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 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.
van Binnendijk
Robert S
RS
Laboratory for Vaccine-Preventable Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. rob.van.binnendijk@rivm.nl
van den Hof
Susan
S
van den Kerkhof
Hans
H
Kohl
Robert H G
RH
Woonink
Frits
F
Berbers
Guy A M
GA
Conyn-van Spaendonck
Marina A E
MA
Kimman
Tjeerd G
TG
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
D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral