van Binnendijk Robert S, van den Hof Susan, van den Kerkhof Hans, Kohl Robert H G, Woonink Frits, Berbers Guy A M, Conyn-van Spaendonck Marina A E, Kimman Tjeerd G
Laboratory for Vaccine-Preventable Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
J Infect Dis. 2003 Sep 15;188(6):898-903. doi: 10.1086/377103. Epub 2003 Aug 25.
We evaluated different approaches for diagnosing measles virus (MV) infection in unvaccinated children and in healthy contact persons (n=194) during a measles epidemic in The Netherlands. MV RNA was detected by reverse-transcriptase polymerase chain reaction in throat-swab specimens from 93% of the patients with clinical symptoms. MV RNA was detected from 5 days before until 12 days after the onset of symptoms. Most patients (88%) also secreted MV RNA in their urine until 5 weeks after the onset of symptoms. Oral fluid proved to be the most practical specimen for the simultaneous detection of MV-specific IgM antibody and viral RNA, which, together, confirmed 93% of measles cases. Viral RNA was also detected in oropharyngeal specimens from 3 healthy contact persons with serological proof of MV infection. The results of this study emphasize the feasibility of combined detection of viral RNA and MV-specific IgM antibodies in oropharyngeal specimens for the diagnosis of clinical and subclinical MV infection.
在荷兰的一次麻疹疫情期间，我们评估了多种方法用于诊断未接种疫苗儿童及健康接触者（n = 194）中的麻疹病毒（MV）感染情况。通过逆转录聚合酶链反应在93%有临床症状患者的咽拭子标本中检测到了MV RNA。在症状出现前5天至症状出现后12天均可检测到MV RNA。大多数患者（88%）在症状出现后5周内尿液中也分泌MV RNA。口腔液被证明是同时检测MV特异性IgM抗体和病毒RNA的最实用标本，二者结合可确诊93%的麻疹病例。在3名有MV感染血清学证据的健康接触者的口咽标本中也检测到了病毒RNA。本研究结果强调了在口咽标本中联合检测病毒RNA和MV特异性IgM抗体用于诊断临床和亚临床MV感染的可行性。
