title: Evaluation of serological and virological tests in the diagnosis of clinical and subclinical measles virus infections during an outbreak of measles in The Netherlands.
abstract: 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.
authors.affiliation: Laboratory for Vaccine-Preventable Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. rob.van.binnendijk@rivm.nl
authors.forename: Robert S
authors.initials: RS
authors.lastname: van Binnendijk
authors.forename: Susan
authors.initials: S
authors.lastname: van den Hof
authors.forename: Hans
authors.initials: H
authors.lastname: van den Kerkhof
authors.forename: Robert H G
authors.initials: RH
authors.lastname: Kohl
authors.forename: Frits
authors.initials: F
authors.lastname: Woonink
authors.forename: Guy A M
authors.initials: GA
authors.lastname: Berbers
authors.forename: Marina A E
authors.initials: MA
authors.lastname: Conyn-van Spaendonck
authors.forename: Tjeerd G
authors.initials: TG
authors.lastname: Kimman
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000918:Antibody Specificity; D001826:Body Fluids / Q000276:immunology / Q000821:virology; D002648:Child; D004196:Disease Outbreaks; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008457:Measles / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D008459:Measles virus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D008875:Middle Aged; D009055:Mouth / Q000276:immunology / Q000821:virology; D009426:Netherlands / Q000453:epidemiology; D010614:Pharynx / Q000821:virology; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis / Q000652:urine; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013048:Specimen Handling
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral