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Measles in the vaccinated host
  1. Rebecca Stout1,2,
  2. David Muir3 and
  3. Shiranee Sriskandan1,2
  1. 1Department of Infectious Diseases, Imperial College London, London, UK
  2. 2Infectious Diseases, St Mary's Hospital, Imperial College London Hospitals, London, UK
  3. 3Virology, Infection & Immunity Department, Northwest London Pathology, Charing Cross Hospital, London, UK
  1. Correspondence to Dr Rebecca Stout; r.stout{at}


A woman in her 40s known to have systemic lupus erythematosus presented with a maculopapular rash on her face, neck and chest following measles exposure. She had received a single-dose measles vaccine as a child in the 1970s and was therefore presumed to be immune, and thus not infectious. As a result, she was initially managed in an open bay. Measles virus IgM antibody in serum was undetectable; however, measles virus RNA was subsequently detected in throat swab by PCR, which is consistent with current infection. Measles is one of the most transmissible diseases in the world and cases are rising both in the UK and globally. Our case and literature review highlight the risk of vaccine failure in measles, especially in people who have not received two doses of the measles, mumps and rubella vaccine. It also highlights the challenges in diagnosing measles in previously vaccinated individuals.

  • infectious diseases
  • immunology
  • vaccination/immunisation
  • nosocomial infections
  • systemic lupus erythematosus

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  • Contributors RS, DM and SS were responsible for drafting the text, sourcing and editing clinical images, interpreting investigation results, creating original diagrams and algorithms and critically revising the manuscript for important intellectual content. RS, DM and SS gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.