Immunization, Vaccines and Biologicals

Measles


Measles and Rubella Laboratory Network

The global measles and rubella laboratory network was developed based on the successful model of the global polio laboratory network. As of 2012, 690 laboratories have been established and 183 of 194 countries are served by a proficient laboratory. Many of these laboratories are also responsible for laboratory-based surveillance of other vaccine preventable diseases in their countries, including polio, yellow fever and japanese encephalitis, where appropriate.

Measles case confirmation is based on confirming suspected cases with the detection of measles specific IgM from a single serum sample collected from a suspected case at first contact with a health facility, anytime within 28 days of rash onset. Most national laboratories use standardized, validated ELISA IgM assays which are simple and rapid to perform, with results possible within 3-4 hours after a sample arrives in the laboratory. Representative measles virus samples are collected from outbreaks and sporadic cases in low incidence settings, wherever possible, and sequencing of these viruses is helpful for determining measles virus transmission patterns and in monitoring progress towards achieving elimination. Databases have been developed for the purposes of allowing timely access to sequence information and currently have more than 13,000 individual datasets for measles viruses. Sequence information, in conjunction with epidemiological data, can help determine whether cases are due to indigenous or imported virus.

Rubella surveillance is often integrated with measles surveillance as the WHO measles case definition also captures rubella cases. Many countries administering rubella vaccine also take advantage of the combination vaccine presentation of measles and/or mumps. The confirmation of rubella cases is very similar to that of measles and uses an IgM ELISA assay performed on a single serum sample. Many countries follow a procedure of testing measles negative samples for rubella. Rubella virus detection is more challenging than for measles, but when successful, sequence information can be utilized for the same molecular epidemiological purposes as for measles and more than 1200 viruses have been submitted to the database for collating rubella molecular data.

Last updated: May 2012

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