Evaluation of Serological and Virological Tests in the Diagnosis of Clinical and Subclinical Measles Virus Infections during an Outbreak of Measles in The Netherlands

We evaluated different approaches for diagnosing measles virus (MV) infection in unvaccinated children and in healthy contact persons (n=194) during a measles epidemic in The Netherlands. MV RNA was detected by reverse-transcriptase polymerase chain reaction in throat-swab specimens from 93% of the...

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Bibliographic Details
Published in:The Journal of infectious diseases 2003-09, Vol.188 (6), p.898-903
Main Authors: van Binnendijk, Robert S., van den Hof, Susan, van den Kerkhof, Hans, Kohl, Robert H. G., Woonink, Frits, Berbers, Guy A. M., Conyn-van Spaendonck, Marina A. E., Kimman, Tjeerd G.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antibodies
Antibodies, Viral - blood
Antibody Specificity
Biological and medical sciences
Blood
Body Fluids - immunology
Body Fluids - virology
Child
Disease Outbreaks
Exanthema
Human viral diseases
Humans
Immunoglobulin M - blood
Infections
Infectious diseases
Measles
Measles - diagnosis
Measles - epidemiology
Measles - physiopathology
Measles - virology
Measles virus - genetics
Measles virus - immunology
Measles virus - isolation & purification
Medical sciences
Middle Aged
Mouth - immunology
Mouth - virology
Netherlands - epidemiology
Pharynx - virology
Predictive Value of Tests
Reverse Transcriptase Polymerase Chain Reaction
RNA
RNA, Viral - analysis
RNA, Viral - urine
Sensitivity and Specificity
Specimen Handling
Specimens
Urine
Viral diseases
Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
Viruses
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Summary:We evaluated different approaches for diagnosing measles virus (MV) infection in unvaccinated children and in healthy contact persons (n=194) during a measles epidemic in The Netherlands. MV RNA was detected by reverse-transcriptase polymerase chain reaction in throat-swab specimens from 93% of the patients with clinical symptoms. MV RNA was detected from 5 days before until 12 days after the onset of symptoms. Most patients (88%) also secreted MV RNA in their urine until 5 weeks after the onset of symptoms. Oral fluid proved to be the most practical specimen for the simultaneous detection of MV-specific IgM antibody and viral RNA, which, together, confirmed 93% of measles cases. Viral RNA was also detected in oropharyngeal specimens from 3 healthy contact persons with serological proof of MV infection. The results of this study emphasize the feasibility of combined detection of viral RNA and MV-specific IgM antibodies in oropharyngeal specimens for the diagnosis of clinical and subclinical MV infection
ISSN:0022-1899
1537-6613
DOI:10.1086/377103