Analysis of Suspected Measles Cases with Discrepant Measles-Specific IgM and rRT-PCR Test Results, Japan.

Publisher: National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) Country of Publication: United States NLM ID: 9508155 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1080-6059 (Electronic) Linking ISSN: 10806040 NLM ISO Abbreviation: Emerg Infect Dis Subsets: MEDLINE

Original Publication: Atlanta, GA : National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), [1995-

Immunoglobulin M*/blood ; Measles*/diagnosis ; Measles*/epidemiology ; Measles*/virology ; Measles*/immunology ; Antibodies, Viral*/blood ; Measles virus*/immunology ; Measles virus*/genetics; Humans ; Japan/epidemiology ; Child ; Child, Preschool ; Male ; Adult ; Female ; Infant ; Adolescent ; Immunoglobulin G/blood ; Reverse Transcriptase Polymerase Chain Reaction/methods ; Measles Vaccine/immunology ; Young Adult ; Real-Time Polymerase Chain Reaction/methods

We investigated clinically suspected measles cases that had discrepant real-time reverse transcription PCR (rRT-PCR) and measles-specific IgM test results to determine diagnoses. We performed rRT-PCR and measles-specific IgM testing on samples from 541 suspected measles cases. Of the 24 IgM-positive and rRT-PCR--negative cases, 20 were among children who received a measles-containing vaccine within the previous 6 months; most had low IgG relative avidity indexes (RAIs). The other 4 cases were among adults who had an unknown previous measles history, unknown vaccination status, and high RAIs. We detected viral nucleic acid for viruses other than measles in 15 (62.5%) of the 24 cases with discrepant rRT-PCR and IgM test results. Measles vaccination, measles history, and contact history should be considered in suspected measles cases with discrepant rRT-PCR and IgM test results. If in doubt, measles IgG avidity and PCR testing for other febrile exanthematous viruses can help confirm or refute the diagnosis.

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Keywords: IgG avidity; IgM testing; Japan; Measles; febrile exanthematous viruses; vaccine-preventable diseases; viruses

0 (Immunoglobulin M)
0 (Antibodies, Viral)
0 (Immunoglobulin G)
0 (Measles Vaccine)

Date Created: 20240405 Date Completed: 20240424 Latest Revision: 20240502

20240502

PMC11060445

10.3201/eid3005.231757

38579738