Measles is a highly contagious disease characterized by a prodromal illness of
fever, coryza,
cough, and
conjunctivitis followed by the appearance of a generalized maculopapular
rash. Despite the availability of an effective and safe live
attenuated vaccine,
measles remains a cause of continuing outbreaks in Japan.
Measles often accompanies diverse complications, including
pneumonitis,
otitis media, and central nervous system involvement. Neurological complications of
measles includes ADEM, MIBE, and
SSPE. MIBE and
SSPE have unfavorable prognosis, which are caused by
persistent infection of particular mutants of measles virus (MV) in brain. In
SSPE patients,
measles antibody titer increase in cerebrospinal fluid and serum. Primary
vaccine failure and secondary
vaccine failure may be a major cause of outbreaks in Japan, therefore, promotion of vaccination should be emphasized. 2 doses vaccination methods began in Japan in 2006, and supplementary vaccination program at 12 and 18 years old begins from 2008. Protection level of antibody titer varies according to the antibody measurement methods. NT provides the best correlate for protection from
infection, however, needs complicated procedure. PA is chosen for the surveillance method in Japan, and 1:128 or over seems protection level. To protect
health-care associated infection of MV, all health care worker under 35 years old should be vaccinated if not have adequate immunity.