Role of oral-fluid based measles diagnostic methods for measles global elimination

Table 1 Samples for laboratory diagnosis of measles virus infections

Virus disease	Samples for virus isolation for detection of antigen	Samples for serology	Remarks
Acute measles	Blood (leukocytes), throat secretions (saliva/oral-fluid), conjunctival secretions, urine; skin biopsies	Acute and convalescent serum	Period of infectivity; prodromal stage until 1-2 d after rash; antibody rises occur at appearance of rash; in tropical measles, possibly prolonged virus excretion also in stools
Measles pneumonia	Blood (leukocytes), throat secretions, conjunctival secretions, urine	Acute and convalescent serum	Frequently no rash; prolonged period of infectivity
Acute measles encephalitis	Brain specimen (biopsy or autopsy specimen), cells in CSF	Serum and CSF	In most cases, no infectious virus is detectable; occasional local production of antibodies in the CNS
SSPE	Brain specimen (biopsy or autopsy specimen), cells in CSF, lymph node biopsy (?)	Serum and CSF	Virus antigen detected in CSF cell; virus isolation requires propagation of explants cultures and cocultivation with susceptible cells; hyper-immune antibody response; local production of antibodies in the CNS

Modified from Norrby et al[137]. CSF: Central spinal fluid; CNS: Central nervous system.