Measles Inclusion-Body Encephalitis Caused by the Vaccine Strain of Measles Virus

• Published in: Clinical infectious diseases Vol. 29; no. 4; pp. 855 - 861
• Main Authors: Bitnun, Ari, Shannon, Patrick, Durward, Andrew, Rota, Paul A., Bellini, William J., Graham, Caroline, Wang, Elaine, Ford-Jones, Elizabeth L., Cox, Peter, Becker, Laurence, Fearon, Margaret, Petric, Martin, Tellier, Raymond
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.10.1999; University of Chicago Press
• Subjects: AIDS/HIV; Biological and medical sciences; Clinical Articles; Encephalitis; Encephalitis, Viral - etiology; Encephalitis, Viral - pathology; Human viral diseases; Humans; Inclusion Bodies, Viral; Infant; Infections; Infectious diseases; Lymphocytes; Male; Measles; Measles - complications; Measles Vaccine - adverse effects; Measles virus; Measles-Mumps-Rubella Vaccine; Medical sciences; Mumps Vaccine - adverse effects; Polymerase chain reaction; Reverse Transcriptase Polymerase Chain Reaction; RNA; Rubella Vaccine - adverse effects; Vaccination; Vaccines, Combined - adverse effects; Viral diseases; Viral diseases of the nervous system; Viruses; Human; Encephalitis; Nervous system diseases; Vaccine strain; Toxicity; Infant; Vaccine; Cerebral disorder; Paramyxoviridae; Infection; Virus; Case study; Prevention; Paramyxovirinae; Immunoprophylaxis; Mononegavirales; Measles; Viral disease; Central nervous system disease; Morbillivirus; Complication; Inclusion body; Measles virus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/520449

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. He had no prior evidence of immune deficiency and no history of measles exposure or clinical disease. During hospitalization, a primary immunodeficiency characterized by a profoundly depressed CD8 cell count and dysgammaglobulinemia was demonstrated. A brain biopsy revealed histopathologic features consistent with MIBE, and measles antigens were detected by immunohistochemical staining. Electron microscopy revealed inclusions characteristic of paramyxovirus nucleocapsids within neurons, oligodendroglia, and astrocytes. The presence of measles virus in the brain tissue was confirmed by reverse transcription polymerase chain reaction. The nucleotide sequence in the nucleoprotein and fusion gene regions was identical to that of the Moraten and Schwarz vaccine strains; the fusion gene differed from known genotype A wild-type viruses.