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• W2978497458 abstract "Introduction: Current quality measures and management guidelines emphasize vaccination for influenza and pneumococcus for IBD patients, as well as the avoidance of live virus vaccines for those who are on immunosuppressive (ISS) therapies with immune modulators or anti-TNFs. Given the recent resurgence of measles virus infections and separately, a nation-wide Bordetella pertussis outbreak, we assessed the immune status of our IBD population in order to advise about these risks. Methods: From Feb 1-May 1 2015, we prospectively collected measles and pertussis titers in IBD patients in one clinician's (DTR) and nurse practitioner's (AW) practice. Immune status based on standard threshold values was determined: measles antibodies ≤0.8 Antibody Index (AI)=negative immunity, 0.8-1.1 AI=equivocal immunity and titers ≥1.2 AI=positive immunity. For pertussis immunity, patients with anti-pertussis (PT) antibodies ≤ 5 IU/mL were considered non-immune. Given that there is no standard threshold for FHA titers, this was not analyzed. Univariate analysis was performed to examine predictive factors including age, disease duration and current medical therapies. Appropriateness for booster vaccination was determined based on these results and ISS therapy. Results: 122 patients' titers were assessed (77 Crohn's disease, 1 Indeterminate colitis, and 45 ulcerative colitis). 16 (13%) patients lacked detectable immunity to measles and 4 (3%) had equivocal immunity. 11 (73%) of the measles non-immune patients were on ISS therapy vs. 67 (63%) of 106 immune patients (OR of ISS and non-immunity =1.7, 95% CI 0.5-5.9, p=0.32). Of those who lack immunity to measles, 7 (44%) are females of childbearing age and 12 (75%) are on ISS therapy. 96 patients had pertussis titers measured and 60% were non-immune. Disease duration >10 years was associated with significant lower pertussis and measles titers, and age >50 was associated with lower pertussis titers (Table). Conclusion: A significant number of our IBD patients lack immunity to measles and a majority of our IBD patients do not have detectable immunity to pertussis. Importantly, of those non-immune to measles, many are females of childbearing age for whom measles infection could pose signficant risk during pregnancy. In addition, many are on ISS and thus unable to receive the live measles vaccine. Knowledge of patients' immune status to these public health concerns is important for management, protection and counseling.Table 1: Assessment of Selective Risk Factors and Measles and Pertussis Immune Status of IBD Patients" @default.
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• W2978497458 date "2015-10-01" @default.
• W2978497458 modified "2023-09-27" @default.
• W2978497458 title "Many IBD Patients Are Not Immune to Measles or Pertussis" @default.
• W2978497458 doi "https://doi.org/10.14309/00000434-201510001-01855" @default.
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