Evaluation of the Measles Clinical Case Definition

Katz, Samuel L.; Hutchins, Sonja S.; Papania, Mark J.; Amler, Robert W.; Maes, Edward F.; Grabowsky, Mark; Bromberg, Kenneth; Glasglow, Victoria; Speed, Tamika; Bellini, William J.; Orenstein, Walter A.

doi:10.1086/379652

Cited by 57 publications

(81 citation statements)

References 8 publications

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“…However, our study revealed that only 47 of the 74 cases met the original case definition for suspected measles, resulting in a sensitivity of only 63.5z. This finding extends to other studies reporting a lower sensitivity as the incidence of measles cases decreases owing to the wide use of vaccines (15).…”

Section: Discussionsupporting

confidence: 87%

Evaluation of an Expanded Case Definition for Vaccine-Modified Measles in a School Outbreak in South Korea in 2010

Choe

Hu²,

Song

et al. 2012

Jpn J Infect Dis

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SUMMARY:In this study, we have described the clinical characteristics of vaccine-modified measles to assess the performance of an expanded case definition in a school outbreak that occurred in 2010. The sensitivity, specificity, and the positive and negative predictive values were evaluated. Among 74 cases of vaccine-modified measles, 47 (64z) met the original case definition. Fever and rash were observed in 73z (54/74); fever was the most common (96z, 71/74) presenting symptom, and rash was noted in 77z (57/74) of the cases. The original case definition showed an overall sensitivity of 63.5z and a specificity of 100.0z. The expanded case definition combining fever and rash showed a higher sensitivity (72.9z) but a lower specificity (88.2z) than the original. The presence of fever and one or more of cough, coryza, or conjunctivitis scored the highest sensitivity among the combinations of signs and symptoms (77.0z), but scored the lowest specificity (52.9z). The expanded case definition was sensitive in identifying suspected cases of vaccine-modified measles. We suggest using this expanded definition for outbreak investigation in a closed community, and consider further discussions on expanding the case definition of measles for routine surveillance in South Korea.

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Section: Discussionsupporting

confidence: 87%

Evaluation of an Expanded Case Definition for Vaccine-Modified Measles in a School Outbreak in South Korea in 2010

Choe

Hu²,

Song

et al. 2012

Jpn J Infect Dis

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“…hsp70 is both constitutively expressed and inducible in humans, in contrast to the lack of significant basal expression in rodents (7,34). Fever is a consistent sequela to MeV infection (19), and temperature elevations as low as 39°C are potent inducers of hsp70 in the human brain (34). Heat-shock-induced hsp70 levels are stable in the brain (43), where hsp70 is localized primarily to the soma of neurons (50).…”

Section: Discussionmentioning

confidence: 99%

Major Histocompatibility Complex Haplotype Determines hsp70-Dependent Protection against Measles Virus Neurovirulence

Carsillo

Traylor³

et al. 2009

J Virol

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In vitro studies show that hsp70 promotes gene expression for multiple viral families, although there are few reports on the in vivo significance of virus-hsp70 interaction. Previously we showed that hsp70-dependent stimulation of Edmonston measles virus (Ed MeV) transcription caused an increased cytopathic effect and mortality in transgenic hsp70-overexpressing C57BL/6 mice (H-2 b ). The response to MeV infection is influenced by the major histocompatibility complex haplotype; H-2 d mice are resistant to brain infection due to robust antiviral immune responses, whereas H-2 b mice are susceptible due to deficiencies in this response. We therefore tested the hypothesis that the outcome of MeV-hsp70 interaction may be dependent upon the host H-2 haplotype. The impact of selective neuronal hsp70 overexpression on Ed MeV brain infection was tested with congenic C57BL/10 H-2 d neonatal mice. In this context, hsp70 overexpression conferred complete protection against virus-induced mortality, compared to >30% mortality in nontransgenic mice. Selective depletion of T-cell populations showed that transgenic mice exhibit a diminished reliance on T cells for protection. Brain transcript analysis indicated enhanced innate immune activation and signaling through Toll-like receptors 2 and 4 at early times postinfection for transgenic infected mice relative to those for nontransgenic infected mice. Collectively, results suggest that hsp70 can enhance innate antiviral immunity through Toll-like receptor signaling, supporting a protective role for physiological responses that enhance tissue levels of hsp70 (e.g., fever), and that the H-2 haplotype determines the effectiveness of this response.The cellular stress response is characterized in part by the increased expression of heat shock proteins, particularly the major inducible 70-kDa isoform (hsp70, also known as hsp72). Numerous physiological stimuli can increase cellular levels of hsp70, including febrile temperatures that frequently accompany viral infection, and 70-kDa heat shock proteins support replication of both DNA and RNA viruses (reviewed in references 30 and 37), yet there is a paucity of studies examining the impact of elevated heat shock protein expression on the outcome of viral infection within animals.In vitro studies have shown that elevated cellular levels of hsp70 are associated with increased gene expression of the morbilliviruses measles virus (MeV) and canine distemper virus, members of the Paramyxoviridae. Selective overexpression via stable transfection or induction via transient heat shock both stimulate viral transcription and genome replication, resulting in increased viral protein expression and cytopathic effect (CPE) (9, 38, 39, 52, 53). hsp70-dependent gene expression reflects direct interaction between hsp70 and the viral nucleocapsid, which is composed of the single-stranded negative-sense genomic RNA packaged by the nucleocapsid protein (N) (40,52,53). The N-protein C terminus provides docking sites for both the viral polymerase and hsp70 (re...

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“…T he major inducible 70-kDa heat shock protein (hsp70) is highly induced by fever (1), a frequent accompaniment of virus infection (2), and the phylogenetic conservation of the febrile response suggests that hsp70 induction plays a host protective role (reviewed in references 3 and 4). hsp70 is expressed in the major histocompatibility complex (MHC) III region of the human genome (5).…”

mentioning

confidence: 99%

hsp70 and a Novel Axis of Type I Interferon-Dependent Antiviral Immunity in the Measles Virus-Infected Brain

Kim

Shu

Carsillo

et al. 2013

J Virol

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Evaluation of the Measles Clinical Case Definition

Cited by 57 publications

References 8 publications

Evaluation of an Expanded Case Definition for Vaccine-Modified Measles in a School Outbreak in South Korea in 2010

Evaluation of an Expanded Case Definition for Vaccine-Modified Measles in a School Outbreak in South Korea in 2010

Major Histocompatibility Complex Haplotype Determines hsp70-Dependent Protection against Measles Virus Neurovirulence

hsp70 and a Novel Axis of Type I Interferon-Dependent Antiviral Immunity in the Measles Virus-Infected Brain

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