Implications of Measles Inclusion by Commercial Syndromic Polymerase Chain Reaction Panels - United States, May 2022-April 2023.

Syndromic polymerase chain reaction (PCR) panels are used to test for pathogens that can cause rash illnesses, including measles. Rash illnesses have infectious and noninfectious causes, and approximately 5% of persons experience a rash 7-10 days after receipt of a measles, mumps, and rubella (MMR) vaccine. MMR vaccine includes live attenuated measles virus, which is detectable by PCR tests. No evidence exists of person-to-person transmission of measles vaccine virus, and illness does not typically result among immunocompetent persons. During September 2022-January 2023, the Tennessee Department of Health received two reports of measles detected by syndromic PCR panels. Both reports involved children (aged 1 and 6 years) without known risk factors for measles, who were evaluated for rash that occurred 11-13 days after routine MMR vaccination. After public health responses in Tennessee determined that both PCR panels had detected measles vaccine virus, six state health departments collaborated to assess the frequency and characteristics of persons receiving a positive measles PCR panel test result in the United States. Information was retrospectively collected from a commercial laboratory testing for measles in syndromic multiplex PCR panels. During May 2022-April 2023, among 1,548 syndromic PCR panels, 17 (1.1%) returned positive test results for measles virus. Among 14 persons who received a positive test result and for whom vaccination and case investigation information were available, all had received MMR vaccine a median of 12 days before specimen collection, and none had known risk factors for acquiring measles. All positive PCR results were attributed to detection of measles vaccine virus. Increased awareness among health care providers about potential measles detection by PCR after vaccination is needed. Any detection of measles virus by syndromic PCR testing should be immediately reported to public health agencies, which can use measles vaccination history and assessment of risk factors to determine the appropriate public health response. If a person recently received MMR vaccine and has no risk factors for acquiring measles, additional public health response is likely unnecessary.

Public Health Actions to Control Measles Among Afghan Evacuees During Operation Allies Welcome - United States, September-November 2021.

On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.S. Department of Defense (DoD) and U.S. Department of State (DoS), to safely resettle U.S. citizens and Afghan nationals from Afghanistan to the United States. Evacuees were temporarily housed at several overseas locations in Europe and Asia* before being transported via military and charter flights through two U.S. international airports, and onward to eight U.S. military bases,† with hotel A used for isolation and quarantine of persons with or exposed to certain infectious diseases.§ On August 30, CDC issued an Epi-X notice encouraging public health officials to maintain vigilance for measles among Afghan evacuees because of an ongoing measles outbreak in Afghanistan (25,988 clinical cases reported nationwide during January-November 2021) (1) and low routine measles vaccination coverage (66% and 43% for the first and second doses, respectively, in 2020) (2).

An assessment of the accuracy of discriminant function equations for sex determination of the femur and tibia from a South African population.

The purpose of this study is to test the accuracy of seven discriminant function equations that have been derived by Steyn and Isçan for sex determination using measurements of the femur and tibia of South Africans of European descent (SAED). While the validity of some of the discriminant functions has been assessed by the authors who derived them, no previous independent study has been carried out to assess the accuracy of these equations. These equations have not been tested on skeletons located outside of the Gauteng province. A suite of measurements were taken on 272 femora and 256 tibiae obtained from four South African skeletal collections. The validity of each of the previously published equations for the femur was confirmed. However, two functions of the tibia showed low accuracy rates, most likely due to difficulties in recording the distal epiphyseal breadth measurement, and thus were found to be poor assessors of sex.

The skull and humerus in the determination of sex: reliability of discriminant function equations.

Sex determination plays a crucial role in the identification of human remains as it narrows the possibility for identification by 50%. The purpose of this study is to test the validity of five discriminant function equations, with accuracies of 80% and higher, that have been derived by Steyn and Iscan [M. Steyn, M.Y. Iscan, Sexual dimorphism in the crania and mandibles of South African Whites, Forensic Sci. Int. 98 (1998) 9-16; M. Steyn, M.Y. Iscan, Osteometric variation in the humerus: sexual dimorphism in South Africans, Forensic Sci. Int. 106 (1999) 77-85] for the skull and humerus of South Africans of European Descent (SAED). These equations were tested on different regional populations of SAED within South Africa. While the validity of some of the discriminant functions has been assessed by the authors who derived them, no other previous independent study has been carried out to assess the reliability of these equations. In addition, these equations have not been tested on skeletons located outside the Gauteng province. The study sample consisted of 230 skulls and 264 humeri of SAED obtained from four South African skeletal collections: Raymond A. Dart Collection of Human Skeletons (Johannesburg); Pretoria Bone Collection; Cape Town Skeletal Collection; and the Osteology Archive Student Collection (Stellenbosch). A total of 14 measurements (12 cranial and 2 humeral) were taken on these skeletal elements. The observed accuracies from the present study (72.0-95.5%), with the exception of one sample's accuracy, compared well with the original classification rates (80.2-92.5%) for most of the functions thereby confirming the validity of the discriminant function equations for sex determination for the skull and humerus of SAED, for SAED in all regions of South Africa.