An atypical measles illness occurred in ten children who had received inactivated (killed) measles virus vaccine five to six years earlier. The illness is characterized by a two- to three-day prodrome of fever and complaints of pain (head, muscle, and abdomen, or both muscle and abdomen) followed by the development of a maculopapular rash with petechial, vesicular, and urticarial components. Peripheral edema and pneumonia occurred in almost all the children. In three instances, significant pleural effusions were noted. Serologic determinations established the diagnosis in all ten children, but measles virus was recovered from none of them.
Fulginiti VA, Eller JJ, Downie AW, Kempe CH. Altered Reactivity to Measles VirusAtypical Measles in Children Previously Immunized With Inactivated Measles Virus Vaccines. JAMA. 1967;202(12):1075-1080. doi:10.1001/jama.1967.03130250057008