title: Investigation of a measles outbreak in Zimbabwe, 2010: potential of a point of care test to replace laboratory confirmation of suspected cases.
abstract: Blood and oral fluid (OF) samples were collected from 103 suspected measles cases between February and November 2010 during a nationwide measles outbreak in Zimbabwe. Siemens measles IgM enzyme immunoassay (EIA) on serum, Microimmune measles IgM capture EIA on OF, real-time haemagglutinin (H) gene PCR and nested nucleocapsid (N) gene PCR on OF were performed, confirming 75 measles cases. These samples were then used to evaluate a newly developed point of care test (POCT) for measles and determine its potential for identifying measles cases in outbreaks. After performing POCTs on OF samples, nucleic acid was extracted from the used test strips and the measles H and N genes amplified by RT-PCR. The sensitivity, specificity, positive and negative predictive values of the POCT for IgM in OF was 75·0% [95% confidence interval (CI) 63·4-84·5], 96·2% (95% CI 80·4-99·9), 98·2% (95% CI 90·3-100) and 58·1% (95% CI 42·1-73·0), respectively. The N gene sequences showed high level of agreement between original OF and corresponding POCT strips. Measles genotype B3 was identified in all cases. We conclude that the measles POCT has the potential to be used, at the point of contact, in outbreak situations and provide molecular characterization of the virus at a later date.
authors: Zimbabwe National Virology Laboratory,Department of Medical Microbiology,College of Health Science,University of Zimbabwe,Zimbabwe.
authors: A
authors: A
authors: Shonhai
authors: Virus Reference Department,Public Health England,London,UK.
authors: L
authors: L
authors: Warrener
authors: Ministry of Health and Child Care,Zimbabwe.
authors: D
authors: D
authors: Mangwanya
authors: Institute of Biotechnology of Vilnius University,Vilnius,Lithuania.
authors: R
authors: R
authors: Slibinskas
authors: Virus Reference Department,Public Health England,London,UK.
authors: K
authors: K
authors: Brown
authors: Virus Reference Department,Public Health England,London,UK.
authors: D
authors: D
authors: Brown
authors: World Health Organization: Expanded Programme on Immunization (EPI),Department of Immunization,Vaccines and Biologicals (IVB),Geneva,Switzerland.
authors: D
authors: D
authors: Featherstone
authors: Virus Reference Department,Public Health England,London,UK.
authors: D
authors: D
authors: Samuel
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood; D001769:Blood / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009055:Mouth / Q000821:virology; D019095:Point-of-Care Systems; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics; D012680:Sensitivity and Specificity; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral
keywords: Genotype; IgM; measles; oral fluid; point of contact