The laboratory investigation of a measles outbreak in the eve of its elimination in Sri Lanka.,Journal of Clinical Virology

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The laboratory investigation of a measles outbreak in the eve of its elimination in Sri Lanka.
Journal of Clinical Virology ( IF 4.0 ) Pub Date : 2019-11-26 , DOI: 10.1016/j.jcv.2019.104230
Buddhini Samaraweera ₁ , Adhyana Mahanama ₁ , Almarz Z Ahamad ₁ , Gayan I Wimalaratne ₁ , Janaki Abeynayake ₁

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BACKGROUND Measles is highly contagious and cause significant morbidity and mortality. Sri-Lanka has the goal to eliminate endogenous measles by 2020 in par with WHO. OBJECTIVE To describe laboratory confirmation and genotype distribution of measles cases during the outbreak occurred from mid-March to May 2019, Sri-Lanka STUDY DESIGN: This retrospective study was conducted at National Measles Reference Laboratory (NMRL), Sri-Lanka. All samples received were tested according to the testing flow chart at NMRL with WHO recommended kits. Blood samples were tested for anti-measles IgM and IgG with IgG avidity for IgG positives. Samples within 5days post-onset rash were tested with measles real-time RT-PCR. Products of genotyping PCR were sent to Regional Reference Laboratory, Thailand for sequencing. Subsequent phylogenetic analysis was done at NMRL. Data were analyzed by descriptive statistics. RESULTS A total of 182 blood and 46 throat/nasopharyngeal swabs were received from 195 suspected cases and 37(19 %) were positive for measles by anti-measles IgM, rRT-PCR or both. Majority was females, with mean age of 20 years. Cases represented three main geographical areas; Western-35 %, Central-32 % and Southern-27 %. High avidity IgG was detected in 27/37(73 %). Sequencing data of six cases (4 from Western and 2 from Central province) revealed genotype D8. CONCLUSION Nineteen percent of the suspected patients were measles positive with 73 % having re-infections. Majority were 22 years or over. Measles genotype was D8 in two provinces, suggesting the spread of virus within the country. Laboratory confirmation with measles PCR; IgG avidity and sequencing/genetic analysis is critical in the verge of measles elimination.

更新日期：2019-11-26

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