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3.
Aerosp Med Hum Perform ; 90(10): 908-910, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558201
4.
mSphere ; 4(4)2019 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-31413172

RESUMO

Here we describe baseline validation studies and field performance of a research-use-only chemiluminescent multiplex serology panel for measles, mumps, rubella, and varicella-zoster virus used with dried blood spots in support of the 2013-2014 Democratic Republic of the Congo Demographic and Health Survey. Characterization of the panel using U.S. FDA-cleared commercial kits shows good concordance for measles, mumps, rubella, and varicella-zoster with average sensitivity across assays of 94.9% and an average specificity of 91.4%. As expected, performance versus available standards validated for plaque-reduction assays does not provide a 1:1 correspondence with international units and yet demonstrates excellent linearity (average Hill's slope = 1.02) and ∼4 logs of dynamic range. In addition, for the four assays, the multiplexed format allowed for inclusion of three positive and two negative controls for each sample. A prototype Dynex Multiplier chemiluminescent automated immunoassay instrument with a charge-coupled device camera provided a rugged and robust processing and data acquisition platform. Performance of a multiplex instrument for serological testing in a substantially resource-limited environment shows excellent reproducibility, minimal cross-reactivity, and a clear discrimination between specific assays and should be considered a viable option for future serosurveys.IMPORTANCE The critical evaluation of immunization programs is key to identifying areas of suboptimal vaccination coverage, monitoring activities, and aiding development of public health policy. For evaluation of vaccine effectiveness, direct antibody binding assay methods, including enzyme immunoassay, enzyme-linked fluorescence assays, and indirect immunofluorescence assay, are most commonly used for detection of IgG antibodies. However, despite their well-demonstrated, reliable performance, they can be labor-intensive and time-consuming and require separate assays for each individual marker. This necessitates increased sample volumes, processing time, and personnel, which may limit assessment to a few key targets in resource-limited settings, that is, low- and middle-income locations where funding for public health or general infrastructure that directly impacts public health is restricted, limiting access to equipment, infrastructure, and trained personnel. One solution is a multiplexed immunoassay, which allows for the detection of multiple analytes in a single reaction for increased efficiency and rapid surveillance of infectious diseases in limited-resource settings. Thus, the scope of the project precluded a full validation, and here we present abbreviated validation studies demonstrating adequate sensitivity, specificity, and reproducibility.


Assuntos
Varicela/diagnóstico , Teste em Amostras de Sangue Seco/normas , Imunoensaio/normas , Medições Luminescentes/normas , Sarampo/diagnóstico , Caxumba/diagnóstico , Rubéola (Sarampo Alemão)/diagnóstico , Anticorpos Antivirais/sangue , Automação Laboratorial/normas , República Democrática do Congo , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
7.
Artigo em Inglês | MEDLINE | ID: mdl-31203583

RESUMO

We report symptomatic confirmed modified measles infection in a person with one documented MMR (measles, mumps, rubella) vaccination and travel to Indonesia. No secondary cases were identified, consistent with other case reports of modified measles infection. The infectivity of modified measles for contact tracing requirements requires further elucidation.


Assuntos
Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Sarampo/diagnóstico , Caxumba/prevenção & controle , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação , Adulto , Austrália , Busca de Comunicante , Feminino , Humanos , Indonésia , Sarampo/prevenção & controle , Viagem
8.
J Infect Chemother ; 25(10): 829-831, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31253475

RESUMO

Patients with measles or rubella infections manifest acute onset fever accompanying systemic exanthema, which are clinically difficult to be distinguish. Rapid diagnosis and differentiation of such epidemic viral diseases is essential to prevent outbreaks. We developed a single-tube multiplex real-time PCR assay for these indistinguishable viruses. We used previously-reported primer settings, with a slight modification of reporter dye, and applied to multiplex Taqman real-time PCR by cobas z480 (Roche Molecular Systems, Inc.). Consequently, the assay could detect 10 copies/10 µl of measles and rubella with coefficient of variations of 11.2% and 21.8%, respectively. Strengths of our methodology include simplicity of operation, short measurement time (2 h), uses of internal control (confirming a run of PCR), and quantitative measurement with high sensitivity. Both measles and rubella currently cause social outbreaks in Japan. We hope that our single-tube multiplex assay contributes to an early diagnosis, leading to an appropriate infection control measure and prevention of epidemics.


Assuntos
Sarampo/diagnóstico , Morbillivirus/isolamento & purificação , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/diagnóstico , Surtos de Doenças/prevenção & controle , Estudos de Viabilidade , Humanos , Japão/epidemiologia , Sarampo/epidemiologia , Sarampo/virologia , Morbillivirus/genética , Reação em Cadeia da Polimerase Multiplex , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/genética , Sensibilidade e Especificidade , Fatores de Tempo
9.
BMC Infect Dis ; 19(1): 392, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068140

RESUMO

BACKGROUND: In Lao PDR, the epidemiology of varicella infection is uncertain, since it is not a notifiable disease and VZV outbreaks are rarely reported as fever/rash (F/R) diseases. METHODS: We estimated the seroprevalence of VZV (IgG ELISA) in different age cohorts (9 months to 46 years; N = 3139) and investigated VZV and 6 other viruses in patients during F/R outbreaks and in an ad hoc sentinel site in the context of the national reporting system (IgM ELISA, PCR). RESULTS: At least 80% of the sampled population had evidence of VZV infection before the age of 15. The largest increase in seroprevalence occurred between the age groups 1 to 5 and 6 to 7 year-olds. A VZV outbreak (clade 2) also occurred in this age group mostly during the first year of primary school (median age 6 years, interquartile range 4.0-7.5). During a dengue outbreak, 6% had varicella. At our F/R sentinel site, 14% of children with viral etiology were laboratory diagnosed as varicella and among others, a sizeable number of measles (N = 12) and rubella cases (N = 25) was detected compared to those reported for the whole country (N = 56 and 45), highlighting nationwide a large challenge of underreporting or misdiagnosis of these notifiable diseases because of lack of diagnostic laboratory capacity. CONCLUSION: We recommend strengthening the clinical and laboratory diagnosis of VZV, measles and rubella, the surveillance and reporting of notifiable F/R diseases by retraining of healthcare workers and by setting up sentinel sites and enhancing laboratory capacity.


Assuntos
Exantema/virologia , Febre/virologia , Infecção pelo Vírus da Varicela-Zoster/epidemiologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Varicela/diagnóstico , Varicela/epidemiologia , Criança , Pré-Escolar , Dengue/epidemiologia , Dengue/etiologia , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática , Exantema/epidemiologia , Feminino , Febre/epidemiologia , Herpes Zoster/epidemiologia , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/imunologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Lactente , Laos/epidemiologia , Masculino , Sarampo/diagnóstico , Sarampo/epidemiologia , Pessoa de Meia-Idade , Rubéola (Sarampo Alemão)/diagnóstico , Rubéola (Sarampo Alemão)/epidemiologia , Estudos Soroepidemiológicos , Infecção pelo Vírus da Varicela-Zoster/etiologia
10.
BMJ Case Rep ; 12(5)2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31076492

RESUMO

Measles is becoming more prevalent; it can be difficult to diagnose, with severe complications in pregnancy. We report a case of measles in a 27-year-old, parainfluenza virus type 2-infected woman who was 32 weeks pregnant. She presented with fever, tachycardia, sore throat and a pruritic rash. She never had the measles, mumps, rubella vaccine. Serology showed raised inflammatory markers with lymphopoenia. Throat swab showed parainfluenza virus. Chest radiography was normal. Despite appropriate antimicrobial therapy, she developed worsening respiratory failure requiring premature delivery via caesarean section.Postoperatively, she was transferred to a tertiary centre for extracorporeal membrane oxygenation. She was decannulated and made a full recovery. Meanwhile, her husband was diagnosed with measles. She was then tested and measles was confirmed. The baby did not develop congenital measles.This case emphasises the importance of vaccine histories at booking of pregnancy and early multidisciplinary team input to facilitate delivery in rapidly deteriorating pregnant women.


Assuntos
Antivirais/uso terapêutico , Vacina contra Sarampo-Caxumba-Rubéola , Sarampo/diagnóstico , Cooperação do Paciente , Complicações Infecciosas na Gravidez/diagnóstico , Vacinação , Adulto , Cesárea , Feminino , Febre , Humanos , Recém-Nascido , Sarampo/tratamento farmacológico , Sarampo/imunologia , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Nascimento Prematuro , Prevalência , Vacinação/estatística & dados numéricos
11.
Emerg Med J ; 36(5): 310-314, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30944113

RESUMO

Infection with the measles virus causes an unpleasant disease with many potentially serious complications. It is predominantly a childhood illness but can affect any age. Measles is extraordinarily contagious, but immunisation with measles containing vaccine provides comprehensive protection. An international programme of universal immunisation from the mid-1980s has been very effective; measles was declared eliminated in the USA nearly two decades ago and became a rarity in other countries with high rates of vaccine uptake. Until recently, this was a forgotten disease in high-income countries, but paediatricians, emergency and primary care physicians worldwide are now encountering measles with increased frequency. Attributed to international travel and pockets of vaccine hesitancy locally, new outbreaks of measles have been recorded in many regions thought to have been free of the disease. Because it was previously so uncommon, measles presents a diagnostic challenge and an unrecognised case may cause infection to spread among communities. The present article presents a case of confirmed measles infection and discusses the epidemiology, clinical features, investigation, management and prevention of measles.


Assuntos
Sarampo/diagnóstico , Criança , Tosse/etiologia , Febre/etiologia , Humanos , Masculino , Sarampo/fisiopatologia , Vacina contra Sarampo/uso terapêutico , Morbillivirus/patogenicidade
14.
BMJ Case Rep ; 12(4)2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31023731

RESUMO

A preterm 32-week neonate presented on the 14th day of life with respiratory distress and cyanosis. The respiratory distress worsened progressively, which was managed with continuous positive airway pressure support. The neonate had blood-tinged oral secretions on the 39th day of life, for which bronchoscopy was performed, whose findings were suggestive of pulmonary hemosiderosis. Lung biopsy confirmed the diagnosis of pulmonary interstitial glycogenosis with pulmonary arterial hypertension. The neonate was treated successfully with systemic corticosteroids and discharged home at 3 months of age.


Assuntos
Hemossiderose/patologia , Doenças Pulmonares Intersticiais/patologia , Pneumopatias/patologia , Alvéolos Pulmonares/patologia , Administração Oral , Assistência ao Convalescente , Biópsia , Broncoscopia , Pressão Positiva Contínua nas Vias Aéreas/métodos , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Evolução Fatal , Glucocorticoides/uso terapêutico , Doença de Depósito de Glicogênio/diagnóstico , Doença de Depósito de Glicogênio/patologia , Hemossiderose/tratamento farmacológico , Hemossiderose/terapia , Humanos , Hipertensão Pulmonar/complicações , Recém-Nascido , Pneumopatias/tratamento farmacológico , Pneumopatias/terapia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Masculino , Sarampo/complicações , Sarampo/diagnóstico , Pneumonia Viral/complicações , Doenças Raras
15.
PLoS Med ; 16(3): e1002770, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30913211

RESUMO

The PLOS Medicine Editors discuss issues of vaccination uptake in the context of recent and ongoing measles outbreaks.


Assuntos
Vacina contra Sarampo/uso terapêutico , Sarampo/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Vacinação/métodos , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vacinação/normas
17.
Am J Dermatopathol ; 41(4): 289-292, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30252698

RESUMO

We report the case of a 32-year-old man with measles in which skin biopsy helped to establish a definitive diagnosis. Follicular involvement is a common histopathologic feature of measles. Multinucleated epidermal and follicular cells are distinctive findings.


Assuntos
Células Gigantes/patologia , Folículo Piloso/patologia , Queratinócitos/patologia , Sarampo/patologia , Glândulas Sebáceas/patologia , Adulto , Biópsia , Humanos , Masculino , Sarampo/diagnóstico
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