1
|
Luu LA, Makin TA, Borish L, Snavely EA, Meyer JS, Zlotoff BJ, Zeichner SL. Fever, Rash, and Cough in a 7-Year-Old Boy. Pediatrics 2023; 151:e2022058194. [PMID: 36601710 DOI: 10.1542/peds.2022-058194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/06/2023] Open
Abstract
A 7-year-old boy presented to the emergency department with fever, cough, congestion, abdominal pain, myalgias, and morbilliform rash. Several aspects of the patient's history, including recent travel, living on a farm, exposure to sick contacts, and new medications, resulted in a wide differential diagnosis. Initial laboratory testing revealed leukocytosis with neutrophilia and elevated atypical lymphocytes, but did not reveal any infectious causes of illness. He was discharged from the hospital, but then represented to the emergency department a day later with worsening rash, continued fever, abdominal pain, and poor intake. He was then admitted. A more comprehensive laboratory evaluation was initiated. During this hospital course, the patient's physical examination changed when he developed head and neck edema, and certain laboratory trends became clearer. With the assistance of several specialists, the team was able to reach a more definitive diagnosis and initiate treatment to appropriately manage his condition.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Steven L Zeichner
- Pediatrics and Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
2
|
McMahon JL, Northill JA, Finger M, Lyon M, Lambert SB, Mackay IM. Laboratory methods supporting measles surveillance in Queensland, Australia, 2010-2017. Access Microbiol 2020; 2:acmi000093. [PMID: 32974570 PMCID: PMC7470308 DOI: 10.1099/acmi.0.000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/19/2019] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Australia was officially recognised as having eliminated endemic measles transmission in 2014. Maintaining laboratory support for surveillance of vaccine-preventable diseases, such as measles, is an essential component of reaching and maintaining transmission-free status. METHODOLOGY Real-time and conventional PCR-based tools were used to detect, differentiate from measles vaccine virus (MeVV), and sequence fragments of measles viruses (MeV) identified from specimens collected in Queensland. Specimens were mostly from travellers who had visited or returned to Queensland from international or interstate sites or been in contact with a case from either group. RESULTS Between 2010 and 2017, 13 678 specimens were tested in our laboratory using real-time RT-PCR (RT-rPCR), identifying 533 positives. Most specimens were swabs (70.98 %) and urines (25.56 %). A MeVV RT-rPCR was used on request and identified 154 instances of MeVV. MeV-positive extracts were genotyped as required. Genotypes identified among sequenced specimens included B3, D4, D8, D9, G3, and H1 as well as members of clade A as expected from the detection of MeV among virus introductions due to global travel and vaccination. CONCLUSION We describe the workflow employed and results from our laboratory between 2010 and 2017 for the sensitive detection of MeV infection, supporting high-quality surveillance to ensure the maintenance of Australia's measles-free status.
Collapse
Affiliation(s)
- Jamie L. McMahon
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Public Health Virology Laboratory, Forensic and Scientific Services, Queensland Health, Coopers Plains, Coopers Plains, Queensland, Australia
| | - Judith A. Northill
- Public Health Virology Laboratory, Forensic and Scientific Services, Queensland Health, Coopers Plains, Coopers Plains, Queensland, Australia
| | - Mitchell Finger
- Public Health Virology Laboratory, Forensic and Scientific Services, Queensland Health, Coopers Plains, Coopers Plains, Queensland, Australia
| | - Michael Lyon
- Public Health Virology Laboratory, Forensic and Scientific Services, Queensland Health, Coopers Plains, Coopers Plains, Queensland, Australia
| | - Stephen B. Lambert
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Ian M. Mackay
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Public Health Virology Laboratory, Forensic and Scientific Services, Queensland Health, Coopers Plains, Coopers Plains, Queensland, Australia
| |
Collapse
|
3
|
Laundy NC, Greig JM, Raza M, Mitchell T. Delay in the diagnosis of measles complicated by pneumonitis and appendicitis in a returning traveller. BMJ Case Rep 2019; 12:e232652. [PMID: 31796443 PMCID: PMC7001684 DOI: 10.1136/bcr-2019-232652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/04/2022] Open
Abstract
A 40-year-old British man presented to the emergency department for the second time in 10 days following a 2-week holiday in Thailand with malaise, bilateral conjunctivitis and a morbilliform rash. He had previously seen his general practitioner and ophthalmology and was diagnosed with conjunctivitis. We confirmed measles following RNA detection on a mouth swab. Four days after admission he developed abdominal pain and a CT abdomen demonstrated acute appendicitis with large appendicoliths. A perforated appendix was identified intraoperatively. Measles RNA was detected in the resected appendix. Preoperatively he developed hypoxia with right upper lobe changes seen on a CT pulmonary angiogram. Bronchoalveolar lavage performed in theatre isolated measles RNA at high level, consistent with measles pneumonitis. He required ventilatory support in the intensive care unit and was also treated with intravenous antibiotics. He made a complete recovery.
Collapse
Affiliation(s)
| | - Julia M Greig
- Infectious Diseases, Sheffield Teaching Hospitals, Sheffield, UK
| | - Mohammad Raza
- Virology, Sheffield Teaching Hospitals, The University of Sheffield, Sheffield, UK
| | - Tamara Mitchell
- Infectious Diseases, Sheffield Teaching Hospitals, Sheffield, UK
| |
Collapse
|
4
|
Piccirilli G, Chiereghin A, Pascucci MG, Frasca G, Zuntini R, Ferrari S, Gabrielli L, Landini MP, Lazzarotto T. Molecular detection and genetic characterization of circulating measles virus in northern Italy. J Clin Virol 2016; 81:34-42. [PMID: 27310466 DOI: 10.1016/j.jcv.2016.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Laboratory diagnosis of measles virus (MV) infection and genetic characterization of circulating MV play an essential role in measles surveillance, allowing proper interventions to interrupt endemic transmission. OBJECTIVES We describe results obtained using serological and molecular methods to confirm MV infection among suspected cases reported in a large region in the north of Italy during 2010-2014 and the genotyping of the MV strains detected. STUDY DESIGN Three hundred seventy-two samples (361 urine and 11 oral fluids) were tested for MV-RNA detection. In 281 cases, the serological results for MV-IgM detection were also available. RESULTS A total of 276 cases were classified as confirmed measles and MV-RNA detection resulted positive for 239/276 cases. Nucleotide sequence analysis revealed sporadic cases of genotypes D9 and different circulations of endemic MV strains (D8, D4 and B3). CONCLUSIONS This data suggests that there is still an unvaccinated part of the population maintaining the endemic circulation of MV in Italy.
Collapse
Affiliation(s)
- Giulia Piccirilli
- Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | - Angela Chiereghin
- Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | | | - Gabriella Frasca
- Public Health Unit Emilia-Romagna Region, Viale Aldo Moro 21, 40127 Bologna, Italy.
| | - Roberta Zuntini
- Unit of Medical Genetics, Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Simona Ferrari
- Unit of Medical Genetics, St. Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Liliana Gabrielli
- Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | - Maria Paola Landini
- Department of Specialised, Experimental, and Diagnostic Medicine, Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Tiziana Lazzarotto
- Department of Specialised, Experimental, and Diagnostic Medicine, Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| |
Collapse
|
5
|
Benamar T, Tajounte L, Alla A, Khebba F, Ahmed H, Mulders MN, Filali-Maltouf A, El Aouad R. Real-Time PCR for Measles Virus Detection on Clinical Specimens with Negative IgM Result in Morocco. PLoS One 2016; 11:e0147154. [PMID: 26812434 PMCID: PMC4727926 DOI: 10.1371/journal.pone.0147154] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 12/28/2015] [Indexed: 01/03/2023] Open
Abstract
Since the confirmation of measles cases represents an important indicator regarding the performance of the measles-elimination program, the aim of this study was to evaluate the effectiveness of the routine procedures followed in Morocco for the laboratory confirmation of measles cases. Suspected cases reported between January 2010 and December 2012 were assessed for the timeliness of the sample collection, occurrence of measles clinical symptoms, and the results of the laboratory diagnoses. For 88% of the 2,708 suspected cases, a clinical specimen was collected within 7d of rash onset, of which 50% were IgM-positive and 2.6% were equivocal. The measles symptoms were reported in 91.4% of the cases; the occurrence of symptoms showed a positive association with the serological results (odds ratio [OR] = 2.9883, 95% confidence interval [CI] 2.2238-4.0157). Of the negative samples, 52% (n = 116) tested positive by real-time polymerase chain reaction (PCR). These results are in favor of using molecular detection to complement serological diagnosis in the context of measles surveillance approach in Morocco. In addition, the introduction of additional laboratory methods for differential diagnosis is required for the final classification of suspected cases with maculopapular rash and fever in the context of the measles elimination program.
Collapse
Affiliation(s)
- Touria Benamar
- National Institute of Hygiene, Ministry of Health, Rabat, Morocco
| | - Latifa Tajounte
- National Institute of Hygiene, Ministry of Health, Rabat, Morocco
| | - Amal Alla
- Epidemiology Department, Ministry of Health, Rabat, Morocco
| | - Fatima Khebba
- National Institute of Hygiene, Ministry of Health, Rabat, Morocco
| | - Hinda Ahmed
- Department of Communicable Disease Prevention & Control, WHO/EMRO, Cairo, Egypt
| | - Mick N. Mulders
- Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland
| | - Abdelkarim Filali-Maltouf
- Microbiology and Molecular Biology Laboratory, Faculty of Sciences, University Mohammed V, Rabat, Morocco
| | - Rajae El Aouad
- School of Medicine and Pharmacy, University Mohamed V Souissi, Rabat, Morocco
| |
Collapse
|
6
|
SHONHAI A, WARRENER L, MANGWANYA D, SLIBINSKAS R, BROWN K, BROWN D, FEATHERSTONE D, SAMUEL D. Investigation of a measles outbreak in Zimbabwe, 2010: potential of a point of care test to replace laboratory confirmation of suspected cases. Epidemiol Infect 2015; 143:3442-50. [PMID: 25865645 PMCID: PMC9150933 DOI: 10.1017/s0950268815000540] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/09/2015] [Accepted: 02/27/2015] [Indexed: 11/06/2022] Open
Abstract
Blood and oral fluid (OF) samples were collected from 103 suspected measles cases between February and November 2010 during a nationwide measles outbreak in Zimbabwe. Siemens measles IgM enzyme immunoassay (EIA) on serum, Microimmune measles IgM capture EIA on OF, real-time haemagglutinin (H) gene PCR and nested nucleocapsid (N) gene PCR on OF were performed, confirming 75 measles cases. These samples were then used to evaluate a newly developed point of care test (POCT) for measles and determine its potential for identifying measles cases in outbreaks. After performing POCTs on OF samples, nucleic acid was extracted from the used test strips and the measles H and N genes amplified by RT-PCR. The sensitivity, specificity, positive and negative predictive values of the POCT for IgM in OF was 75·0% [95% confidence interval (CI) 63·4-84·5], 96·2% (95% CI 80·4-99·9), 98·2% (95% CI 90·3-100) and 58·1% (95% CI 42·1-73·0), respectively. The N gene sequences showed high level of agreement between original OF and corresponding POCT strips. Measles genotype B3 was identified in all cases. We conclude that the measles POCT has the potential to be used, at the point of contact, in outbreak situations and provide molecular characterization of the virus at a later date.
Collapse
Affiliation(s)
- A. SHONHAI
- Zimbabwe National Virology Laboratory, Department of Medical Microbiology, College of Health Science, University of Zimbabwe, Zimbabwe
| | - L. WARRENER
- Virus Reference Department, Public Health England, London, UK
| | | | - R. SLIBINSKAS
- Institute of Biotechnology of Vilnius University, Vilnius, Lithuania
| | - K. BROWN
- Virus Reference Department, Public Health England, London, UK
| | - D. BROWN
- Virus Reference Department, Public Health England, London, UK
| | - D. FEATHERSTONE
- World Health Organization: Expanded Programme on Immunization (EPI), Department of Immunization, Vaccines and Biologicals (IVB), Geneva, Switzerland
| | - D. SAMUEL
- Virus Reference Department, Public Health England, London, UK
| |
Collapse
|
7
|
Assessment of the Utility of Whole Genome Sequencing of Measles Virus in the Characterisation of Outbreaks. PLoS One 2015; 10:e0143081. [PMID: 26569100 PMCID: PMC4646484 DOI: 10.1371/journal.pone.0143081] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/30/2015] [Indexed: 11/25/2022] Open
Abstract
Background Measles is a highly infectious disease caused by measles virus (MeV). Despite the availability of a safe and cost-effective vaccine, measles is one of the world-leading causes of death in young children. Within Europe, there is a target for eliminating endemic measles in 2015, with molecular epidemiology required on 80% of cases for inclusion/exclusion of outbreak transmission chains. Currently, MeV is genotyped on the basis of a 450 nucleotide region of the nucleoprotein gene (N-450) and the hemagglutinin gene (H). However, this is not sufficiently informative for distinguishing endemic from imported MeV. We have developed an amplicon-based method for obtaining whole genome sequences (WGS) using NGS or Sanger methodologies from cell culture isolates or oral fluid specimens, and have sequenced over 60 samples, including 42 from the 2012 outbreak in the UK. Results Overall, NGS coverage was over 90% for approximately 71% of the samples tested. Analysis of 32 WGS excluding 3’ and 5’ termini (WGS-t) obtained from the outbreak indicates that the single nucleotide difference found between the two major groups of N-450 sequences detected during the outbreak is most likely a result of stochastic viral mutation during endemic transmission rather than of multiple importation events: earlier strains appear to have evolved into two distinct strain clusters in 2013, one containing strains with both outbreak-associated N-450 sequences. Additionally, phylogenetic analysis of each genomic region of MeV for the strains in this study suggests that the most information is acquired from the non-coding region located between the matrix and fusion protein genes (M/F NCR) and the N-450 genotyping sequence, an observation supported by entropy analysis across genotypes. Conclusions We suggest that both M/F NCR and WGS-t could be used to complement the information from classical epidemiology and N-450 sequencing to address specific questions in the context of measles elimination.
Collapse
|
8
|
Self-collected buccal swabs and rapid, real-time PCR during a large measles outbreak in Wales: Evidence for the protective effect of prior MMR immunisation. J Clin Virol 2015; 67:1-7. [DOI: 10.1016/j.jcv.2015.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/12/2015] [Accepted: 03/14/2015] [Indexed: 11/18/2022]
|
9
|
Mashazi P, Vilakazi S, Nyokong T. Design and evaluation of an electrochemical immunosensor for measles serodiagnosis using measles-specific Immunoglobulin G antibodies. Talanta 2013; 115:694-701. [PMID: 24054649 DOI: 10.1016/j.talanta.2013.06.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 06/19/2013] [Accepted: 06/21/2013] [Indexed: 01/05/2023]
Abstract
The design of electrochemical immunosensors for the detection of measles-specific antibodies is reported. The measles-antigen modified surface was used as an antibody capture surface. The detection of measles-specific IgG antibodies was accomplished using the voltammetric method and horse-radish peroxidase (HRP) labeled secondary antibody (anti-IgG) as a detecting antibody. The potential applications of the designed immunosensor were evaluated in buffer and serum solutions. The immunosensor exhibited good linearity at concentrations less than 100 ng mL(-1) with R(2)=0.997 and the limit of detection of 6.60 ng mL(-1) at 3σ. The potential application of the immunosensor was evaluated in the deliberately infected human and newborn calf serum samples with measles-IgG antibody mimicking real-life samples. The designed electrochemical immunosensor could differentiate between infected and un-infected serum samples as higher catalytic currents were obtained for infected serum samples.
Collapse
Affiliation(s)
- Philani Mashazi
- Nanotechnology Innovation Centre, Advanced Materials Division, Mintek, Private Bag X3015, Randburg 2125, South Africa; Nanotechnology Innovation Centre, Sensors, Chemistry Department, Rhodes University, P.O. Box 94, Grahamstown 6140, South Africa.
| | | | | |
Collapse
|
10
|
Michel Y, Saloum K, Tournier C, Quinet B, Lassel L, Pérignon A, Grimprel E, Carbajal R, Vabret A, Freymuth F, Garbarg-Chenon A, Schnuriger A. Rapid molecular diagnosis of measles virus infection in an epidemic setting. J Med Virol 2013; 85:723-30. [DOI: 10.1002/jmv.23515] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2012] [Indexed: 01/03/2023]
|
11
|
Rodpothong P, Auewarakul P. Viral evolution and transmission effectiveness. World J Virol 2012; 1:131-4. [PMID: 24175217 PMCID: PMC3782273 DOI: 10.5501/wjv.v1.i5.131] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 08/10/2012] [Accepted: 09/07/2012] [Indexed: 02/05/2023] Open
Abstract
Different viruses transmit among hosts with different degrees of efficiency. A basic reproductive number (R0) indicates an average number of cases getting infected from a single infected case. R0 can vary widely from a little over 1 to more than 10. Low R0 is usually found among rapidly evolving viruses that are often under a strong positive selection pressure, while high R0 is often found among viruses that are highly stable. The reason for the difference between antigenically diverse viruses with low R0, such as influenza A virus, and antigenically stable viruses with high R0, such as measles virus, is not clear and has been a subject of great interest. Optimization of transmissibility fitness considering intra-host dynamics and inter-host transmissibility was shown to result in strategies for tradeoff between transmissibility and diversity. The nature of transmission, targeting either a naïve children population or an adult population with partial immunity, has been proposed as a contributing factor for the difference in the strategies used by the two groups of viruses. The R0 determines the levels of threshold heard immunity. Lower R0 requires lower herd immunity to terminate an outbreak. Therefore, it can be assumed that the outbreak saturation can be reached more readily when the R0 is low. In addition, one may assume that when the outbreak saturation is reached, herd immunity may provide a strong positive selection pressure that could possibly result in an occurrence of escape mutants. Studies of these hypotheses will give us an important insight into viral evolution. This review discusses the above hypotheses as well as some possible mechanistic explanation for the difference in transmission efficiency of viruses
Collapse
Affiliation(s)
- Patsarin Rodpothong
- Patsarin Rodpothong, Prasert Auewarakul, Department of Microbiology, Faculty of Medicine Siriraj Hospital, Bangkok 10700, Thailand
| | | |
Collapse
|
12
|
Biological feasibility of measles eradication. Virus Res 2011; 162:72-9. [PMID: 21963661 DOI: 10.1016/j.virusres.2011.09.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 09/16/2011] [Accepted: 09/17/2011] [Indexed: 11/21/2022]
Abstract
Because of the success of global measles control programs, the World Health Organization (WHO), along with its partner agencies, is once again considering the possibility of setting a target date for measles eradication. Measles would be the fourth viral agent to be eradicated joining the successful programs to eradicate smallpox and rinderpest virus, and the continuing effort to eradicate polio virus. A description of the recent progress toward measles eradication was recently published as a supplement in the Journal of Infectious Diseases (15 July, 2011, 204 (Suppl. 1)) and the reader is referred to this document for a detailed summary of the global status of measles control. This review will focus on the biologic and virologic aspects of measles eradication.
Collapse
|
13
|
Warrener L, Slibinskas R, Chua KB, Nigatu W, Brown KE, Sasnauskas K, Samuel D, Brown D. A point-of-care test for measles diagnosis: detection of measles-specific IgM antibodies and viral nucleic acid. Bull World Health Organ 2011; 89:675-82. [PMID: 21897488 PMCID: PMC3165981 DOI: 10.2471/blt.11.088427] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 06/27/2011] [Accepted: 06/27/2011] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To evaluate the performance of a newly developed point-of-care test (POCT) for the detection of measles-specific IgM antibodies in serum and oral fluid specimens and to assess if measles virus nucleic acid could be recovered from used POCT strips. METHODS The POCT was used to test 170 serum specimens collected through measles surveillance or vaccination programmes in Ethiopia, Malaysia and the Russian Federation: 69 were positive for measles immunoglobulin M (IgM) antibodies, 74 were positive for rubella IgM antibodies and 7 were positive for both. Also tested were 282 oral fluid specimens from the measles, mumps and rubella (MMR) surveillance programme of the United Kingdom of Great Britain and Northern Ireland. The Microimmune measles IgM capture enzyme immunoassay was the gold standard for comparison. A panel of 24 oral fluids was used to investigate if measles virus haemagglutinin (H) and nucleocapsid (N) genes could be amplified by polymerase chain reaction directly from used POCT strips. FINDINGS With serum POCT showed a sensitivity and specificity of 90.8% (69/76) and 93.6% (88/94), respectively; with oral fluids, sensitivity and specificity were 90.0% (63/70) and 96.2% (200/208), respectively. Both H and N genes were reliably detected in POCT strips and the N genes could be sequenced for genotyping. Measles virus genes could be recovered from POCT strips after storage for 5 weeks at 20-25 °C. CONCLUSION The POCT has the sensitivity and specificity required of a field-based test for measles diagnosis. However, its role in global measles control programmes requires further evaluation.
Collapse
Affiliation(s)
- Lenesha Warrener
- Virus Reference Department, Centre for Infections, Health Protection Agency, London, England.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Rota PA, Brown KE, Hübschen JM, Muller CP, Icenogle J, Chen MH, Bankamp B, Kessler JR, Brown DW, Bellini WJ, Featherstone D. Improving Global Virologic Surveillance for Measles and Rubella. J Infect Dis 2011; 204 Suppl 1:S506-13. [DOI: 10.1093/infdis/jir117] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
15
|
Hutse V, Van Hecke K, De Bruyn R, Samu O, Lernout T, Muyembe JJ, Brochier B. Oral fluid for the serological and molecular diagnosis of measles. Int J Infect Dis 2010; 14:e991-7. [PMID: 20851015 DOI: 10.1016/j.ijid.2010.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 06/02/2010] [Accepted: 06/09/2010] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Since measles presents mostly in children, a non-invasive sample collection technique such as oral fluid sampling would be very useful in the early detection of measles RNA and antibodies. The aim of this study was to validate the detection of anti-measles IgM and measles virus RNA in oral fluid and to make a comparison with the gold standard methods of ELISA using serum (Enzygnost(®) anti-Measles IgM) and in-house nested reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal secretions. METHODS Three samples each from 73 measles-positive and 44 measles-negative subjects (serum, oral fluid, and nasopharyngeal secretions) were analyzed. RESULTS The anti-measles IgM ELISA (MicroImmune) on oral fluid was validated against the IgM ELISA (Siemens) for serum and this resulted in a sensitivity of 92% and specificity of 100%. A molecular nested RT-PCR using oral fluid was validated against the standard assay on nasopharyngeal secretions and gave a sensitivity of 100% and specificity of 100%. CONCLUSIONS The results confirm that both serological and molecular oral fluid assays are suitable for routine use. The use of oral fluid samples for the detection of measles virus may encourage patients, general practitioners, and pediatricians to participate in the Belgian measles surveillance system and other epidemiological studies in the framework of the World Health Organization elimination program.
Collapse
Affiliation(s)
- V Hutse
- Viral Diseases, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | | | | | | | | | | | | |
Collapse
|
16
|
Ito M, Suga T, Akiyoshi K, Nukuzuma S, Kon-no M, Umegaki Y, Kohdera U, Ihara T. Detection of measles virus RNA on SYBR green real-time reverse transcription-polymerase chain reaction. Pediatr Int 2010; 52:611-5. [PMID: 20337982 DOI: 10.1111/j.1442-200x.2010.03124.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND As the coverage rate of the measles vaccine increases, not all patients present the typical symptoms of measles after exposure to the measles virus (MV). The virus loads in clinical specimens from patients with vaccine-modified non-typical measles are expected to be low compared with those of primary MV infection. A rapid and sensitive laboratory procedure is required for diagnosis of measles. METHODS SYBR Green (TaKaRa) and TaqMan (ABI) real-time reverse transcription-polymerase chain reaction (RT-PCR) assays were developed to detect MV-RNA. For the real-time RT-PCR, primer sets were designed from a region of the MV H gene of the Edmonston strain (genotype A). A TaqMan probe specific for the H gene of genotype D MV was used. The minimum detectable level of MV-RNA in the SYBR Green and TaqMan real-time RT-PCR assays was evaluated using synthetic MV-RNA. The sensitivity of real-time RT-PCR was compared with that of nested RT-PCR and the virus isolation method using throat swabs and peripheral blood samples from patients with measles. RESULTS The minimum detectable level of RNA was 10 and 10(2) copies for SYBR Green RT-PCR and TaqMan RT-PCR, respectively. Ten-10(6) copies of standard RNA were linearly detected on SYBR Green RT-PCR. The sensitivity of SYBR Green RT-PCR was equal to that of nested RT-PCR. MV-RNA was detected in virus isolation-negative throat swabs on SYBR Green RT-PCR. CONCLUSION SYBR Green RT-PCR is a highly sensitive, rapid, and useful diagnostic procedure for the detection of MV.
Collapse
Affiliation(s)
- Masahiro Ito
- Kyoto City Institute of Health and Environment Science, Nakagyo, Kyoto, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Warrener L, Slibinskas R, Brown D, Sasnauskas K, Samuel D. Development and evaluation of a rapid immunochromatographic test for mumps-specific IgM in oral fluid specimens and use as a matrix for preserving viral nucleic acid for RT-PCR. J Med Virol 2010; 82:485-93. [DOI: 10.1002/jmv.21693] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
18
|
Akiyama M, Kimura H, Tsukagoshi H, Taira K, Mizuta K, Saitoh M, Nagano M, Sutoh A, Noda M, Morita Y, Sakatsume O, Okabe N, Tashiro M. Development of an assay for the detection and quantification of the measles virus nucleoprotein (N) gene using real-time reverse transcriptase PCR. J Med Microbiol 2009; 58:638-643. [PMID: 19369526 DOI: 10.1099/jmm.0.005439-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We developed a new quantification method for the measles virus (MeV) nucleoprotein (N) gene using real-time reverse transcriptase PCR. This method allowed us to quantify 10(1)-10(7) copies per reaction (corresponding to 5x10(-1)-5x10(5) copies microl(-1)) of the MeV N gene. We also quantified the MeV N gene from the throat swabs of 22 patients with measles as well as the MeV genotypes A, D3, D5, D9 and H1 in viral suspensions derived from MeV-infected cells. As a result, 3.9x10(3)-5.2x10(6) copies ml(-1) and 7.4x10(7)-2.0x10(8) copies ml(-1) of the MeV genomes (N gene) were detected in the throat swabs and viral suspensions, respectively. No other viruses (enteroviruses, respiratory syncytial virus, human metapneumovirus or mumps virus) were detected in the assay. The results suggest that this method is applicable to the detection and quantification of some genotypes of MeV.
Collapse
Affiliation(s)
- Miho Akiyama
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Hiroyuki Tsukagoshi
- Gunma Prefectural Institute of Public Health and Environmental Sciences, 378 Kamioki-machi, Maebashi, Gunma 371-0052, Japan
| | - Katsuya Taira
- Okinawa Prefectural Institute of Public Health and Environmental Sciences, 2085 Ozato, Nanjo, Okinawa 910-1202, Japan
| | - Katsumi Mizuta
- Yamagata Prefectural Institute of Public Health, 1-6-6 Tokamachi, Yamagata 990-0031, Japan
| | - Mika Saitoh
- Gunma Prefectural Institute of Public Health and Environmental Sciences, 378 Kamioki-machi, Maebashi, Gunma 371-0052, Japan
| | - Manami Nagano
- Molecular and Cellular Biology Division, Applied Biosystems Japan Ltd, 4-5-4 Hatchobori, Chuo-ku, Tokyo 104-0032, Japan
| | - Asuka Sutoh
- Yamagata Prefectural Institute of Public Health, 1-6-6 Tokamachi, Yamagata 990-0031, Japan
| | - Masahiro Noda
- Department of Virology III, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Yukio Morita
- Gunma Prefectural Institute of Public Health and Environmental Sciences, 378 Kamioki-machi, Maebashi, Gunma 371-0052, Japan
| | - Osamu Sakatsume
- Molecular and Cellular Biology Division, Applied Biosystems Japan Ltd, 4-5-4 Hatchobori, Chuo-ku, Tokyo 104-0032, Japan
| | - Nobuhiko Okabe
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Masato Tashiro
- Department of Virology III, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| |
Collapse
|