We describe the occurrence of measles in an 18 month- old… who received the first dose of a measles-containing vaccine seven days before onset of prodromal symptoms.
[V]iral genotyping permitted the confirmation of a vaccine-associated illness.
In early March 2015, measles-mumps-rubella-varicella zoster (MMRV) vaccine was administered to an apparently healthy 18-month-old child…
Seven days later, the child presented to the family paediatrician with fever… catarrhal cough, runny nose and eyelid oedema. Macular rash appeared over the body two days later, starting on the trunk and then spreading to the neck and face.
By day 13, the rash was fading, but due to the persistence of symptoms, the child was admitted to a children’s hospital and reported as a possible case of vaccine-related measles…
On day 17, the patient’s symptoms resolved without complications and the patient was discharged from hospital.
Measles virus was detected in throat swabs taken on days 17, 19, 21 and 25…
The measles virus was determined to be the Schwarz vaccine strain…
In Italy, vaccination against measles is included in the national vaccination schedule. Two doses of measles-mumps-rubella (MMR) vaccine have been recommended in all regions since the early 1990s, sometimes in association with varicella vaccination. The first dose is given at 13–15 months-old and the second at the age of 5–6 years.
[V]accine-associated cases could be misreported, suggesting that there is a need to improve the ability to distinguish between vaccine-associated measles and ‘true’ wild-type measles virus infection.
Firstly, although unlikely, measles after MMRV vaccination is possible, and this can mimic wild-type infection, leading to potential measles case misclassification.
[V]irus excretion was demonstrated over a 25-day period after vaccination, which is longer than previously reported.