Sunday, October 13, 2019

Asymptomatic Transmission & Shedding


The likely epidemiological sources of the transmitted mumps virus were children who were recently vaccinated with the mumps vaccine containing Leningrad-Zagreb or Leningrad-3 MuV. The etiology of the described cases of the horizontal transmission of both mumps vaccine viruses was confirmed by PCR with the sequential restriction analysis.
The likely epidemiological source of the transmitted L-3 mumps virus was children who were recently vaccinated at the schools attended by the six symptomatic mumps patients described here
Mumps outbreak in Netherlands linked to those vaccinated twice with MMR:
We found 18 reports of measles outbreaks in very highly immunized school populations where 71% to 99.8% of students were immunized against measles. Despite these high rates of immunization, 30% to 100% (mean, 77%) of all measles cases in these outbreaks occurred in previously immunized students. In our hypothetical school model, after more than 95% of schoolchildren are immunized against measles, the majority of measles cases occur in appropriately immunized children.
Measles virus RNA was detected as early as 1 day or as late as 14 days after vaccination. Measles virus RNA was also detected in the urine samples from all four of the young adults between 1 and 13 days after vaccination. This assay will enable continued studies of the shedding and transmission of measles virus and, it is hoped, will provide a rapid means to identify measles infection, especially in mild or asymptomatic cases.
Measles virus was isolated in a throat swab taken 4 days after fever onset. This virus was then further genetically characterised as a vaccine-type virus

http://www.sciencedirect.com/science/article/pii/S0264410X01004959
An infant boy with a congenital immunodeficiency had fatal disseminated measles after administration of a live attenuated measles vaccine



BROTHER-TO-SISTER TRANSMISSION OF MEASLES AFTER MEASLES, MUMPS, AND RUBELLA IMMUNISATION



We describe excretion of measles vaccine strain Schwarz in a child who developed a febrile rash illness eight days after primary immunisation against measles, mumps and rubella
We report a case of measles inclusion-body encephalitis (MIBE) occurring in an apparently healthy 21-month-old boy 8.5 months after measles-mumps-rubella vaccination

SEVERAL acute systemic viral illnesses have been associated with the presence of multinucleated giant cells or inclusion-bearing cells (or both) detected in nasal discharges1 and specimens of urine in human patients. Such cells have also been observed in the urinary sediments of children vaccinated with poliovirus and measles
Small Pox vaccine sheds to toddler from parent (military personnel)

 
http://mobile.nytimes.com/2007/05/18/health/18smallpox.html
A 12-month-old healthy boy had approximately 30 vesicular skin lesions 24 days after receiving varicella vaccine. Sixteen days later his pregnant mother had 100 lesions. Varicella-vaccine virus was identified by polymerase chain reaction in the vesicular lesions of the mother. This case documents transmission of varicella-vaccine virus from a healthy 12-month-old infant to his pregnant mother.
Zostavax contains live attenuated VZV, and the package insert warns newly vaccinated individuals to avoid contact for an unspecified time with newborn infants, immunosuppressed individuals, and pregnant women who have not had chicken pox or have not been immunized for chicken pox. Because VZV DNA is present in saliva of zoster patients for at least 2 weeks [5] and VZV in saliva can also be infectious [6], we examined the inoculation site and saliva of Zostavax-vaccinated subjects for the presence of VZV DNA for 4 weeks after immunization”


“Vaccine-type rotavirus was detected in all 50 antigen-positive specimens and 8 of 8 antigen-negative specimens. Nine (75%) of 12 EIA-positive and 1 EIA-negative samples tested culture-positive for vaccine-type rotavirus. Fecal shedding of rotavirus vaccine virus after the first dose of RV5 occurred over a wide range of post-vaccination days not previously studied.”
“The RotaTeq vaccine contains five live, attenuated strains derived through laboratory reassortment of human rotavirus strains with a bovine rotavirus strain. Three RotaTeq strains each contain a single human rotavirus gene segment and ten bovine rotavirus segments, and two strains contain two human strain segments and nine bovine strain segments. In the study, RotaTeq was detected in 16 stool samples. Ten of these contained between one and four individual vaccine component strains. Six samples were found to contain a vaccine-derived G1P[8] (vdG1P[8]) strain. vdG1P[8] is believed to be the product of a genetic reassortment event in which the G1 gene segment of strain WI79-9 is inserted into strain WI79-4, as evidenced by the association of G1-VP7 and P[8]-VP4 human rotavirus genes with the M2-VP3 and I2-VP6 of the bovine rotavirus. Donato et al. observed that approximately a fifth of the infants having diarrhea within 2 weeks of rotavirus vaccination were shedding vaccine strain components exclusive of any detectable enteric pathogen.”


Post-marketing experience suggests that transmission of vaccine virus may occur rarely between healthy vaccinees who develop a varicella-like rash and healthy susceptible contacts. Transmission of vaccine virus from a mother who did not develop a varicella-like rash to her newborn infant has been reported.
Due to the concern for transmission of vaccine virus, vaccine recipients should attempt to avoid whenever possible close association with susceptible high-risk individuals for up to six weeks following vaccination with VARIVAX

Rotavirus shedding in stool occursafter vaccination with peak excretion occurring around Day7after Dose
https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Rotarix/pdf/ROTARIX-PI-PIL.PDF

Analysis of 36 individuals over age 60 years who were immunized with Zostavax revealed varicella zoster virus (VZV) DNA in swabs of skin inoculation sites obtained immediately after immunization. vaccine virus DNA is shed in saliva up to 4 weeks
conclude that acellular vaccines may well have contributed to -- even exacerbated -- the recent pertussis outbreak by allowing infected individuals without symptoms to unknowingly spread pertussis multiple times in their lifetimes

Investigation of a measles outbreak in a fully vaccinated school population including serum studies before and after revaccination

http://www.ncbi.nlm.nih.gov/pubmed/8483623
According to statistics, the majority of outbreaks occur in populations where the majority of individuals were previously vaccinated.

http://aje.oxfordjournals.org/content/139/1/77.short
Correction: This article and an accompanying video previously included a photograph of a child with a rash linked to a vaccination. The image has been removed.



Clark County Public Health said 3 people suspected of having measles earlier this week had rashes, but those rashes were simply reactions to the MMR vaccine and not the measles virus. 


Examples:
CORRECTION:  An earlier version of this story showed a file photograph of a child who had an adverse reaction to the MMR vaccine.  Due to an editing error, the child was misidentified in the caption as having measles. CBSDFW apologizes for the error.
Seattle Children's Hospital says the patient was one of its nurses who was working with a child who had contracted measles. They say she was fully vaccinated and was wearing protective equipment but still contracted the disease anyway.
Officials said specialized laboratory testing was done after it was learned that the child had been vaccinated days before being diagnosed with measles. The tests determined that the child was experiencing symptoms of a vaccine reaction, rather than measles.
The child is vaccinated, did not have any serious complications, and is fully recovered from the disease

The child is vaccinated, did not have any serious complications, and is fully recovered from the disease

University of Florida spokesperson Steve Orlando confirmed there are 24 cases of the mumps on campus. All 24 students were vaccinated.

McCabe said she was vaccinated twice and tested positive for presumed immunity against measles three times in the last 20 years


The person was fully immunized but came into contact with an 11-month-old San Diego resident who contracted the disease after a recent trip to the Philippines.


The Student Health Center says all of the students had received required doses of the vaccine to prevent mumps.

Even those who have been fully vaccinated can still catch the disease, and so far all of the children who have caught the virus were vaccinated, Smith said

All students effected up to date.

The public health department in Cambridge, Mass., where Harvard is located, determined a month ago that all infected students to that point had received a mumps vaccine prior to contracting the infection

Some 97% of those in the Ohio outbreak have been vaccinated
https://www.cnn.com/2014/03/24/health/ohio-mumps
The Navy's Bureau of Medicine and Surgery (BUMED) later explained to BI that "based on clinical presentation and laboratory testing, these cases are currently classified as probable cases of mumps," one of a number of illnesses that all US military personnel are vaccinated against


 A whooping cough outbreak is causing concern in Summit County as 19 children have been diagnosed, and it's the first time in years Park City schools have seen a case of pertussis.
Officials said all of the children who have been diagnosed were vaccinated against the illness.


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