Real-Time PCR for Measles Virus Detection on Clinical Specimens with Negative IgM Result in Morocco.

Wednesday, 27th of January 2016

PLoS One. 2016 Jan 26;11(1):e0147154. doi: 10.1371/journal.pone.0147154.

Real-Time PCR for Measles Virus Detection on Clinical Specimens with Negative IgM Result in Morocco.

Benamar T¹ Tajounte L¹ Alla A² Khebba F¹ Ahmed H³ Mulders MN⁴ Filali-Maltouf A⁵ El Aouad R⁶.

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Abstract

Since the confirmation of measles cases represents an important indicator regarding the performance of the measles-elimination program the aim of this study was to evaluate the effectiveness of the routine procedures followed in Morocco for the laboratory confirmation of measles cases. Suspected cases reported between January 2010 and December 2012 were assessed for the timeliness of the sample collection occurrence of measles clinical symptoms and the results of the laboratory diagnoses. For 88% of the 2708 suspected cases a clinical specimen was collected within 7d of rash onset of which 50% were IgM-positive and 2.6% were equivocal. The measles symptoms were reported in 91.4% of the cases; the occurrence of symptoms showed a positive association with the serological results (odds ratio [OR] = 2.9883 95% confidence interval [CI] 2.2238-4.0157). Of the negative samples 52% (n = 116) tested positive by real-time polymerase chain reaction (PCR). These results are in favor of using molecular detection to complement serological diagnosis in the context of measles surveillance approach in Morocco. In addition the introduction of additional laboratory methods for differential diagnosis is required for the final classification of suspected cases with maculopapular rash and fever in the context of the measles elimination program.