由其他病毒引起。每例疑似疫苗接种失败病例都需要实验室确诊，以维持可靠的监测和控制，并确定疾病的具体病因。
