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CORRESPONDENCE
Year : 2002  |  Volume : 20  |  Issue : 4  |  Page : 226-227
 

Authors' reply


Department of Clinical Virology, Christian Medical College and Hospital, Vellore-632 004, Tamil Nadu, India

Correspondence Address:
Department of Clinical Virology, Christian Medical College and Hospital, Vellore-632 004, Tamil Nadu, India



How to cite this article:
Manayani D J, Sridharan G. Authors' reply. Indian J Med Microbiol 2002;20:226-7


How to cite this URL:
Manayani D J, Sridharan G. Authors' reply. Indian J Med Microbiol [serial online] 2002 [cited 2020 Oct 28];20:226-7. Available from: https://www.ijmm.org/text.asp?2002/20/4/226/6966


Dear Editor,
The authors consider that Dr. Yash Paul's first comment is relevant. To a large extent our patients were drawn from different parts of India predominantly from West Bengal, Bihar and Tamil Nadu. This is in contrast to the earlier report from Vellore (1983-1987) where patients were residents of Tamil Nadu. The earlier study was reported during a period when measles vaccination was hardly given on a community basis. In contrast to this the current report is after the introduction of measles vaccination in India. It may be that the protective effect of vaccination bringing a decline in the SSPE cases will take some time to manifest given the usual long incubation period between primary measles and SSPE (incubation period being 7-10 years). The authors are unable to comment on the impact of OPV coverage on measles immunization.
Regarding the second point, information was not elicited as to the age of administration of measles vaccine in our study. Dr. Yash Paul is correct in pointing out that neither the cold chain maintenance for the vaccine nor the different genotypes that may be circulating in India could entirely account for the observed vaccine failure. He refers to the importance of immunization age of children. The best seroconversion is achieved only by immunization at twelve months of age or later. This of course raises the issue that measles may have occurred in children prior to vaccination making it appear that SSPE is related to vaccine failure. Experts opine that early immunization may not produce good seroconversion due to interference by maternal antibodies.
In his letter, Dr. Paul has raised an important issue regarding measles immunization policy in childhood. It may be appropriate to give immunization at 6-9 months of age, as now practiced in view for early childhood measles. The beneficial effect of immunization will be felt in another decade when SSPE may have largely disappeared like in more developed countries. 

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