There has been a milestone reached in 2019, but not one to celebrate. There are now more cases of measles in the United States than any time since 1992.  1,077 individual measles cases were confirmed as of June 2019, according to the Centers for Disease Control and Prevention (CDC). With doctors less familiar than they once were in clinically detecting a disease that was largely eradicated, IVDs such as immunoassays and molecular tools are fortunately available and effective. Kalorama Information covers infectious disease in our report – Infectious Disease World Market Analysis.

This year Measles virus (MeV) cases have been reported this year in 22 states – Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas, Tennessee, and Washington. About 71% of people who have gotten sick from measles this year have been unvaccinated, 11% were vaccinated and the rest had an unknown status, according to a recent CDC Morbidity and Mortality Weekly Report. Symptoms include cold, fever, runny nose accompanied by a rash.

“Because of the disease’s decline, many doctors have not recently seen a measles case, and the rash can be confused with a number of other illnesses. So blood tests are useful to confirm whether if a rash is truly measles.”

Measles is not eradicated worldwide, though it is considered so in the United States. Globally, 451,756 suspected measles cases were registered in 2014. In 2013, the WHO estimated the global measles deaths to145,700. There is a tendency to think of measles as a children’s disease alone, but it is a deadly disease due to the immunosuppresion it can cause. It is also highly contagious human. It can result in complications like pneumonia, brain damage and deafness and can be fatal.

When last there was a noteworthy outbreak, In March 1990, a large measles outbreak began in New York City and other cities in the United States with significant unvacinnated populations. Through December 1990, approximately 2500 cases and eight measles-associated deaths were reported. The CDC and the Academy recommend children receive the first routine dose of MMR vaccine at 12-15 months and the second dose at 4-6 years. One dose is about 93% effective, and two doses are about 97% effective.

Normally, doctors can usually diagnose measles based on the disease’s noteworthy rash as well as a small, “Koplik’s spot” a bluish spot on the inside lining of the cheek. Because of the disease’s decline, many doctors have not recently seen a measles case, and the rash can be confused with a number of other illnesses. So blood tests are useful to confirm whether if a rash is truly measles.

Testing for measles is typically immunoassay-based as it is cost-effective. Enzyme-linked immunosorbent assay (ELISA) is normally used to quantify the amount of serum IgG antibodies against measles, mumps, rubella, and varicella-zoster virus. Examples are Roche’s Elecsys Rubella IgM, ELISA Anti-Measles-Virus/IgM test kit from Siemens Healthineers, Microimmune Ltd’s Measles IgM capture EIA. The method is time-consuming and in some cases, the IgM response is not detectable until 3 days after symptom onset. Some molecular tests are also availalble for more immediate detection, Roche MeVA RT-qPCR on the Roche LightCycler 480, QIAamp viral RNA mini kit, Creative Biogene and Fast Track Diagnostics also have products. Where not available, a second IgM test is often used to find late developing MeV.

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