Characteristics of serological profile in adult measles patients depending on the development of complications

Authors

DOI:

https://doi.org/10.14739/2310-1210.2020.6.218457

Keywords:

measles in adults, serological tests, complications

Abstract

 

The aim – to determine the characteristics of serological profile in adult measles patients depending on the development of complications.

Material and methods. In total, 88 patients with measles aged between 21 and 53 years were followed-up (36 men and 52 women). Measles was diagnosed according to the WHO criteria (2013). All the patients were tested for measles virus IgM at the end of the first week of the disease to confirm the diagnosis. Measles IgG was measured using ELISA (Vircell Microbiologists,Spain) on hospital admission, on average the (4.8 ± 0.2) day of the disease, to determine probable post-vaccination immunity to measles.

Results. It was found that in most adult measles patients (75.0 %), the diagnosis was confirmed by the detection of IgM to measles virus at the end of the first week of the disease, while the other patients were diagnosed with measles by clinical and epidemiological criteria.

Most patients (71.6 %) were seropositive with the presence of measles virus IgG on the 4.8 ± 0.2 day of the disease, others had a negative IgG serologic result. Complications of measles were diagnosed in the majority of adult patients (76.1 %), the frequency of which was associated (χ2 = 4.84, P < 0.01) with seropositivity in this follow-up period, namely complications were more common in the seronegative patients (92.0 %) against 69.8 % in the seropositive patients. Seronegative patients were more likely to have gastrointestinal complications as compared to seropositive individuals (68.0 % vs. 30.2 %, χ2 = 10.60, P < 0.001) due to more frequent development of hepatitis (68.0 % vs. 28.6 %, χ2 = 11.61, P < 0.001). The frequency of two or more complications combined was also clearly correlated with the presence of measles virus IgG in patients on day 4.8 ± 0.2 of the disease (χ2 = 7.70, P < 0.01).

A comparison of the quantitative content of IgG against measles virus in seropositive adult measles patients showed an association with the development of complications: the highest level was detected in patients with uncomplicated measles amounting to 23.58 [21.87; 26.78] optical density units. In seropositive adult patients with measles-associated hepatitis, the measles virus IgG content was lower (P = 0.004) than that in patients with uncomplicated measles. A similar pattern was observed in pneumonia development (P = 0.0002). There were correlations between measles virus IgG content and platelet count (r = +0.32, P < 0.05), relative number of lymphocytes (r = +0.46, P < 0.05), ALT activity (r = -0.45, P < 0.05), relative number of band neutrophils (r = -0.36, P < 0.05).

Conclusions. In adult measles patients on day 4.8 ± 0.2 of the disease, seropositivity with measles virus IgG presence was observed in 71.6 % of cases. Measles complications were recorded in 76.1 % of adult patients. The incidence of complications was correlated with the presence of IgG against measles virus. Complications were more common in seronegative patients than in seropositive ones (92.0 % vs. 69.8 %, P < 0.01). The development of pneumonia (P < 0.01) and hepatitis (P < 0.01) was associated with the lowest level of measles virus IgG.

References

Zadorozhna, V. I., Marychev, I. L., Protsap, O. I., & Bryzhata, S. I. (2019). Epidemichna sytuatsiia po zakhvoriuvanosti na kir v Ukraini u 2017 - 2018 rr. [Epidemic situation on measles in Ukraine in 2017 - 2018]. Infectious diseases of the present: etiology, epidemiology, diagnosis, treatment, prevention, biological safety: Proceedings of the scientific-practical conference dedicated to the annual «Reading» in memory of L. V. Gromashevsky. (pp. 76-79), SPD FO «Kolomitsyn V. Yu.». [in Ukrainian].

Hayman, D. (2019). Measles vaccination in an increasingly immunized and developed world. Human Vaccines & Immunotherapeutics, 15(1), 28-33. https://doi.org/10.1080/21645515.2018.1517074

Golubovska, O., Podolyuk, O., Ryabokon’, E., & Gainutdinova, T. (2018). Osobennosti klinicheskogo techeniya kori u vzroslykh v period epidemii 2018 goda [Features of the clinical course of measles in adults during the 2018 epidemic]. Klinicheskaya infektologiya i parazitologiya, 7(4), 518-526. [in Russian].

Gidding, H. F., Quinn, H. E., Hueston, L., Dwyer, D. E., & McIntyre, P. B. (2018). Declining measles antibodies in the era of elimination: Australia's experience. Vaccine, 36(4), 507-513. https://doi.org/10.1016/j.vaccine.2017.12.002

Toptygina, A. P., Smerdova, M. A., Naumova, M. A., Vladimirova, N. P., & Mamaeva, T. A. (2018). Vliyanie osobennostei populyatsionnogo immuniteta na strukturu zabolevaemosti kor'yu i krasnukhoi [Influence of population immunity peculiarities on the structure of measles and rubella prevalence]. Infektsiya i immunitet, 8(3), 341-348. https://doi.org/10.15789/2220-7619-2018-3-341-348 [in Russian].

Moyseyeva, A. V., Zadorozhna, V. I., Demchyshyna, I. V., & Novyk, L. V. (2013). Monitorynh populiatsiinoho imunitetu proty koru naselennia Ukrainy [Monitoring of population’s immunity is against measles of population in Ukraine]. Infektsiini khvoroby, (3), 10-15. https://doi.org/10.11603/1681-2727.2010.3.671 [in Ukrainian].

Kramarov, S. O., Yevtushenko, V. V., Kovalyukh, I. Yu., Kaminska, T. M., & Golovach, O. V. (2018). Klinichna kartyna koru v ditei, hospitalizovanykh pid chas spalakhu 2017-2018 rr. [Clinical features of measles in children hospitalized during 2017-2018 outbreak]. Aktual'naya infektologiya, 6(5), 240-245. https://doi.org/10.22141/2312-413x.6.5.2018.146773 [in Ukrainian].

Grammens, T., Schirvel, C., Leenen, S., Shodu, N., Hutse, V., Mendes da Costa, E., & Sabbe, M. (2017). Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. Euro Surveillance, 22(17), Article 30524. https://doi.org/10.2807/1560-7917.ES.2017.22.17.30524

Gibney, K. B., Attwood, L. O., Nicholson, S., Tran, T., Druce, J., Healy, J., Strachan, J., Franklin, L., Hall, R., & Cross, G. B. (2020). Emergence of Attenuated Measles Illness Among IgG-positive/IgM-negative Measles Cases: Victoria, Australia, 2008-2017. Clinical Infectious Diseases, 70(6), 1060-1067. https://doi.org/10.1093/cid/ciz363

Yu, D., Zhang, G., Gao, L., Xu, W., & Cao, B. (2018). High ratio of measles-specific IgG/IgM associated with nodular pneumonia in vaccinated individuals. International Journal of Infectious Diseases, 76, 38-44. https://doi.org/10.1016/j.ijid.2018.08.015

Monfort, L., Muñoz, D., Trenchs, V., Hernández, S., García, J. J., Aguilar, A. C., Juncosa, M. T., & Luaces, C. (2010). Measles outbreak in Barcelona. Clinical and epidemiological characteristics. Enfermedades Infecciosas y Microbiologia Clinica, 28(2), 82-86. https://doi.org/10.1016/j.eimc.2009.05.006

Premaratna, R., Luke, N., Perera, H., Gunathilake, M., Amarasena, P., & Chandrasena, T. G. (2017). Sporadic cases of adult measles: a research article. BMC Research Notes, 10(1), Article 38. https://doi.org/10.1186/s13104-017-2374-6

Trykhlib, V. I., Shchur, A. B., Hrushkevych, V. V., Hryshyn, O. S., Pavlovska, M. O., Musiienko, T. I., Muzyka A. A., Ralets, N. V., Dudar, D. M., & Kozachenko, L. V. (2018). Osoblyvosti klinichnykh proiaviv ta perebihu koru [Peculiarities of measles clinical manifestations and course]. Aktual'naya infektologiya, 6(3), 141-152. https://doi.org/10.22141/2312-413x.6.3.2018.136647 [in Ukrainian].

Pang, M., Xu, J. Y., Li, P., Han, X. X., & Li, M. Y. (2008). Clinical analysis of 51 cases of atypical measles syndrome characterized by fever and multiple lung lesions. Zhonghua Jie He He Hu Xi Za Zhi, 31(10), 731-735.

Moss, W. J. (2017). Measles. The Lancet, 390(10111), 2490-2502. https://doi.org/10.1016/S0140-6736(17)31463-0

Melenotte, C., Cassir, N., Tessonnier, L., & Brouqui, P. (2015). Atypical measles syndrome in adults: still around. BMJ Case Reports, 2015, Article bcr2015211054. https://doi.org/10.1136/bcr-2015-211054

Dinh, A., Fleuret, V., & Hanslik, T. (2013). Liver involvement in adults with measles. International Journal of Infectious Diseases, 17(12), e1243-e1244. https://doi.org/10.1016/j.ijid.2013.06.014

Casanova-Cardiel, L. J., & Hermida-Escobedo, C. (1994). Measles in the young adult. Clinical features of 201 cases. Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion, 46(2), 93-98.

Laksono, B. M., de Vries, R. D., McQuaid, S., Duprex, W. P., & de Swart, R. L. (2016). Measles Virus Host Invasion and Pathogenesis. Viruses, 8(8), Article 210. https://doi.org/10.3390/v8080210

Shostakovych-Koretsraya, L. R., Mavrutenkov, V. V., Cherhinets, A. V., Budayeva, I. V., Yakunina, O. M., & Chykarenko, Z. A. (2013). Kir (lektsiia, prodovzhennia) [Measles (lecture, continuing)]. Medychni perspektyvy, 18(4), С. 4-15. [in Ukrainian].

Downloads

How to Cite

1.
Bilokobyla SO, Riabokon OV, Riabokon YY, Onishchenko NV. Characteristics of serological profile in adult measles patients depending on the development of complications. Zaporozhye medical journal [Internet]. 2020Dec.9 [cited 2024Mar.28];22(6). Available from: http://zmj.zsmu.edu.ua/article/view/218457

Issue

Section

Original research