Clinical and genetic characterization of measles viruses isolated from adult patients in Shanghai in 2006

Severe acute measles pneumonitis: virus isolation in bronchoalveolar lavage fluid

In the past few years, several endemic outbreaks of measles have been recognised, not only in children but also in adults, with severe and, occasionally, even fatal complications, possibly due to delayed diagnosis of the disease in adult medicine and decreasing vaccination rates. Furthermore, the treatment consists of supportive measures only. We present a case of severe measles pneumonitis in a 42-year-old man, a travel returnee, proven by direct virus isolation with PCR from bronchoalveolar lavage fluid. CT findings and pulmonary function testing revealed features of obstructive bronchiolitis; the patient was successfully treated with corticosteroids. He fully recovered, and lung function measurement returned to normal values. We conclude that acute measles can present as obstructive bronchiolitis and may be successfully treated with corticosteroids.

Epidemic trend of measles in Shandong Province, China, 1963-2005

OBJECTIVES

Although measles is a vaccine-preventable infectious disease and the measles vaccine is safe and effective, it still poses a serious threat to the health of children and susceptible populations in China every year. This study aimed to investigate the epidemiological characteristics of measles in Shandong Province, China, including its spatial distribution pattern, in order to have a precise prediction of measles epidemics for better public health strategic planning and resource allocation.

STUDY DESIGN

Longitudinal data study.

METHODS

This study was based on the surveillance data set of measles from all 17 regions (cities) in Shandong Province between 1963 and 2005. Geographical Information Systems and piecewise exponential smoothing of logarithmic transformed data were applied with consideration of the spatial and temporal features of the data. The parameters of epidemic peaks were estimated by filtering off the drifting long-term trends.

RESULTS

Measles presented in almost all regions in Shandong Province with different spatial distribution over the 43-year study period. The incidence of measles was very high in the pre-vaccination period, with an average incidence of 617.61/100,000 population in 1963. With the implementation of vaccination, the average incidence of measles decreased to 3.63/100,000 population in 2005, the periodicity died out and the trend remained at a stable low level. Outbreaks have been reported recently.

CONCLUSIONS

This study identified the effects of different strategies on the incidence of measles observed in Shandong, China, and will provide valuable information to assist local and national public health policy making. There are still some challenges to improve vaccination coverage and efficacy in order to eliminate measles in China. Strengthening surveillance will be essential in the framework of the anticipated global elimination campaign for measles.

Molecular epidemiology of measles virus in Iran 2009-2010: first detection of measles genotype H1

Measles virus (MV) genotyping is an important component of measles surveillance in the context of monitoring immunization program effectiveness and documenting MV elimination. The molecular epidemiology and genetic variability of circulating MV strains in Iran during the 2009-2010 were studied in consecutive MV isolates from throat swab and urine. Sequence information obtained from 41 cases based on the 456 nucleotides of the most variable region of the C-terminal part of the N-protein revealed that these sequences belonged to two different genotypes. This is the first description of the genetic characterization of sporadic MV genotype H1 cases in northern Iran. Cases were probably linked to MV importation from distant parts of Asia. The genotype H1 has not been detected in the Eastern Mediterranean Region. In addition, both sequence analysis and epidemiologic data indicated that the more recently detected genotype D4 viruses in Iran were related very closely to viruses that were detected in Pakistan, suggesting that these viruses may have been imported from Pakistan. J. Med. Virol. 83:2200-2207, 2011. © 2011 Wiley Periodicals, Inc.

Comparison of laboratory diagnostic methods for measles infection and identification of measles virus genotypes in Hong Kong

The sensitivities of IgM detection, virus isolation, and RT-PCR for the diagnosis of measles infection were assessed using samples collected from confirmed measles cases from 2006 to 2009. The optimal timing of specimen collection and the preferred specimen type(s) for these tests were also determined. IgM detection showed highest sensitivity when serum samples were collected >or=5 days after rash onset. Virus isolation gave the highest sensitivity when samples were collected <or=3 days after rash onset, with nasopharyngeal aspirate being the best specimen type, followed by urine and throat/combined throat and nasal swab. The highest RT-PCR positive rate (81.0%) was obtained with serum samples collected <or=3 days after rash onset. RT-PCR positive rate of 100% was observed with throat/combined throat and nasal swab, urine and nasopharyngeal aspirate collected <or=16, 4-16, and 4-7 days after rash onset, respectively. The genotype of each measles case was confirmed by sequencing. It was shown that the predominant measles viruses detected in Hong Kong during 2006-2009 belonged to genotype H1 (subtype a) and these strains were related closely to those detected in China.