engleski

Aseptic meningitis after measles, mumps and rubella vaccination

A strategy for immunization against measles, mumps and rubella (MMR) infection was introduced into the vaccination program in Croatia in the early 1970s. In Croatia MMR vaccination with domestically produced vaccine using Edmonston-Zagreb strain for measles, L-Zagreb strain for mumps and RA 27 strain for rubella was firstly introduced into the routine immunization for 12-month-old children. Revaccination was introduced during the 1990s. Introduction of mass MMR vaccination into the vaccination program in Croatia (coverage 92%) exhibited a rapid decline in measles, mumps and rubella morbidity among our children. Although there is no doubt that MMR vaccination sharply reduces wild measles, mumps and rubella infection incidence in Croatia, some concerns about vaccine-related complications, especially about aseptic meningitis due to attenuated mumps strain, remained. In our first report on aseptic meningitis following MMR vaccination estimated incidence for 1988-1992 period was 90 cases per 100 000 doses which was significantly higher than that reported from Slovenia. The main criticism on our report was lack of virologic confirmation of aseptic meningitis cases. With a view to overcoming this insufficiency routine cultivation of CSF samples taken from patients with suspected aseptic meningitis following MMR vaccination on Vero cells started in 1993. The majority of isolated mumps strains were further analysed using PCR technique. Over the period 1994-99, 30 cases of confirmed aseptic meningitis following mumps vaccination were registered.

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