Deep sequencing reveals persistence of cell-associated mumps vaccine virus in chronic encephalitis

Acta Neuropathol. 2017 Jan;133(1):139-147. doi: 10.1007/s00401-016-1629-y. Epub 2016 Oct 21.

Abstract

Routine childhood vaccination against measles, mumps and rubella has virtually abolished virus-related morbidity and mortality. Notwithstanding this, we describe here devastating neurological complications associated with the detection of live-attenuated mumps virus Jeryl Lynn (MuVJL5) in the brain of a child who had undergone successful allogeneic transplantation for severe combined immunodeficiency (SCID). This is the first confirmed report of MuVJL5 associated with chronic encephalitis and highlights the need to exclude immunodeficient individuals from immunisation with live-attenuated vaccines. The diagnosis was only possible by deep sequencing of the brain biopsy. Sequence comparison of the vaccine batch to the MuVJL5 isolated from brain identified biased hypermutation, particularly in the matrix gene, similar to those found in measles from cases of SSPE. The findings provide unique insights into the pathogenesis of paramyxovirus brain infections.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Biopsy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / virology*
  • Chronic Disease
  • Encephalitis, Viral / complications
  • Encephalitis, Viral / diagnostic imaging
  • Encephalitis, Viral / therapy
  • Encephalitis, Viral / virology*
  • Fatal Outcome
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Infant
  • Male
  • Mumps Vaccine / adverse effects*
  • Mumps virus / genetics
  • Mumps virus / isolation & purification*
  • Severe Combined Immunodeficiency / complications
  • Severe Combined Immunodeficiency / diagnostic imaging
  • Severe Combined Immunodeficiency / therapy

Substances

  • Mumps Vaccine