title: A point-of-care test for measles diagnosis: detection of measles-specific IgM antibodies and viral nucleic acid.
abstract: OBJECTIVE
  To evaluate the performance of a newly developed point-of-care test (POCT) for the detection of measles-specific IgM antibodies in serum and oral fluid specimens and to assess if measles virus nucleic acid could be recovered from used POCT strips.
  
  
  METHODS
  The POCT was used to test 170 serum specimens collected through measles surveillance or vaccination programmes in Ethiopia, Malaysia and the Russian Federation: 69 were positive for measles immunoglobulin M (IgM) antibodies, 74 were positive for rubella IgM antibodies and 7 were positive for both. Also tested were 282 oral fluid specimens from the measles, mumps and rubella (MMR) surveillance programme of the United Kingdom of Great Britain and Northern Ireland. The Microimmune measles IgM capture enzyme immunoassay was the gold standard for comparison. A panel of 24 oral fluids was used to investigate if measles virus haemagglutinin (H) and nucleocapsid (N) genes could be amplified by polymerase chain reaction directly from used POCT strips.
  
  
  RESULTS
  With serum POCT showed a sensitivity and specificity of 90.8% (69/76) and 93.6% (88/94), respectively; with oral fluids, sensitivity and specificity were 90.0% (63/70) and 96.2% (200/208), respectively. Both H and N genes were reliably detected in POCT strips and the N genes could be sequenced for genotyping. Measles virus genes could be recovered from POCT strips after storage for 5 weeks at 20-25 °C.
  
  
  CONCLUSIONS
  The POCT has the sensitivity and specificity required of a field-based test for measles diagnosis. However, its role in global measles control programmes requires further evaluation.
authors: Virus Reference Department, Centre for Infections, Health Protection Agency, London, England. lenesha.warrener@hpa.org.uk
authors: Lenesha
authors: L
authors: Warrener
authors: Rimantas
authors: R
authors: Slibinskas
authors: Kaw Bing
authors: KB
authors: Chua
authors: Wondatir
authors: W
authors: Nigatu
authors: Kevin E
authors: KE
authors: Brown
authors: Kestutis
authors: K
authors: Sasnauskas
authors: Dhanraj
authors: D
authors: Samuel
authors: David
authors: D
authors: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007124:Immunoenzyme Techniques; D007075:Immunoglobulin M / Q000097:blood*; D007223:Infant; D038622:Internationality; D008457:Measles / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D018103:Morbillivirus / Q000302:isolation & purification*; D019251:Nucleocapsid / Q000097:blood / Q000235:genetics; D019095:Point-of-Care Systems / Q000592:standards*; D011237:Predictive Value of Tests; D012463:Saliva / Q000821:virology*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M