ABSTRACT
The Democratic Republic of the Congo (DRC) has a high measles incidence despite elimination efforts and has yet to introduce rubella vaccine. We evaluated the performance of a prototype rapid digital microfluidics powered (DMF) enzyme-linked immunoassay (ELISA) assessing measles and rubella infection, by testing for immunoglobulin M (IgM), and immunity from natural infection or vaccine, by testing immunoglobulin G (IgG), in outbreak settings. Field evaluations were conducted during September 2017, in Kinshasa province, DRC. Blood specimens were collected during an outbreak investigation of suspected measles cases and tested for measles and rubella IgM and IgG using the DMF-ELISA in the field. Simultaneously, a household serosurvey for measles and rubella IgG was conducted in a recently confirmed measles outbreak area. DMF-ELISA results were compared with reference ELISA results tested at DRC's National Public Health Laboratory and the US Centers for Disease Control and Prevention. Of 157 suspected measles cases, rubella IgM was detected in 54% while measles IgM was detected in 13%. Measles IgG-positive cases were higher among vaccinated persons (87%) than unvaccinated persons (72%). In the recent measles outbreak area, measles IgG seroprevalence was 93% overall, while rubella seroprevalence was lower for children (77%) than women (98%). Compared with reference ELISA, DMF-ELISA sensitivity and specificity were 82% and 78% for measles IgG; 88% and 89% for measles IgM; 85% and 85% for rubella IgG; and 81% and 83% for rubella IgM, respectively. Rubella infection was detected in more than half of persons meeting the suspected measles case definition during a presumed measles outbreak, suggesting substantial unrecognized rubella incidence, and highlighting the need for rubella vaccine introduction into the national schedule. The performance of the DMF-ELISA suggested that this technology can be used to develop rapid diagnostic tests for measles and rubella.
Subject(s)
Measles , Rubella , Child , Humans , Female , Democratic Republic of the Congo/epidemiology , Seroepidemiologic Studies , Microfluidics , Antibodies, Viral , Rubella/diagnosis , Rubella/epidemiology , Rubella/prevention & control , Measles/diagnosis , Measles/epidemiology , Measles/prevention & control , Rubella Vaccine , Immunoglobulin M , Immunoglobulin G , Immunoenzyme Techniques , Disease OutbreaksABSTRACT
The gill monogene communities of Pimephales promelas (fathead minnow) in 3 distinct sites on converging streams were investigated from 2004 to 2006 in 3 different seasons. Thirty collections of P. promelas were made in southeastern Nebraska along 3 converging tributaries: Elk Creek (40.88534°N, 96.83366°W), West Oak Creek (40.9082°N, 96.81432°W), and Oak Creek (40.91402°N, 96.770583°W), Lancaster County, Nebraska. In all, 103 P. promelas were collected from Elk Creek, 115 from West Oak Creek, and 78 from Oak Creek and examined for gill monogenes. Among the P. promelas collected, 93.5% were infected with up to 3 species of Dactylogyrus, including Dactylogyrus simplex Mizelle, 1937, Dactylogyrus bychowskyi Mizelle, 1937, and Dactylogyrus pectenatus Mayes, 1977. Mean intensities at Elk Creek, West Oak Creek, and Oak Creek were 17.6, 22.8, and 25.1, and prevalences 88, 95, and 97%, respectively. At these 3 sites: (1) P. promelas does not share Dactylogyrus species with Semotilus atromaculatus (Creek chub) or Notropis stramineus (Sand shiner); (2) fish size and sex are not predictive of Dactylogyrus infection; (3) Dactylogyrus spp. vary (not always predictably) in their seasonal occurrence; (4) populations of Dactylogyrus spp. respond to environmental differences among sites; and (5) the community structure of Dactylogyrus spp. (order of abundance) is independent of environment.
