el Mubarak H S, Van De Bildt M W, Mustafa O A, Vos H W, Mukhtar M M, Groen J, el Hassan A M, Niesters H G, Ibrahim S A, Zijlstra E E, Wild T F, Osterhaus A D, De Swart R L
Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
J Clin Microbiol. 2000 Mar;38(3):987-91. doi: 10.1128/JCM.38.3.987-991.2000.
Measles continues to be a major childhood disease in terms of global morbidity and mortality. In the main areas of its endemicity the only available means of diagnosis are based on clinical criteria: the presence of a maculopapular rash and fever accompanied by cough, coryza, and/or conjunctivitis. We have studied 38 clinically diagnosed cases of measles in Khartoum, Sudan, by means of serology, reverse transcriptase PCR (RT-PCR) on throat swabs and virus isolation from lymphocytes. On the basis of serology, 28 patients were diagnosed as having an acute measles virus (MV) infection, while in 10 cases the clinical symptoms proved to have other causes. It was shown that in cases with low serum immunoglobulin M (IgM) levels, an additional measurement of IgG or virus-neutralizing antibodies was necessary to discriminate between patients with an acute MV infection sampled during an early stage of the disease and patients who had experienced an MV infection in the more distant past. The serological laboratory diagnosis was validated by an MV-specific RT-PCR: for all confirmed measles cases tested a fragment of the correct size which hybridized with a third MV-specific primer could be amplified, while all serologically negative cases were also RT-PCR negative. MV could be isolated from 17 out of 23 of the serologically confirmed cases, demonstrating that virus isolation is less reliable as a diagnostic tool than serology or RT-PCR. This study stresses the urgent need for a rapid diagnostic field test for measles.
就全球发病率和死亡率而言，麻疹仍然是一种主要的儿童疾病。在其地方性流行的主要地区，现有的诊断方法仅基于临床标准：出现斑丘疹、发热并伴有咳嗽、鼻炎和/或结膜炎。我们通过血清学、对咽拭子进行逆转录酶聚合酶链反应（RT-PCR）以及从淋巴细胞中分离病毒，对苏丹喀土穆38例临床诊断为麻疹的病例进行了研究。根据血清学检查，28例患者被诊断为患有急性麻疹病毒（MV）感染，而10例患者的临床症状被证明是由其他原因引起的。结果表明，在血清免疫球蛋白M（IgM）水平较低的病例中，需要额外检测IgG或病毒中和抗体，以区分疾病早期采样的急性MV感染患者和过去较远时间经历过MV感染的患者。通过MV特异性RT-PCR验证了血清学实验室诊断：对于所有检测的确诊麻疹病例，均可扩增出与第三条MV特异性引物杂交的正确大小的片段，而所有血清学阴性病例的RT-PCR结果也为阴性。在23例血清学确诊病例中，有17例可分离出MV，这表明病毒分离作为一种诊断工具不如血清学或RT-PCR可靠。本研究强调迫切需要一种用于麻疹的快速现场诊断检测方法。
