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Measles Risk in Transplant Patients

People with a compromised immune system who have undergone organ transplantation could be at a high risk of measles if they don’t receive the measles, mumps and rubella vaccine in a timely manner.//

Completion of MMR vaccination in southeast London is among the lowest in the United Kingdom. Just over 60 percent of children aged 2 years received a first dose of the vaccine by March 2003. (Data shows there were 66 cases of measles reported in the second quarter of the year.) In a letter in this week’s issue of The Lancet, researchers describe how two children with kidney transplants developed complications from measles. Both children received a single dose of the MMR vaccine before transplantation, but since they were about 2 years old at the time, they were unable to have a preschool booster dose. The first dose of the vaccine is recommended at about 13 months old. The booster dose is then given between 3 and 5 years old.

Authors of the letter write, "The reappearance of measles in the community poses a severe threat to vulnerable immunocompromised individuals, including recipients of transplants. Without a substantial increase in the uptake of MMR vaccination, difficult challenges lie ahead. Measles is a notoriously infectious disease and will spread easily among those who are non-immune."

Researchers also say the two children in their report did not have typical presentations of measles and they caution researchers to be aware of this. They write, "Immunocompromised individuals may manifest only a non-specific illness without rash, which makes rapid diagnosis difficult and may delay measures to prevent further spread"

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