Measles elimination in Italy: data from laboratory activity, 2011-2013.
BACKGROUND
The European Regional Office of the World Health Organization developed a strategic approach to halt the indigenous transmission of measles in its 53 Member States by 2015, World Health Organization [1]. Many European countries, including Italy began the implementation of national programs to reach this goal.


OBJECTIVE
To describe and discuss the results of laboratory activity in measles surveillance, performed from January 2011 to December 2013 by the Italian National Reference Laboratory for Measles and Rubella.


METHODS
Samples of suspected measles cases were collected from different Italian regions to confirm clinical diagnosis. Anti-measles IgM antibodies detection by Enzyme-Linked Immunosorbent Assay and/or molecular detection by Reverse Transcriptase-Polymerase Chain Reaction assay were performed. Positive samples were sequenced for viral characterization.


CONCLUSIONS
According to results from the National Reference Laboratory's activity urine and blood seem to be the best specimens for measles laboratory surveillance. Phylogenetic analysis revealed a co-circulation of the genotypes D4 and D8 during the reviewed period, a cluster of B3 and sporadic cases of D9 and H1.
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: fabio.magurano@iss.it.
Fabio
F
Magurano
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: melissa.baggieri@guest.iss.it.
Melissa
M
Baggieri
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: claudia.fortuna@iss.it.
Claudia
C
Fortuna
National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Via Giano della Bella 34, 00162 Rome, Italy. Electronic address: antonino.bella@iss.it.
Antonino
A
Bella
National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Via Giano della Bella 34, 00162 Rome, Italy. Electronic address: antonietta.filia@iss.it.
Antonietta
A
Filia
National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Via Giano della Bella 34, 00162 Rome, Italy. Electronic address: mariacristina.rota@iss.it.
Maria Cristina
MC
Rota
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: eleonora.benedetti@iss.it.
Eleonora
E
Benedetti
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: paola.bucci@iss.it.
Paola
P
Bucci
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: antonella.marchi@iss.it.
Antonella
A
Marchi
Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: loredana.nicoletti@iss.it.
Loredana
L
Nicoletti
D000914:Antibodies, Viral / Q000097:blood*; D060740:Disease Eradication; D004797:Enzyme-Linked Immunosorbent Assay; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007558:Italy / Q000453:epidemiology; D007753:Laboratories; D008457:Measles / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control* / Q000652:urine; D008459:Measles virus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D010802:Phylogeny; D062486:Public Health Surveillance; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D013997:Time Factors
D000914:Antibodies, Viral; D007075:Immunoglobulin M
Laboratory diagnosis; Laboratory surveillance; Measles; Measles elimination