Volume 99, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We sought to compare seroprevalence of protective measles and rubella-specific antibody in mother–infant pairs across two populations: a pre-disease elimination Nepal population with recently introduced rubella vaccine and post-disease elimination U.S. population. Qualitative measles and rubella immunoglobulin G was assessed in maternal serum and cord blood from 258 pairs in Nepal, 2012–2013 and 49 pairs in Seattle, WA, 2014–2015. High rates of protective antibody were observed in both populations. Two hundred and forty-four (95%) pregnant women in Nepal had protective measles antibody versus 44 (92%) in Seattle ( = 0.42). Ninety-six percent of infants in Nepal ( = 246) and Seattle ( = 43) had protective measles antibody ( = 0.75). Ninety-four percentage of pregnant women in Nepal ( = 242) and Seattle ( = 45) had protective rubella antibody ( = 0.23). Two hundred and thirty-eight (93%) infants in Nepal had protective rubella antibody versus 44 (98%) in Seattle ( = 0.12). Continued surveillance will be necessary to ensure protective immunity, inform progress toward disease elimination in Nepal and avoid reemergence in the United States.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Wendorf KA, Winter K, Zipprich J, Schechter R, Hacker JK, Preas C, Cherry JD, Glaser C, Harriman K, , 2017. Subacute sclerosing panencephalitis: the devastating measles complication that might be more common than previously estimated. Clin Infect Dis 65: 226232. [Google Scholar]
  2. World Health Organization, 2017. Measles vaccines: WHO position paper—April 2017. Wkly Epidemiol Rec 92: 205227. [Google Scholar]
  3. World Health Organization, 2011. Rubella vaccines: WHO position paper—July 2011. Wkly Epidemiol Rec 86: 301316. [Google Scholar]
  4. Keller-Stanislawski B, Englund JA, Kang G, Mangtani P, Neuzil K, Nohynek H, Pless R, Warton M, Lambach P, Zuber P, , 2014. Safety of immunization during pregnancy: a review of the evidence, Global Advisory Committee on Vaccine Safety. Vaccine 32: 70577064. [Google Scholar]
  5. Fiebelkorn AP, Redd SB, Gastañaduy PA, Clemmons N, Rota PA, Rota JS, Bellini WJ, Wallace GS, , 2017. A comparison of postelimination measles epidemiology in the United States, 2009–2014 versus 2001–2008. J Pediatric Infect Dis Soc 6: 4048. [Google Scholar]
  6. Zipprich J, Winter K, Hacker J, Xia D, Watt J, Harriman K, Centers for Disease Control and Prevention (CDC); , 2015. Measles outbreak—California, December 2014–February 2015. MMWR Morb Mortal Wkly Rep 64: 153154. [Google Scholar]
  7. Hall V, 2017. Measles outbreak—Minnesota April–May 2017. MMWR Morb Mortal Wkly Rep 66: 713717. [Google Scholar]
  8. Centers for Disease Control and Prevention, 2017. Notifiable diseases and mortality tables. MMWR Morb Mortal Wkly Rep 66: ND-664-ND-683. Available at: https://www.cdc.gov/mmwr/volumes/66/wr/mm6634md.htm?s_cid=mm6634md_w. Accessed October 23, 2017.
  9. World Health Organization, 2012. Global Measles and Rubella Strategic Plan, 2012–2020. Geneva, Switzerland: WHO. Available at: http://apps.who.int/iris/bitstream/10665/44855/1/9789241503396_eng.pdf. Accessed October 23, 2017.
  10. Khanal S, 2016. Progress toward measles elimination—Nepal, 2007–2014. MMWR Morb Mortal Wkly Rep 65: 206210. [Google Scholar]
  11. World Health Organization, 2018. Immunization, Vaccines and Biologicals. Vaccine Preventable Diseases Vaccines Monitoring System 2016 Global Summary–Country List for WHO-UNICEF Review of National Immunization Coverage. Available at: http://apps.who.int/immunization_monitoring/globalsummary/wucoveragecountrylist.html. Accessed May 3, 2018.
  12. Upreti SR, 2011. Developing rubella vaccination policy in Nepal—results from rubella surveillance and seroprevalence and congenital rubella syndrome studies. J Infect Dis 204 (Suppl 1): S433S438. [Google Scholar]
  13. Hyde TB, Kruszon-Moran D, McQuillan GM, Cossen C, Forghani B, Reef SE, , 2006. Rubella immunity levels in the United States population: has the threshold of viral elimination been reached? Clin Infect Dis 43 (Suppl 3): S146S150. [Google Scholar]
  14. Steinhoff MC, 2017. Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial. Lancet Infect Dis 17: 981989. [Google Scholar]
  15. Hartter HK, Oyedele OI, Dietz K, Kreis S, Hoffman JP, Muller CP, , 2000. Placental transfer and decay of maternally acquired antimeasles antibodies in Nigerian children. Pediatr Infect Dis J 19: 635641. [Google Scholar]
  16. Boulton ML, Wang X, Wagner AL, Zhang Y, Carlson B, Gillespie B, Ding Y, , 2017. Measles antibodies in mother-infant dyads in Tianjin, China. J Infect Dis 216: 11221129. [Google Scholar]
  17. Waaijenborg S, Hahné SJ, Mollema L, Smits GP, Berbers GA, van der Klis FR, de Melker HE, Wallinga J, , 2013. Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage. J Infect Dis 208: 1016. [Google Scholar]
  18. van den Berg JP, Westerbeek EA, van der Klis FR, Berbers GA, van Elburg RM, , 2011. Transplacental transport of IgG antibodies to preterm infants: a review of the literature. Early Hum Dev 87: 6772. [Google Scholar]
  19. Palmeira P, Quinello C, Silveira-Lessa AL, Zago CA, Carneiro-Sampaio M, , 2012. IgG placental transfer in healthy and pathological pregnancies. Clin Dev Immunol 2012: 985646. [Google Scholar]

Data & Media loading...

Supplemental appendix

  • Received : 26 Oct 2017
  • Accepted : 22 May 2018
  • Published online : 17 Sep 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error