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Encephalitis Caused by the Vaccine Strain of Measles Virus

Report of 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.

Measles vaccine has been implicated previously in two immunocompromised patients with MIBE [35, 36]. The first was a 2-year-old child with acute lymphoblastic leukemia who developed delayed prolonged atypical measles with pneumonitis 1 month after vaccination, from which he partially recovered but relapsed and subsequently developed encephalitis [35]. Measles virus was recovered from the throat and conjunctivae but was not further characterized.The second patient was a 7-year-old child with acute lymphoblastic leukemia who presented with a clinical picture consistent with MIBE 54 days after vaccination [36]. The presence of measles virus in the CSF was established by immunofluorescence assay of an inoculated Vero cell culture, but no further characterization was done. The possibility of infection with wild-type measles virus cannot be ruled out in either of these cases.

The capacity of measles vaccine viruses to cause severe neurological disease in immunocompetent individuals remains controversial.

Stratton KR,Howe CJ, Johnston RB, eds. Adverse events associated with childhood vaccines: evidence bearing on causality. Washington, DC: National Academy Press, 1994;118–86

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