Review
Copyright ©2013 Baishideng Publishing Group Co.
World J Exp Med. Nov 20, 2013; 3(4): 87-99
Published online Nov 20, 2013. doi: 10.5493/wjem.v3.i4.87
Table 1 Samples for laboratory diagnosis of measles virus infections
Virus diseaseSamples for virus isolation for detection of antigenSamples for serologyRemarks
Acute measlesBlood (leukocytes), throat secretions (saliva/oral-fluid), conjunctival secretions, urine; skin biopsiesAcute and convalescent serumPeriod 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 pneumoniaBlood (leukocytes), throat secretions, conjunctival secretions, urineAcute and convalescent serumFrequently no rash; prolonged period of infectivity
Acute measles encephalitisBrain specimen (biopsy or autopsy specimen), cells in CSFSerum and CSFIn most cases, no infectious virus is detectable; occasional local production of antibodies in the CNS
SSPEBrain specimen (biopsy or autopsy specimen), cells in CSF, lymph node biopsy (?)Serum and CSFVirus 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
Table 2 Application of oral-fluid methods under different countries settings
Applications of oral-fluid methods Setting for country/district
Low /Med uptake routineHigh uptake routineCampaign
Population surveyMethods: community surveys of IgG across wide age range. Including hard-to-reach groups, informal settlements. Purpose: immunity profiles. Identifies susceptibility gaps and age range for campaigns. Implications: increase in coverage, need for and age range for campaignsAs previousAs previous plus. Methods: Post-campaign surveys of IgG and perhaps IgM. Purpose: IgG-Identify immunity levels post-campaign. Susceptibility in target age group and outside target group. IgM-indicator of impact, i.e., proportion responding to vaccine. Implications: Age-range for future campaigns; locate problems of vaccine efficacy
Vaccine surveysMethods: Vaccine clinic samples pre- and post-vaccination. IgM and/or IgG testing. Purpose: Assess efficacy of routine vaccination. Implications: Identify cause of low efficacy.As previousAs previous plus. Methods: IgG survey of individuals attending vaccine clinics. Purpose: Identify proportion able to respond to vaccine. Implications: Assess potential effectiveness, and suggest alternative method for delivery eg hard-to-reach groups.
DiagnosisNot indicated while measles incidence remains highMethod: IgM testing on demand. Purpose: Confirmation of clinical diagnosisAs previous
Case surveillance: serological and geneticNot indicated while measles transmission remains highMethod: System of reporting and oral fluid sampling from sporadic cases and outbreaks. IgM and Genotyping Purpose: Verify cases, and monitor distribution of virus and endemicity Implications: Need for additional control measuresAs previous