Brinkman, Iris D; de Wit, Jelle; Smits, Gaby P; Ten Hulscher, Hinke I; Jongerius, Maria C; Abreu, Taymara C; van der Klis, Fiona R M; Hahné, Susan J M; Koopmans, M P G; Rots, Nynke Y; et al. (2019-04-11)
The majority of infants will not be protected by maternal antibodies until their first measles vaccination between 12-15 months of age. This provides incentive to reduce the age of measles vaccination, but immunological consequences are insufficiently understood and long-term effects are largely unknown. Infants who received early measles vaccination between 6-12 months and a second dose at 14 months of age (n=79) were compared with a control group who received one dose at 14 months of age (n=44). Measles-neutralizing antibody concentrations and avidity were determined up to 4 years of age. Infants with a first measles vaccination administered before 12 months of age show long-term reduced measles-neutralizing antibody concentrations and avidity compared to the control group. For 11.1% of children with a first dose before 9 months of age, antibody levels had dropped below the cutoff for clinical protection at 4 years of age. Early measles vaccination provides immediate protection in the majority of infants, but long-term neutralizing antibody responses are reduced compared to infants vaccinated at a later age. Additional vaccination at 14 months of age does not improve this. Long-term, this may result in an increasing number of children susceptible to measles.
Nic Lochlainn, Laura M; Sane, Jussi; Schimmer, Barbara; Mooij, Sofie; Roelfsema, Jeroen; Van Pelt, Wilfrid; Kortbeek, Titia (2018-11-03)
In 2012, cryptosporidiosis cases increased in the Netherlands, but no single source was identified. In April 2013, we began a three year population based case-control study, coupled with genotyping, to identify risk factors for sporadic cryptosporidiosis. Cryptosporidium cases were laboratory confirmed (microscopy or PCR), followed by C. hominis and C. parvum species determination testing. We analysed data by study year, combined and by species. We performed single variable analysis and variables with a P-value ≤0.10 were included in a multivariable logistic regression model adjusting for age, sex and season. The study included 609 cases and 1,548 frequency-matched controls. C. parvum was the predominant species in the first two study years, shifting to C. hominis in the third year. Household person-to-person transmission and eating barbequed food were strongly associated with being a case. Eating tomatoes was negatively associated. By study year, person-to-person transmission was an independent risk factor. Analysis by species identified different risk factors for C. parvum and C. hominis cases. This was the first case-control study examining risk factors for sporadic cryptosporidiosis in the Netherlands. Providing information about Cryptosporidium exposure during outdoor activities and improvements in hygiene within households could prevent future sporadic infections.
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