Antibodies against measles and rubella virus among different age groups in Thailand: A population-based serological survey

Autoři: Nasamon Wanlapakorn aff001;  Rujipat Wasitthankasem aff001;  Preeyaporn Vichaiwattana aff001;  Chompoonut Auphimai aff001;  Pornsak Yoocharoen aff004;  Sompong Vongpunsawad aff001;  Yong Poovorawan aff001
Působiště autorů: Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand aff001;  Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand aff002;  National Biobank of Thailand, National Science and Technology Development Agency, Pathum Thani, Thailand aff003;  Department of Disease Control, Division of Vaccine Preventable Diseases, Ministry of Public Health, Nonthaburi, Thailand aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225606


Measles and rubella are highly contagious viral diseases transmitted via respiratory secretions and aerosolized droplets. Thailand has implemented universal vaccination against measles using the monovalent measles (M) or the trivalent measles-mumps-rubella (MMR) vaccine for the past 30 years. Nevertheless, incidence of measles and rubella remains in some parts of the country. We conducted a seroprevalence study to evaluate the antibodies to measles and rubella virus among Thais of all ages and to determine pre-existing immunity resulting from either vaccination and/or natural exposure. A total of 1,781 serum samples collected in 2014 was tested for IgG to measles and rubella virus by commercial enzyme-linked immunosorbent assays (ELISA). Percentages of individuals with protective antibody levels and the geometric mean concentrations (GMC) of IgG in each age group were analysed. The GMC of anti-measles IgG and anti-rubella IgG were 653.7 IU/L (95% confidence interval (CI); 555.9–751.4) and 39.5 IU/mL (95% CI;35.0–43.9), respectively. Thais between the ages of six months and 25 years did not demonstrate sufficient protective herd immunity for measles. This observation is consistent with the recent measles outbreaks in this age group. Lower prevalence of immunity against rubella was found among children ages 5–6 years who may not have completed vaccination as infants. Our findings identify gaps in rubella and measles immunity in specific age groups and support recommendations for catch-up MMR vaccination in individuals 30 years of age or younger.

Klíčová slova:

Age groups – Immunity – Measles – MMR vaccine – Rubella – Thailand – Vaccination and immunization – Vaccines


1. Chapter 13: Measles. In: Hamborsky J, Kroger A, Wolfe S, editors. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington D.C. Public Health Foundation, 2015. Available from: [cited 5 May 2019]

2. The World Health Organization Fact sheet. Measles Available from: [cited 9 May 2019]

3. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand. Surveillance Data:Measles; 2018. Available from: [Cited 13 November 2018]

4. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand. Surveillance Data: Rubella; 2018. Available from: [Cited 13 November 2018]

5. Posuwan N, Wanlapakorn N, Sa-Nguanmoo P, Wasitthankasem R, Vichaiwattana P, Klinfueng S, et al. The Success of a Universal Hepatitis B Immunization Program as Part of Thailand's EPI after 22 Years' Implementation. PloS one. 2016;11(3):e0150499. eCollection 2016. doi: 10.1371/journal.pone.0150499 26938736.

6. Ngaovithunvong V, Wanlapakorn N, Tesapirat L, Suratannon N, Poovorawan Y. Mumps antibody in the Thai population 17 years after the universal measles mumps rubella vaccination program. Journal of infection in developing countries. 2016;10(7):735–40. doi: 10.3855/jidc.7560 27482805.

7. Meng QH, Liu Y, Yu JQ, Li LJ, Shi W, Shen YJ, et al. Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing. Scientific reports. 2018;8(1):13021. doi: 10.1038/s41598-018-31283-y 30158679.

8. Skendzel LP. Rubella immunity. Defining the level of protective antibody. American journal of clinical pathology. 1996;106(2):170–4. doi: 10.1093/ajcp/106.2.170 8712168.

9. Guidelines for disease surveillance, outbreak control, treatment, and laboratory diagnosis in accordance with the international commitment to the elimination of measles. The Ministry of Public Health, Thailand. Available form: [cited 5 January 2019]

10. Tharmaphornpilas P, Yoocharean P, Rasdjarmrearnsook AO, Theamboonlers A, Poovorawan Y. Seroprevalence of antibodies to measles, mumps, and rubella among Thai population: evaluation of measles/MMR immunization programme. Journal of health, population, and nutrition. 2009;27(1):80–6. doi: 10.3329/jhpn.v27i1.3320 19248651.

11. Guerra FM, Bolotin S, Lim G, Heffernan J, Deeks SL, Li Y, et al. The basic reproduction number (R0) of measles: a systematic review. The Lancet Infectious diseases. 2017;17(12):e420–e8. doi: 10.1016/S1473-3099(17)30307-9 28757186

12. Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA. Rubella. Lancet (London, England). 2015;385(9984):2297–307. doi: 10.1016/S0140-6736(14)60539-0 25576992.

13. The World Health Organization vaccine-preventable diseases: monitoring system. 2019 global summary. Available from [cited 5 April 2019]

14. Choisy M, Trinh ST, Nguyen TND, Nguyen TH, Mai QL, Pham QT, et al. Sero-Prevalence Surveillance to Predict Vaccine-Preventable Disease Outbreaks; A Lesson from the 2014 Measles Epidemic in Northern Vietnam. Open forum infectious diseases. 2019;6(3):ofz030. doi: 10.1093/ofid/ofz030 30863786.

15. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand. Surveillance Data: Measles; 2015–2018. Available from: [Cited 4 October 2019]

16. Lei L, Yang Y, Zhao X, Zhang S, Yuan L, Liu Y, et al. Identify the susceptibility profile to measles in the general population: Serological survey of measles antibodies in Shaanxi province, China, in 2016. Vaccine. 2017;35(52):7250–7255. doi: 10.1016/j.vaccine.2017.11.012 29153585.

17. Mollema L, Smits GP, Berbers GA, Van Der Klis FR, Van Binnendijk RS, De Melker HE, etal.High risk of a large measles outbreak despite 30 years of measles vaccination in The Netherlands. Epidemiol Infect. 2014;142(5):1100–8. doi: 10.1017/S0950268813001532 23915981.

18. Tomášková H, Zelená H, Kloudová A, Tomášek I. Serological survey of measles immunity in the Czech Republic, 2013. Cent Eur J Public Health. 2018;26(1):22–27. doi: 10.21101/cejph.a5251 29684293.

19. Amela C, Pachon I, de Ory F. Evaluation of the measles, mumps and rubella immunisationprogramme in Spain by using a sero-epidemiological survey. European journal of epidemiology. 2003;18(1):71–79. doi: 10.1023/a:1022567811765 12705626

20. Edirisuriya C, Beard FH, Hendry AJ, Dey A, Gidding HF, Hueston L, et al. Australian rubella serosurvey 2012–2013: On track for elimination? Vaccine. 2018;36(20):2794–8. doi: 10.1016/j.vaccine.2018.03.086 29661586

21. Vaccine coverage survey in 2561 (2018) Thailand. Division of vaccine preventable disease, Department of Disease Control, Ministry of Public Health. Available from [cited 15 June 2019].

Článek vyšel v časopise


2019 Číslo 11