measles (Tresivac)

When Vaccination Meets Infection Prevention: National Practices for Inpatient Administration of Measles-Mumps-Rubella, Varicella, and Rotavirus Vaccines.

Altez Maria Susana Rueda MSR, Hutto Celia C, Hobby-Noland Delphene D, Song Xiaoyan X

Recurrent Mumps in a Fully Vaccinated Young Adult With a Prior Breakthrough Infection: A Case Report.

Ramadugu Rithika R, Pidikiti Chandra Varshini CV, Cordero Peña Alesha A, Almonte Angelis A et al.

Mumps is a vaccine-preventable viral disease that typically presents with parotid gland swelling and constitutional symptoms. Although widespread immunization has substantially reduced disease incidence, outbreaks continue to occur among vaccinated populations, raising concerns regarding waning immunity and vaccine failure. Recurrent mumps following both prior natural infection and complete vaccination is uncommon and remains infrequently reported. We describe a 21-year-old woman who presented with a four-day history of fever, malaise, myalgia, and progressive painful swelling of the left parotid gland associated with difficulty chewing and speaking. She had received two doses of measles-mumps-rubella (MMR) vaccine according to the national immunization schedule and had a documented history of mumps infection at nine years of age, occurring after she had already completed her two-dose MMR series (vaccine-breakthrough infection). Physical examination revealed tender unilateral parotid enlargement, cervical lymphadenopathy, and evidence of undernutrition with a body mass index of 16.7 kg/m². Laboratory evaluation demonstrated iron deficiency anemia. Further evaluation, including positive mumps RT-PCR and positive anti-mumps IgM serology, confirmed acute mumps infection, while investigations excluded alternative causes of parotid enlargement. The patient was managed conservatively with isolation, supportive care, nutritional supplementation, and symptomatic treatment, resulting in complete clinical recovery without complications. This case highlights that recurrent mumps can occur despite prior natural infection and complete MMR vaccination. Although waning immunity and host factors such as undernutrition may have contributed to susceptibility, a causal relationship cannot be established from a single case. Continued surveillance and awareness of breakthrough infections remain important, particularly in resource-limited settings.

A bivalent oral yeast vaccine displaying Nocardia seriolae FHA and LMBV MCP confers protection in largemouth bass (Micropterus salmoides).

Lu Jianfei J, Gu Boge B, Yu Pengzhen P, Chen Jiong J

Largemouth bass ranavirus (LMBV) and Nocardia seriolae are major pathogens affecting largemouth bass (Micropterus salmoides), causing significant economic losses. In this study, recombinant yeasts expressing the fibronectin-binding protein A (FHA) of N. seriolae or the major capsid protein (MCP) of LMBV were constructed using the yeast surface display (YSD) system. Based on these recombinant strains, a bivalent oral yeast-based vaccine was developed and its protective efficacy was systematically evaluated. Oral administration of the vaccine induced specific antibodies against FHA and MCP in serum, as well as increased the transcription levels of adaptive immune genes (IgM, IgT, MHC-II) and innate immune genes (IL-1β, TNF-α, IFN-1, Mx2) in the hindgut, liver, and spleen. Importantly, the bivalent oral vaccine provided significant protection against both pathogens in largemouth bass, with relative percent survival (RPS) values of 56.7% against N. seriolae and 63.3% against LMBV. Meanwhile, the oral vaccine reduced pathogen loads and alleviated histopathological lesions. In summary, these findings suggest that the bivalent oral vaccine developed in this study could serve as a promising strategy for controlling N. seriolae and LMBV infections in largemouth bass aquaculture.

Diagnostic Accuracy of the Delta Neutrophil Index in Predicting Sepsis-Associated Acute Kidney Injury: A Cross-Sectional Study.

Varuneil Yallambhotla Y, Patro Shubhransu S, Rout Nikunj Kishore NK, Arora Parmarth P et al.

Sepsis-associated acute kidney injury (SA-AKI) is a worldwide health concern. It necessitates prompt and precise diagnosis of sepsis and renal dysfunction. The delta neutrophil index (DNI), C-reactive protein (CRP), procalcitonin, and serum lactate are potential biomarkers for early detection of SA-AKI. Hence, we conducted this study to evaluate the diagnostic accuracy of DNI in predicting SA-AKI among patients with sepsis and to calculate the area under the curve (AUC). We also compared the same with those of CRP, procalcitonin, and serum lactate. This cross-sectional study was carried out at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India, from March 2024 to February 2026. We enrolled adult sepsis patients from the medicine intensive care unit (ICU) during this period. We excluded referred cases, patients with sepsis before ICU admission, and those with prior renal dysfunction. White blood cell (WBC) count, serum creatinine, estimated glomerular filtration rate (eGFR), CRP, procalcitonin, serum lactate, DNI, and the Sequential Organ Failure Assessment (SOFA) scores were evaluated on days 0, 1, 3, and 7. We calculated the sensitivity, specificity, and diagnostic accuracy of CRP, procalcitonin, serum lactate, DNI, and SOFA scores. We used R software version 4.6.1 (R Foundation for Statistical Computing, Vienna, Austria) for data analysis. We enrolled 937 patients with sepsis. Their median age was 56.0 (48.0-67.0) years. The study population was predominantly male (569, 60.73%). Two hundred thirty-four (24.97%) participants had SA-AKI. The median WBC counts among participants without and with AKI on day 0 were 18.5 (16.9-20.7) x 10⁹/L and 20.4 (18.4-22.8) x 10⁹/L, respectively (p < 0.001). Their median baseline serum creatinine values were 1.05 (0.96-1.12) mg/dL and 1.06 (0.97-1.16) mg/dL, respectively (p = 0.063). The corresponding median baseline DNI values were 8.0 (7.1-8.6)% and 9.1 (8.2-10.2)%, respectively (p < 0.001). On day 7, the DNI values were 7.0 (6.4-7.7)% and 8.4 (7.6-9.0)%, respectively (p < 0.001). Their median CRP values were 17.1 (14.4-20.9) mg/dL and 26.2 (22.6-30.2) mg/dL, respectively (p < 0.001). The median procalcitonin values were 1.98 (1.68-2.34) ng/mL and 2.11 (1.91-2.36) ng/mL, respectively (p < 0.001). The median serum lactate values were 2.6 (2.0-3.2) mmol/L and 2.6 (1.9-4.6) mmol/L, respectively (p = 0.004). All these parameters decreased over time. The sensitivity values for CRP, DNI, procalcitonin, serum lactate, and SOFA scores were 0.799, 0.594, 0.880, 0.308, and 0.026, respectively. Their specificity values were 0.764, 0.804, 0.351, 0.920, and 0.982, respectively. The corresponding diagnostic accuracy values were 0.773, 0.752, 0.483, 0.767, and 0.743, respectively. The AUCs for CRP, DNI, procalcitonin, serum lactate, and SOFA scores were 0.855 (0.831-0.880), 0.753 (0.716-0.790), 0.593 (0.556-0.630), 0.562 (0.515-0.610), and 0.436 (0.393-0.479), respectively. DNI values were significantly lower in patients with sepsis without AKI than in those with AKI. The diagnostic accuracy of DNI was comparable to CRP. Our results show that baseline DNI is a potential marker of SA-AKI, which can predict downstream risks of renal impairment in sepsis.