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Rubalskaia TS, Erokhov DV, Zherdeva PE, Mamaeva TA, Tikhonova NT. Global genetic diversity of measles virus (Paramyxoviridae: Morbillivirus: Morbillivirus hominis): historical aspects and current state. Vopr Virusol 2023; 68:361-371. [PMID: 38156571 DOI: 10.36233/0507-4088-187] [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] [Received: 07/19/2023] [Indexed: 12/30/2023]
Abstract
Monitoring the circulation of the measles virus and studying its genetic diversity is an important component of the measles elimination program. A methodological approach to molecular genetic studies and their interpretation in the measles surveillance was developed in the early 2000s. During its development, clear areas of circulation of each genotype of the virus were identified, therefore, the determination of viruses' genotypes was proposed to monitor circulation and identify transmission pathways. However, in the future, due to a significant decrease in the number of active genotypes, an approach based on sub-genotyping was proposed: determining not only the genotype of the virus, but also its genetic lineage/genetic variant. The Global Measles and Rubella Laboratory Network (GMRLN) systematically monitors the circulation of the measles virus at the sub-genotypic level, depositing the results in a specialized database MeaNS2. It is this database that is the most complete and reliable source of information about the genetic characteristic of measles viruses. This review presents both historical information and the latest data on the global genetic diversity of the measles virus.
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Affiliation(s)
- T S Rubalskaia
- G.N. Gabrichevsky Moscow research institute of epidemiology and microbiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
| | - D V Erokhov
- G.N. Gabrichevsky Moscow research institute of epidemiology and microbiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
| | - P E Zherdeva
- G.N. Gabrichevsky Moscow research institute of epidemiology and microbiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
| | - T A Mamaeva
- G.N. Gabrichevsky Moscow research institute of epidemiology and microbiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
| | - N T Tikhonova
- G.N. Gabrichevsky Moscow research institute of epidemiology and microbiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing
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2
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Pabbaraju K, Fonseca K, Wong S, Koch MW, Joseph JT, Tipples GA, Tellier R. Genetic characterization of measles virus genotype D6 subacute sclerosing panencephalitis case, Alberta, Canada. J Neurovirol 2018; 24:720-729. [PMID: 30291564 DOI: 10.1007/s13365-018-0668-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 07/09/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Abstract
Subacute sclerosing panencephalitis (SSPE) is a progressive and eventually fatal neurological disease arising from a persistent infection with measles virus (MV) acquired at a young age. SSPE measles virus strains are defective and unable to produce progeny virions, due to multiple and extensive mutations in a number of key genes. We sequenced the full MV genome from our recently reported SSPE case, which typed as genotype D6, and compared it with other genotype D6 wild type and SSPE sequences. The Alberta D6 strain was significantly different from other reported SSPE D6 sequences. Mutations were observed in all the genes of the Alberta strain, with the greatest sequence divergence noted in the M gene with 17.6% nucleotide and 31% amino acid variation. The L gene showed the least variation with 1.3% nucleotide and 0.7% amino acid differences respectively. The nucleotide variability for 15,672 bases of the complete genome compared to the wild type and other SSPE D6 strains was around 3%.
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Affiliation(s)
- K Pabbaraju
- Provincial Laboratory for Public Health, Calgary, Alberta, Canada.
| | - K Fonseca
- Provincial Laboratory for Public Health, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - S Wong
- Provincial Laboratory for Public Health, Calgary, Alberta, Canada
| | - M W Koch
- Departments of Clinical Neurosciences and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - J T Joseph
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - G A Tipples
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada.,Provincial Laboratory for Public Health, Edmonton, Alberta, Canada
| | - R Tellier
- Provincial Laboratory for Public Health, Calgary, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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Zaidi SSZ, Hameed A, Suleman Rana M, Alam MM, Umair M, Aamir UB, Hussain M, Sharif S, Shaukat S, Angez M, Khurshid A. Identification of measles virus genotype B3 associated with outbreaks in Islamabad, Pakistan, 2013-2015. J Infect Public Health 2017; 11:540-545. [PMID: 29129527 DOI: 10.1016/j.jiph.2017.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/02/2017] [Accepted: 10/12/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Measles virus infection remains a significant cause of childhood mortality and morbidity despite continued global efforts and the availability of a safe and effective vaccine. Molecular analysis of indigenous measles viruses could provide critical information on outbreak linkages and transmission pathways that can aid the implementation of appropriate control programs in Pakistan. METHODS Blood samples and throat swabs were collected from subjects suspected with measles in Islamabad, Pakistan from 2013 to 2015. Serum samples were tested for the presence of measles immunoglobulin M (IgM) antibodies using enzyme-linked immunosorbent assay (ELISA) while throat swabs were used for the isolation (Vero/SLAM cell line) and subsequent characterization and phylogenetic analysis of measles strains. RESULTS Of 373 blood samples, 66% tested positive for measles IgM. Male subjects were more often infected (58%) than female (42%) with the highest frequency of positive cases (63%) in the 0-5-years age group. Among the positive cases, only 13% had received one or two doses of the measles vaccine, while 87% were unvaccinated. Of 80 throat swabs, 29 (36%) showed a measles virus-specific cytopathic effect (CPE) and were characterized as genotype B3 through partial sequencing of the nucleoprotein (N) gene. Phylogenetic analysis revealed the Pakistani B3 strains to be closely related to strains from neighboring countries (Iran and Afghanistan) as well as with B3 viruses from the USA, Germany, and the UK. CONCLUSIONS The study results showed that despite the availability of an effective vaccine, the burden of measles infections is very high in Pakistan due to poor routine immunization coverage even in major cities, including the capital city of Islamabad. It is imperative that national health authorities take urgent strategic steps to improve routine immunization and implement adequate molecular identification methods to tackle future measles outbreaks.
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Affiliation(s)
- Syed S Z Zaidi
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan; Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan.
| | - Abdul Hameed
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan; International Islamic University, Islamabad, Pakistan
| | - Muhammad Suleman Rana
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Muhammad M Alam
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Massab Umair
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Uzma B Aamir
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | | | - Salmaan Sharif
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Shahzad Shaukat
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Mehar Angez
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Adnan Khurshid
- Department of Virology, National Institute of Health, Park Road, Chak Shahzad, Islamabad, Pakistan
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Antigenic Drift Defines a New D4 Subgenotype of Measles Virus. J Virol 2017; 91:JVI.00209-17. [PMID: 28356529 DOI: 10.1128/jvi.00209-17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/19/2017] [Indexed: 01/25/2023] Open
Abstract
The measles virus hemagglutinin (MeV-H) protein is the main target of protective neutralizing antibodies. Using a panel of monoclonal antibodies (MAbs) that recognize known major antigenic sites in MeV-H, we identified a D4 genotype variant that escapes neutralization by MAbs targeting the neutralizing epitope (NE) antigenic site. By site-directed mutagenesis, L249P was identified as the critical mutation disrupting the NE in this genotype D4 variant. Forty-two available D4 genotype gene sequences were subsequently analyzed and divided into 2 groups according to the presence or absence of the L249P MeV-H mutation. Further analysis of the MeV-N gene sequences of these 2 groups confirmed that they represent clearly definable, sequence-divergent D4 subgenotypes, which we named subgenotypes D4.1 and D4.2. The subgenotype D4.1 MeVs were isolated predominantly in Kenya and Ethiopia, whereas the MAb-resistant subgenotype D4.2 MeVs were isolated predominantly in France and Great Britain, countries with higher vaccine coverage rates. Interestingly, D4.2 subgenotype viruses showed a trend toward diminished susceptibility to neutralization by human sera pooled from approximately 60 to 80 North American donors. Escape from MAb neutralization may be a powerful epidemiological surveillance tool to monitor the evolution of new MeV subgenotypes.IMPORTANCE Measles virus is a paradigmatic RNA virus, as the antigenic composition of the vaccination has not needed to be updated since its discovery. The vaccine confers protection by inducing neutralizing antibodies that interfere with the function of the hemagglutinin protein. Viral strains are indistinguishable serologically, although characteristic nucleotide sequences differentiate 24 genotypes. In this work, we describe a distant evolutionary branch within genotype D4. Designated subgenotype D4.2, this virus is distinguishable by neutralization with vaccine-induced monoclonal antibodies that target the neutralizing epitope (NE). The subgenotype D4.2 viruses have a higher predominance in countries with intermediary levels of vaccine coverage. Our studies demonstrate that subgenotype D4.2 lacks epitopes associated with half of the known antigenic sites, which significantly impacts our understanding of measles virus evolution.
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Subacute sclerosing panencephalitis in pregnancy. THE LANCET. INFECTIOUS DISEASES 2016; 16:366-75. [PMID: 26809815 PMCID: PMC7164796 DOI: 10.1016/s1473-3099(15)00524-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/29/2015] [Accepted: 12/01/2015] [Indexed: 01/21/2023]
Abstract
We present a case of subacute sclerosing panencephalitis that developed in a previously healthy 29-year-old pregnant woman who had returned from a trip to rural India shortly before the onset of symptoms. She was admitted to hospital at 27 weeks' gestation with a history of cognitive decline and difficulty completing simple tasks. She had no clinical signs of infection. The working diagnosis was autoimmune encephalitis, although extensive investigations did not lead to a final classifying diagnosis. The patient became comatose and developed hypertension, and an emergency caesarean section was done at 31 weeks to deliver the child, who seemed healthy. The patient died about 6 weeks after the onset of symptoms. The patient was found to have had subacute sclerosing panencephalitis at autopsy. In this Grand Round, we review the clinical features and treatment of subacute sclerosing panencephalitis, and the epidemiological and public health aspects of the case.
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Gahr P, DeVries AS, Wallace G, Miller C, Kenyon C, Sweet K, Martin K, White K, Bagstad E, Hooker C, Krawczynski G, Boxrud D, Liu G, Stinchfield P, LeBlanc J, Hickman C, Bahta L, Barskey A, Lynfield R. An outbreak of measles in an undervaccinated community. Pediatrics 2014; 134:e220-8. [PMID: 24913790 PMCID: PMC8167837 DOI: 10.1542/peds.2013-4260] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Measles is readily spread to susceptible individuals, but is no longer endemic in the United States. In March 2011, measles was confirmed in a Minnesota child without travel abroad. This was the first identified case-patient of an outbreak. An investigation was initiated to determine the source, prevent transmission, and examine measles-mumps-rubella (MMR) vaccine coverage in the affected community. Investigation and response included case-patient follow-up, post-exposure prophylaxis, voluntary isolation and quarantine, and early MMR vaccine for non-immune shelter residents >6 months and <12 months of age. Vaccine coverage was assessed by using immunization information system records. Outreach to the affected community included education and support from public health, health care, and community and spiritual leaders. Twenty-one measles cases were identified. The median age was 12 months (range, 4 months to 51 years) and 14 (67%) were hospitalized (range of stay, 2-7 days). The source was a 30-month-old US-born child of Somali descent infected while visiting Kenya. Measles spread in several settings, and over 3000 individuals were exposed. Sixteen case-patients were unvaccinated; 9 of the 16 were age-eligible: 7 of the 9 had safety concerns and 6 were of Somali descent. MMR vaccine coverage among Somali children declined significantly from 2004 through 2010 starting at 91.1% in 2004 and reaching 54.0% in 2010 (χ(2) for linear trend 553.79; P < .001). This was the largest measles outbreak in Minnesota in 20 years, and aggressive response likely prevented additional transmission. Measles outbreaks can occur if undervaccinated subpopulations exist. Misunderstandings about vaccine safety must be effectively addressed.
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Affiliation(s)
- Pamala Gahr
- Minnesota Department of Health, St Paul, Minnesota;
| | | | - Gregory Wallace
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Karen Martin
- Minnesota Department of Health, St Paul, Minnesota
| | - Karen White
- Minnesota Department of Health, St Paul, Minnesota
| | - Erica Bagstad
- Hennepin County Human Services and Public Health, Hopkins, Minnesota
| | - Carol Hooker
- Hennepin County Human Services and Public Health, Hopkins, Minnesota
| | | | - David Boxrud
- Minnesota Department of Health, St Paul, Minnesota
| | - Gongping Liu
- Minnesota Department of Health, St Paul, Minnesota
| | | | - Julie LeBlanc
- Children’s Hospital and Clinics of Minnesota, St Paul, Minnesota
| | | | - Lynn Bahta
- Minnesota Department of Health, St Paul, Minnesota
| | - Albert Barskey
- Centers for Disease Control and Prevention, Atlanta, Georgia
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8
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Pattamadilok S, Incomserb P, Primsirikunawut A, Lukebua A, Rota PA, Sawanpanyalert P. Genetic characterization of measles viruses that circulated in Thailand from 1998 to 2008. J Med Virol 2012; 84:804-13. [PMID: 22431030 DOI: 10.1002/jmv.23249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
During the period between 1998 and 2008, 48 representative measles viruses (MeVs) circulating in Thailand were subjected to genetic characterization. Three genotypes, G2, D5, and D9 were detected. The results suggested that measles genotype D5, which has been circulating since at least 1998, is the endemic genotype in Thailand. Genotype G2 was detected between 1998 and 2001. In addition, almost all of the MeVs detected throughout the country in 2008 were genotype D9. This is the first report of genotype D9 in Thailand. This report provides important baseline data about measles genotypes in Thailand and this information will be needed to help verify measles elimination in Thailand.
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Affiliation(s)
- Sirima Pattamadilok
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand.
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9
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Nestibo L, Lee BE, Fonseca K, Beirnes J, Johnson MM, Sikora CA. Differentiating the wild from the attenuated during a measles outbreak. Paediatr Child Health 2012; 17:e32-3. [PMID: 23543773 PMCID: PMC3381670 DOI: 10.1093/pch/17.4.e32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2011] [Indexed: 11/14/2022] Open
Abstract
In the midst of a local measles outbreak, a recently immunized child was investigated for a new-onset measles-type rash. Nucleic acid testing identified that a vaccine-type measles virus was being shed in the urine. Clinically differentiating measles from a nonmeasles rash is challenging, but can be supported by a thorough medical history evaluation. Rashes are expected to occur after immunization; nucleic acid testing can be used when it is difficult to differentiate between wild and attenuated strains.
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Affiliation(s)
| | - Bonita E Lee
- Paediatric Infectious Disease, University of Alberta
| | | | - Jennifer Beirnes
- National Microbiology Laboratory, Public Health Agency of Canada
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10
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Duraisamy R, Rota PA, Palani G, Elango V, Sambasivam M, Lowe L, Lopareva E, Ramamurty N. Molecular characterization of wild-type measles viruses in Tamil Nadu, India, during 2005-2006: Relationship of genotype D8 strains from Tamil Nadu to global strains. J Med Virol 2011; 84:348-57. [DOI: 10.1002/jmv.22244] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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11
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Macey JF, Tam T, Lipskie T, Tipples G, EisBrenner T. Rubella Elimination, the Canadian Experience. J Infect Dis 2011; 204 Suppl 2:S585-92. [DOI: 10.1093/infdis/jir406] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Icenogle JP, Siqueira MM, Abernathy ES, Lemos XR, Fasce RA, Torres G, Reef SE. Virologic Surveillance for Wild-type Rubella Viruses in the Americas. J Infect Dis 2011; 204 Suppl 2:S647-51. [DOI: 10.1093/infdis/jir431] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Wairagkar N, Chowdhury D, Vaidya S, Sikchi S, Shaikh N, Hungund L, Tomar RS, Biswas D, Yadav K, Mahanta J, Das VNR, Yergolkar P, Gunasekaran P, Raja D, Jadi R, Ramamurty N, Mishra AC. Molecular epidemiology of measles in India, 2005-2010. J Infect Dis 2011; 204 Suppl 1:S403-13. [PMID: 21666192 DOI: 10.1093/infdis/jir150] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Measles is a childhood disease that causes great morbidity and mortality in India and worldwide. Because measles surveillance in India is in its infancy, there is a paucity of countrywide data on circulating Measles virus genotypes. This study was conducted in 21 of 28 States and 2 of 7 Union Territories of India by MeaslesNetIndia, a national network of 27 centers and sentinel practitioners. MeaslesNetIndia investigated 52 measles outbreaks in geographically representative areas from 2005 through June 2010. All outbreaks were serologically confirmed by detection of antimeasles virus immunoglobulin M (IgM) antibodies in serum or oral fluid samples. Molecular studies, using World Health Organization (WHO)-recommended protocols obtained 203 N-gene, 40 H-gene, and 4 M-gene sequences during this period. Measles genotypes D4, D7, and D8 were found to be circulating in various parts of India during the study period. Further phylogenetic analysis revealed 4 lineages of Indian D8 genotypes: D8a, D8b, D8c, and D8d. This study generated a large, countrywide sequence database that can form the baseline for future molecular studies on measles virus transmission pathways in India. This study has created support and capabilities for countrywide measles molecular surveillance that must be carried forward.
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Affiliation(s)
- Niteen Wairagkar
- WHO Regional Measles Reference Laboratory, National Institute of Virology, Pune, India.
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Moulin E, Beal V, Jeantet D, Horvat B, Wild TF, Waku-Kouomou D. Molecular characterization of measles virus strains causing subactute sclerosing panencephalitis in France in 1977 and 2007. J Med Virol 2011; 83:1614-23. [DOI: 10.1002/jmv.22152] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Woo GKS, Wong AH, Lee WY, Lau CS, Cheng PKC, Leung PCK, Lim WWL. Comparison of laboratory diagnostic methods for measles infection and identification of measles virus genotypes in Hong Kong. J Med Virol 2010; 82:1773-81. [PMID: 20827776 DOI: 10.1002/jmv.21888] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The sensitivities of IgM detection, virus isolation, and RT-PCR for the diagnosis of measles infection were assessed using samples collected from confirmed measles cases from 2006 to 2009. The optimal timing of specimen collection and the preferred specimen type(s) for these tests were also determined. IgM detection showed highest sensitivity when serum samples were collected >or=5 days after rash onset. Virus isolation gave the highest sensitivity when samples were collected <or=3 days after rash onset, with nasopharyngeal aspirate being the best specimen type, followed by urine and throat/combined throat and nasal swab. The highest RT-PCR positive rate (81.0%) was obtained with serum samples collected <or=3 days after rash onset. RT-PCR positive rate of 100% was observed with throat/combined throat and nasal swab, urine and nasopharyngeal aspirate collected <or=16, 4-16, and 4-7 days after rash onset, respectively. The genotype of each measles case was confirmed by sequencing. It was shown that the predominant measles viruses detected in Hong Kong during 2006-2009 belonged to genotype H1 (subtype a) and these strains were related closely to those detected in China.
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Affiliation(s)
- Gibson K S Woo
- Virology Division, Department of Health, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong SAR, China
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16
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Cheng WY, Lee L, Rota PA, Yang DCF. Molecular evolution of measles viruses circulated in Taiwan 1992-2008. Virol J 2009; 6:219. [PMID: 20003242 PMCID: PMC2797522 DOI: 10.1186/1743-422x-6-219] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 12/10/2009] [Indexed: 11/17/2022] Open
Abstract
Genetic analyses of viral samples from 74 laboratory confirmed measles cases occurring in Taiwan during 1992-2008 identified six viral genotypes D3, D5, D9, G2, H1 and H2. The most frequently detected genotype, H1, was associated with outbreaks in 1994 and 2002, and was the likely indigenous genotype in 1992. In response to the outbreaks, two catch-up campaigns were launched and a routine second dose of measles, mumps, and rubella vaccine at entry to elementary school was introduced. The vaccination campaigns successfully reduced the number of measles cases in Taiwan, and many of the more recent cases can be traced to importations, primarily from other Asian countries. A number of measles genotypes which were associated with outbreaks in other Asian countries were detected among the more recent cases. The more recent genotype H1 viruses had sequences that were identical to those currently circulating in China or associated with international importation of virus.
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Affiliation(s)
- Wen-Yueh Cheng
- Research and Diagnostic Center, Centers for Disease Control, DOH, Taiwan.
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Zhang Y, Ji Y, Jiang X, Xu S, Zhu Z, Zheng L, He J, Ling H, Wang Y, Liu Y, Du W, Yang X, Mao N, Xu W. Genetic characterization of measles viruses in China, 2004. Virol J 2008; 5:120. [PMID: 18928575 PMCID: PMC2600640 DOI: 10.1186/1743-422x-5-120] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Accepted: 10/20/2008] [Indexed: 11/25/2022] Open
Abstract
Genetic characterization of wild-type measles virus was studied using nucleotide sequencing of the C-terminal region of the N protein gene and phylogenetic analysis on 59 isolates from 16 provinces of China in 2004. The results showed that all of the isolates belonged to genotype H1. 51 isolates were belonged to cluster 1 and 8 isolates were cluster 2 and Viruses from both clusters were distributed throughout China without distinct geographic pattern. The nucleotide sequence and predicted amino acid homologies of the 59 H1 strains were 96.5%-100% and 95.7%-100%, respectively. The report showed that the transmission pattern of genotype H1 viruses in China in 2004 was consistent with ongoing endemic transmission of multiple lineages of a single, endemic genotype. Multiple transmission pathways leaded to multiple lineages within endemic genotype.
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Affiliation(s)
- Yan Zhang
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Yixin Ji
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Xiaohong Jiang
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Songtao Xu
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Zhen Zhu
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Lei Zheng
- Shanxi Provincial Center for Disease Control and Prevention, PR China
| | - Jilan He
- Sichuan Provincial Center for Disease Control and Prevention, PR China
| | - Hua Ling
- Chongqing Provincial Center for Disease Control and Prevention, PR China
| | - Yan Wang
- Liaoning Provincial Center for Disease Control and Prevention, PR China
| | - Yang Liu
- Tianjin Provincial Center for Disease Control and Prevention, PR China
| | - Wen Du
- Guizhou Provincial Center for Disease Control and Prevention, PR China
| | - Xuelei Yang
- Pediatric Institute of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi city, Xinjiang province, PR China
| | - Naiying Mao
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
- State Key Laboratory for Molecular Virology & Genetic Engineering, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China
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18
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Kremer JR, Brown KE, Jin L, Santibanez S, Shulga SV, Aboudy Y, Demchyshyna IV, Djemileva S, Echevarria JE, Featherstone DF, Hukic M, Johansen K, Litwinska B, Lopareva E, Lupulescu E, Mentis A, Mihneva Z, Mosquera MM, Muscat M, Naumova MA, Nedeljkovic J, Nekrasova LS, Magurano F, Fortuna C, de Andrade HR, Richard JL, Robo A, Rota PA, Samoilovich EO, Sarv I, Semeiko GV, Shugayev N, Utegenova ES, van Binnendijk R, Vinner L, Waku-Kouomou D, Wild TF, Brown DWG, Mankertz A, Muller CP, Mulders MN. High genetic diversity of measles virus, World Health Organization European Region, 2005-2006. Emerg Infect Dis 2008; 14:107-14. [PMID: 18258089 PMCID: PMC2600148 DOI: 10.3201/eid1401.070778] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During 2005-2006, nine measles virus (MV) genotypes were identified throughout the World Health Organization European Region. All major epidemics were associated with genotypes D4, D6, and B3. Other genotypes (B2, D5, D8, D9, G2, and H1) were only found in limited numbers of cases after importation from other continents. The genetic diversity of endemic D6 strains was low; genotypes C2 and D7, circulating in Europe until recent years, were no longer identified. The transmission chains of several indigenous MV strains may thus have been interrupted by enhanced vaccination. However, multiple importations from Africa and Asia and virus introduction into highly mobile and unvaccinated communities caused a massive spread of D4 and B3 strains throughout much of the region. Thus, despite the reduction of endemic MV circulation, importation of MV from other continents caused prolonged circulation and large outbreaks after their introduction into unvaccinated and highly mobile communities.
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Affiliation(s)
- Jacques R Kremer
- World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Laboratoire National de Santé-Immunology 20A, rue Auguste Lumiere, Luxembourg, Luxembourg.
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19
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Muscat M, Vinner L, Christiansen AH, Glismann S, Böttiger BE. The benefit of molecular characterization during a measles upsurge in Denmark. Vaccine 2007; 25:6232-6. [PMID: 17629377 DOI: 10.1016/j.vaccine.2007.05.063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 05/01/2007] [Accepted: 05/30/2007] [Indexed: 11/22/2022]
Abstract
Molecular characterization of measles virus was part of the epidemiological investigation of 27 measles cases reported in Denmark in 2006. RT-PCR detected measles virus RNA from various types of clinical specimens in 24 cases. Virus genotypes were determined by sequencing the nucleocapsid (N) gene. Four different genotypes, B3, D4, D5 and D9 were identified including two variants of the D4 genotype. In combination with the epidemiological data four clusters of measles cases and three sporadic cases were revealed. Our study showed that measles in Denmark resulted from imported measles virus strains. The limited duration and short chain of transmission of the identified clusters ascertain that the interruption of measles virus circulation is being sustained. However, measles transmission still has a potential to occur. To minimise the development of pools of susceptible individuals high (>/=95%) routine vaccination coverage with two doses of measles-containing vaccine needs to be attained. Molecular epidemiological studies have proved to be both a useful and a necessary component of an enhanced surveillance system required in the measles elimination phase.
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Affiliation(s)
- Mark Muscat
- Department of Epidemiology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
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20
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Zhang Y, Zhu Z, Rota PA, Jiang X, Hu J, Wang J, Tang W, Zhang Z, Li C, Wang C, Wang T, Zheng L, Tian H, Ling H, Zhao C, Ma Y, Lin C, He J, Tian J, Ma Y, Li P, Guan R, He W, Zhou J, Liu G, Zhang H, Yan X, Yang X, Zhang J, Lu Y, Zhou S, Ba Z, Liu W, Yang X, Ma Y, Liang Y, Li Y, Ji Y, Featherstone D, Bellini WJ, Xu S, Liang G, Xu W. Molecular epidemiology of measles viruses in China, 1995-2003. Virol J 2007; 4:14. [PMID: 17280609 PMCID: PMC1802751 DOI: 10.1186/1743-422x-4-14] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2007] [Accepted: 02/05/2007] [Indexed: 11/28/2022] Open
Abstract
This report describes the genetic characterization of 297 wild-type measles viruses that were isolated in 24 provinces of China between 1995 and 2003. Phylogenetic analysis of the N gene sequences showed that all of the isolates belonged to genotype H1 except 3 isolates, which were genotype A. The nucleotide sequence and predicted amino acid homologies of the 294-genotype H1 strains were 94.7%-100% and 93.3%-100%, respectively. The genotype H1 isolates were divided into 2 clusters, which differed by approximately 2.9% at the nucleotide level. Viruses from both clusters were distributed throughout China with no apparent geographic restriction and multiple co-circulating lineages were present in many provinces. Even though other measles genotypes have been detected in countries that border China, this report shows that genotype H1 is widely distributed throughout the country and that China has a single, endemic genotype. This important baseline data will help to monitor the progress of measles control in China.
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Affiliation(s)
- Yan Zhang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhen Zhu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Xiaohong Jiang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Jiayu Hu
- Shanghai Provincial Center for Disease Control and Prevention, China
| | - Jianguo Wang
- Shanghai Provincial Center for Disease Control and Prevention, China
| | - Wei Tang
- Shanghai Provincial Center for Disease Control and Prevention, China
| | - Zhenying Zhang
- Henan Provincial Center for Disease Control and Prevention, China
| | - Congyong Li
- Henan Provincial Center for Disease Control and Prevention, China
| | - Changyin Wang
- Shandong Provincial Center for Disease Control and Prevention, China
| | - Tongzhan Wang
- Shandong Provincial Center for Disease Control and Prevention, China
| | - Lei Zheng
- Shanxi Provincial Center for Disease Control and Prevention, China
| | - Hong Tian
- Tianjin Provincial Center for Disease Control and Prevention, China
| | - Hua Ling
- Chongqing Provincial Center for Disease Control and Prevention, China
| | - Chunfang Zhao
- Chongqing Provincial Center for Disease Control and Prevention, China
| | - Yan Ma
- Hainan Provincial Center for Disease Control and Prevention, China
| | - Chunyan Lin
- Hainan Provincial Center for Disease Control and Prevention, China
| | - Jilan He
- Sichuan Provincial Center for Disease Control and Prevention, China
| | - Jiang Tian
- Liaoning Provincial Center for Disease Control and Prevention, China
| | - Yan Ma
- Liaoning Provincial Center for Disease Control and Prevention, China
| | - Ping Li
- Shannxi Provincial Center for Disease Control and Prevention, China
| | - Ronghui Guan
- Shannxi Provincial Center for Disease Control and Prevention, China
| | - Weikuan He
- Anhui Provincial Center for Disease Control and Prevention, China
| | - Jianhui Zhou
- Jilin Provincial Center for Disease Control and Prevention, China
| | - Guiyan Liu
- Jilin Provincial Center for Disease Control and Prevention, China
| | - Hong Zhang
- Hunan Provincial Center for Disease Control and Prevention, China
| | - Xinge Yan
- Guangdong Provincial Center for Disease Control and Prevention, China
| | - Xuelei Yang
- Xinjiang Provincial Center for Disease Control and Prevention, China
| | - Jinlin Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, China
| | - Yiyu Lu
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Shunde Zhou
- Jiangxi Provincial Center for Disease Control and Prevention, China
| | - Zhuoma Ba
- Qinghai Provincial Center for Disease Control and Prevention, China
| | - Wei Liu
- Jiangxi Provincial Center for Disease Control and Prevention, China
| | - Xiuhui Yang
- Fujian Provincial Center for Disease Control and Prevention, China
| | - Yujie Ma
- Heilongjiang Provincial Center for Disease Control and Prevention, China
| | - Yong Liang
- Hebei Provincial Center for Disease Control and Prevention, China
| | - Yeqiang Li
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Yixin Ji
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - David Featherstone
- Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - William J Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Songtao Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Guodong Liang
- National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100052, China
| | - Wenbo Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, China
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Waku-Kouomou D, Landreau D, Olivier S, Palmyre P, Benoit-Catin T, Freymuth F, Wild TF. Molecular characterization of measles virus circulating in the Indian Ocean Islands during 2005–2006 and in France in 2006. J Med Virol 2007; 79:1381-7. [PMID: 17607778 DOI: 10.1002/jmv.20959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite the availability of safe and immunogenic vaccines, measles still causes significant morbidity and mortality especially in Africa. In this study, two measles outbreaks in the Indian Ocean Islands; Mayotte in 2005-2006 and Seychelles in 2006 were studied. Nasopharyngeal swabs, urine and/or blood samples were collected from patients with clinically diagnosed measles. Measles viruses were isolated in four cases from patients in Mayotte. Measles strains circulating in both outbreaks were determined to be genotype D4 when compared to the WHO reference strains. During this time, measles virus was isolated from patients in France and they were also found to belong to the same genotype. The viruses clustered into two distinct D4 subgroups; The Indian Ocean strains were similar to the Montreal-subgroup, whereas the French strains associated with the Johannesburg-subgroup. The Indian Ocean strains formed a homogeneous group. They shared four specific amino acids in the 3' region of the N gene and two amino acids in the H gene, which differed from other genotype D4 viruses. This suggests that the same measles lineage circulated in Mayotte and Seychelles. Sequence comparison of the French isolates with other measles strains showed that they were more closely related to strains circulating in Germany in 2005, which had their origin in Romania. This study provides the baseline for molecular epidemiology of measles virus in Mayotte and Seychelles. The knowledge of circulating measles virus will help in documenting measles elimination program. This report also highlights the fact that progress of measles elimination is blighted continually by the phenomenon of measles importation.
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Alla A, Waku-Kouomou D, Benjouad A, Elaouad R, Wild TF. Rapid diversification of measles virus genotypes circulating in Morocco during 2004-2005 epidemics. J Med Virol 2006; 78:1465-72. [PMID: 16998886 DOI: 10.1002/jmv.20720] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Measles virus strains circulating in six different regions in Morocco during 2004-2005 were analysed. They were genotyped using two different methods: the recently developed method based on real-time PCR amplification and melting curve analyses, and the conventional method based on nucleic acid sequencing and phylogenetic analysis of 456 nucleotides of the 3'-region of the nucleoprotein (N) gene sequence. Five genotypes (A, B3.2, C2, D7 and D8) were shown to be circulating during this period. Previous studies on measles virus genotypes in Morocco (1998-2003) showed that only the genotype C2 was present and was considered to be endemic. Sequence comparison of the 2004-2005 viruses with other measles strains suggests that measles strains belonging to genotype B3.2 were probably imported from West Africa, whereas those belonging to genotypes D7 and D8 were imported from Europe. These studies which identify the route of importation of measles are important for developing strategies for measles elimination in Morocco.
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Affiliation(s)
- Amal Alla
- National Institute of Hygiene, Rabat, Morocco
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23
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Nigatu W, Nokes DJ, Afework A, Brown DWG, Cutts FT, Jin L. Serological and molecular epidemiology of measles virus outbreaks reported in Ethiopia during 2000–2004. J Med Virol 2006; 78:1648-55. [PMID: 17063528 DOI: 10.1002/jmv.20750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Twenty-eight outbreaks in six regions and two major cities in Ethiopia from 2000 to 2004 were investigated, with the collection of 207 venous blood and/or oral fluid samples. Measles diagnosis was confirmed by detection of measles-specific IgM and/or detection of measles virus by polymerase chain reaction (PCR). Of 176 suspected cases tested for specific measles IgM, 142 (81%) were IgM positive. Suspected cases in vaccinated children were much less likely to be laboratory confirmed than in unvaccinated children (42% vs. 83%, P < 0.0001). Of 197 samples analyzed by RT-PCR measles virus genome was detected in 84 (43%). A total of 58 wild-type measles viruses were characterized by nucleic acid sequence analysis of the nucleoprotein (N) and hemagglutinin (H) genes. Two recognized genotypes (D4 and B3) were identified. Each outbreak comprised only a single genotype and outbreaks of each genotype tended to occur in distinct geographical locations. B3 was first observed in 2002, and has now been the cause of three documented outbreaks near to the border of Sudan. D4 genotype was previously observed in an outbreak in 1999 and occurs in more diverse locations throughout the country. These data yield insights into geographical and age-related sources of continued transmission. Refinement of measles control measures might include targeting older age groups (5-14 years) and strengthening routine immunization particularly where importation of cases is a concern.
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Affiliation(s)
- W Nigatu
- Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, Ethiopia
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24
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Djebbi A, Bahri O, Mokhtariazad T, Alkhatib M, Ben Yahia A, Rezig D, Mohsni E, Triki H. Identification of measles virus genotypes from recent outbreaks in countries from the Eastern Mediterranean Region. J Clin Virol 2005; 34:1-6. [PMID: 16061419 DOI: 10.1016/j.jcv.2004.11.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2004] [Revised: 11/16/2004] [Accepted: 11/17/2004] [Indexed: 12/01/2022]
Abstract
BACKGROUND Molecular characterization of measles viruses (MV) helps to identify transmission pathways of the virus and to document persistence or interruption of endemic virus circulation. In the Eastern Mediterranean Region, measles genotypes from only few countries have been documented. OBJECTIVES This study reports the genetic characteristics of virus strains from recent measles outbreaks in Tunisia, Libya, Syria and Iran in 2002-2003. STUDY DESIGN Virus sequences in the nucleoprotein gene were obtained by PCR amplification of virus isolates or serum samples. The sequences were compared to the reference ones for genotype identification and to other published sequences within the same genotype. RESULTS AND CONCLUSIONS The Tunisian and Libyan epidemic strains belonged to genotype B3, they were closely related to each other and to isolates from Western Africa. The Syrian and Iranian viruses belonged to genotype D4, and differed from each other and from the other published sequences within this genotype. Our results provide valuable baseline and new tools for improved virological measles surveillance in the future, at country, regional and global levels.
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Affiliation(s)
- Ahlem Djebbi
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis, Belvédère, Tunisia
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize important papers concerning measles disease and measles-containing vaccines published in 2004. RECENT FINDINGS Endemic measles has been successfully controlled in the Americas and, to a lesser extent, in Europe. This has been achieved with a high uptake of two doses of a measles-containing vaccine. Even in industrialized countries, where vaccine uptake is poor, for example Japan, the disease is still a significant cause of morbidity and mortality. Vaccine failure is predominantly due to primary vaccine failure, which may, in part, be genetic in origin and related to HLA type. Measles-containing vaccines have been shown to be associated with febrile convulsions, but there is no strong evidence of a link with atopy. There is considerable evidence that there is no causal relationship with autistic disorders. In spite of this, many parents and some professionals have concerns about the safety of the vaccines, which may lead to their underuse. SUMMARY It is possible to eliminate measles with a high uptake of two doses of measles-containing vaccine, but concerns about safety persist and need to be tackled. More research is required into how to do this effectively and also to elucidate the causes of vaccine failure.
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Affiliation(s)
- David Elliman
- Islington PCT and Great Ormond Street Hospital, London, UK.
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26
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Tischer A, Santibanez S, Siedler A, Heider A, Hengel H. Laboratory investigations are indispensable to monitor the progress of measles elimination--results of the German Measles Sentinel 1999-2003. J Clin Virol 2004; 31:165-78. [PMID: 15465408 DOI: 10.1016/j.jcv.2004.05.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2004] [Accepted: 05/14/2004] [Indexed: 11/17/2022]
Abstract
BACKGROUND The elimination of measles is a goal set by the World Health Organisation to be reached by 2010 in the European region. OBJECTIVES To enhance the measles surveillance in Germany, a country-wide laboratory supported a sentinel was established. STUDY DESIGN A network of >1200 representatively distributed practitioners reported detailed data on all clinically diagnosed cases and provided specimens for laboratory diagnosis. RESULTS A total of 3225 suspected cases were reported between October 1999 and December 2003. The incidence in Western Germany decreased from >15 cases per 100,000 population to one case in 2003, while in Eastern Germany <1 case per 100,000 population was observed during these years. Laboratory investigations were undertaken in 40% of cases in 2000/2001. This rate increased to 79% in 2003. Simultaneously, the rate of confirmed cases dropped from 60% in the former years to 23% in 2003. Measles virus (MV) detection by serology and by PCR revealed concordant results in 92%. Most suspected cases (85%) were unvaccinated with 66% being laboratory confirmed. Only 10% of suspected cases occurred in vaccinated individuals and very few (22%) could be confirmed. Analyses of confirmed measles in vaccinated patients (n = 49) revealed 24.5% primary vaccine failures, 24.5% reinfections after successful vaccination and 31% MV infection before or shortly after vaccination. The genetic characterisation of 389 MV isolates identified eight genotypes: B3, C2, D4, D5, D6, D7, G2 and H1. Only the C2, D6 and D7 MV genotypes circulated endemically in Western Germany. The newly emerged MV D7 almost completely replaced the pre-existing C2 and D6 MVs in 2001. The few measles cases detected in Eastern Germany were mostly caused by imported MVs. CONCLUSION The data demonstrate that laboratory investigations including molecular methods are an indispensable tool for surveillance in all countries advanced in measles elimination.
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Affiliation(s)
- Annedore Tischer
- Division of Viral Infections, Robert Koch Institute, Nordufer 20, D-13353 Berlin, Germany.
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King A, Varughese P, De Serres G, Tipples GA, Waters J. Measles Elimination in Canada. J Infect Dis 2004; 189 Suppl 1:S236-42. [PMID: 15106117 DOI: 10.1086/378499] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
To describe the progress and challenges in achieving measles elimination in Canada, we analyzed national data on measles cases for 1998-2001. To assess the status of measles elimination in Canada, we estimated the effective reproductive number, R. Measles elimination was defined as the interruption of endemic transmission and failure to reestablish endemic transmission after importation. Twelve isolated cases, 29 cases (72.4% were linked to 2 outbreaks), 199 cases (96.9% were linked to 4 outbreaks of 2, 6, 30, and 155 cases), and 34 cases (73.5% were linked to 8 outbreaks of 2, 2, 2, 2, 3, 3, 3, and 8 cases) were reported in 1998, 1999, 2000, and 2001, respectively. R ranged from 0.58 to 0.95. Multiple chains of transmission occurred in religious communities that actively oppose or resist immunization efforts. Epidemiological and virological evidence suggests that endemic transmission of measles has been mostly interrupted since 1998.
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Affiliation(s)
- Arlene King
- Immunization and Respiratory Infections Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Ottawa, Ontario, Canada.
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28
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Rota PA, Bellini WJ. Update on the global distribution of genotypes of wild type measles viruses. J Infect Dis 2003; 187 Suppl 1:S270-6. [PMID: 12721925 DOI: 10.1086/368042] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Molecular characterization of measles viruses is an important component of measles surveillance because these studies enhance our ability to identify the source and transmission pathways of the virus. Molecular surveillance is most beneficial when it is possible to observe the change in virus genotypes over time in a particular region. Such information can help to document the interruption of transmission of measles virus and thus provide an important method for assessing the effectiveness of vaccination programs. It is recommended that virus surveillance be conducted during all phases of measles control and be expanded to give an accurate description of the global distribution of measles genotypes. This review provides updated information on the circulation patterns of measles genotypes and examples of the utility of virologic surveillance.
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Affiliation(s)
- Paul A Rota
- Measles Virus Section, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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