Measles infection continues to be a major global health problem, and in many countries the disease is frequently diagnosed on clinical grounds alone, although it is easily confused with other conditions. In order to discuss approaches to improving this situation, a WHO Consultation on Laboratory Diagnosis of Measles Infection and Monitoring of Measles Immunization was held in Glasgow on 7-8 August 1993. The discussions and recommendations made by the participants are summarized in this Memorandum.
PIP: Measles infection remains a major global health problem. Although it may be easily confused with other conditions, the disease is frequently diagnosed in many countries on clinical grounds alone. A World Health Organization Consultation on Laboratory Diagnosis of Measles Infection and Monitoring of Measles Immunization was held in Glasgow August 7-8, 1993, to discuss ways to improve the situation. This brief summarizes the discussions and recommendations made by the participants. It is recommended that since only limited efforts have been made in recent years to develop tools for the diagnosis and surveillance of measles virus infection, focus should be given to techniques for the rapid diagnosis of measles using inexpensive techniques and technologies currently employed in other immunological and molecular diagnostic methods, with priority given to assay systems which determine parameters associated with current and recent infection; an international network of laboratories involved in the diagnosis and surveillance of measles should be established; and to evaluate next-generation diagnostic tools and establish criteria for their use, panels of serum samples should be established from individuals with a well-defined history of vaccination and/or wild-type measles virus infection. A bank of clinical specimens from monkeys experimentally infected or vaccinated with different measles viruses should also be established. Ongoing efforts will require a sound financial base. The proposed laboratory network is described, followed by sections on the laboratory diagnosis of measles in clinical materials, the direct detection of measles virus antigens in clinical specimens, and the detection of specific nucleic acids.