The Measles Laboratory Network in the Region of the Americas

Abstract

The success of measles eradication depends upon a laboratory network to rapidly analyze samples obtained as part of surveillance and case investigation. The Pan American Measles Laboratory Network was established in 1995. Major activities of the 22 participating laboratories include the rapid testing of serum samples to diagnose measles, analysis and recommendation of techniques to be used in serologic testing, training in virus isolation, and procurement and distribution of laboratory materials. In addition, a comprehensive quality-control program and an electronic communication network have been developed. Testing for rubella has also been incorporated. The Network has been crucial to the great progress made toward eradicating measles from the Western Hemisphere. The priority given to the laboratories in the Network must continue in order to ensure that the eradication goal is reached and that validation of the interruption of endemic transmission of measles is documented.

Global Distribution of Rubella Virus Genotypes

“…Live attenuated vaccines, available since the late 1960s ( 2 ), are currently in use in roughly half of the countries in the world, including all industrialized countries, although vaccine coverage varies widely ( 3 ). Concentration on comprehensive rubella vaccination has recently increased in developing countries in conjunction with measles elimination efforts, particularly in Latin America ( 4 , 5 ). As part of the surveillance component of these efforts, an understanding of the worldwide molecular epidemiology of rubella virus, which is limited, is necessary.…”

Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004

“…The availability of additional laboratory testing supported the findings from the epidemiological investigation. In accordance with the established procedures of the regional measles laboratory network 28 , public health laboratories throughout the State of São Paulo used a single commercial indirect ELISA kit for measles serological assays. The state health department added a second serological assay, the IgM-capture ELISA, at the state reference laboratory to aid in the interpretation of positive measles IgM serology.…”

Novel Replicon-Based Reporter Gene Assay for Detection of Rubella Virus in Clinical Specimens

“…potential exposure of a woman in the first trimester of pregnancy (2), is necessary for confirmation of potential cases of congenital rubella syndrome in newborns (12), and is important in the surveillance component of rubella vaccination programs (4,11,20). Interestingly, diagnosis of RUB infection is also an important aspect of surveillance in measles vaccination programs since rubella is the most common nonmeasles rash illness screened during measles surveillance.…”

“…The assay was specific in that it was positive for RUB strains of both genotypes and was negative for a panel of human viruses. It was also possible to genetically sequence the RUB present in positive clinical specimens detected in the assay for genotypic strain determination.Diagnosis of rubella virus (RUB) infection is essential after potential exposure of a woman in the first trimester of pregnancy (2), is necessary for confirmation of potential cases of congenital rubella syndrome in newborns (12), and is important in the surveillance component of rubella vaccination programs (4,11,20). Interestingly, diagnosis of RUB infection is also an important aspect of surveillance in measles vaccination programs since rubella is the most common nonmeasles rash illness screened during measles surveillance.…”