Measles inclusion-body encephalitis caused by the vaccine strain of measles virus

Clin Infect Dis. 1999 Oct;29(4):855-61. doi: 10.1086/520449.


We report a case of measles inclusion-body encephalitis (MIBE) occurring in an apparently healthy 21-month-old boy 8.5 months after measles-mumps-rubella vaccination. He had no prior evidence of immune deficiency and no history of measles exposure or clinical disease. During hospitalization, a primary immunodeficiency characterized by a profoundly depressed CD8 cell count and dysgammaglobulinemia was demonstrated. A brain biopsy revealed histopathologic features consistent with MIBE, and measles antigens were detected by immunohistochemical staining. Electron microscopy revealed inclusions characteristic of paramyxovirus nucleocapsids within neurons, oligodendroglia, and astrocytes. The presence of measles virus in the brain tissue was confirmed by reverse transcription polymerase chain reaction. The nucleotide sequence in the nucleoprotein and fusion gene regions was identical to that of the Moraten and Schwarz vaccine strains; the fusion gene differed from known genotype A wild-type viruses.

Publication types

  • Case Reports

MeSH terms

  • Encephalitis, Viral / etiology*
  • Encephalitis, Viral / pathology
  • Humans
  • Inclusion Bodies, Viral*
  • Infant
  • Male
  • Measles / complications*
  • Measles Vaccine / adverse effects*
  • Measles-Mumps-Rubella Vaccine
  • Mumps Vaccine / adverse effects*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Rubella Vaccine / adverse effects*
  • Vaccines, Combined / adverse effects


  • Measles Vaccine
  • Measles-Mumps-Rubella Vaccine
  • Mumps Vaccine
  • Rubella Vaccine
  • Vaccines, Combined