Improving Global Virologic Surveillance for Measles and Rubella

Abstract

An important aspect of laboratory surveillance for measles and rubella is the genetic characterization of circulating wild-type viruses to support molecular epidemiologic studies and to track transmission pathways. Virologic surveillance that is sufficient to document the interruption of transmission of measles and rubella viruses will be an essential criterion for verification of elimination. Laboratories in the World Health Organization (WHO) Measles and Rubella Laboratory Network have worked to improve and expand virologic surveillance as many regions move toward elimination of measles and rubella/congenital rubella syndrome. As countries approach elimination, it will be necessary to obtain genetic information from as many chains of transmission as possible. In addition, baseline virologic surveillance, especially for rubella, needs to be improved in many countries. This report contains a summary of recent improvements to the methods used for virologic surveillance.

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

“…Sequence data are submitted to a global sequence database, MeaNS, 90 which allows rapid tracking of lineages (referred to as named strains) of measles virus between and among countries. 91 …”

Research priorities for global measles and rubella control and eradication

“…The value of molecular epidemiologic surveillance for measles and rubella viruses is well established, but existing sequencing methods have limited ability to distinguish between closely related viruses [43]. Research is needed to develop additional sequencing methods to distinguish between closely related strains of measles and rubella viruses, which will provide a better understanding of viral transmission pathways, the distribution of circulating virus genotypes, and help to identify areas with underperforming surveillance.…”

Improving molecular tools for global surveillance of measles virus

“…The position of MeV214 increases the distance between the primer binding site and the 3′ terminus of N-450, which improves sequence quality. Unlike several previously published primer pairs [11,[18][19][20][21], the new primers allow sequencing of the entire N-450 which is required to assign a genotype [32] and to submit the sequence to MeaNS [2], the global measles sequence database. In this study, only one representative for each genotype was sequenced.…”

“…Molecular characterization of MeV has provided a valuable tool for measuring the effectiveness of measles control programs [1][2][3]. The WHO Measles and Rubella Laboratory Network (LabNet) supports genetic characterization of circulating wild-type viruses throughout the world [2,4].…”

“…The WHO Measles and Rubella Laboratory Network (LabNet) supports genetic characterization of circulating wild-type viruses throughout the world [2,4]. Genetic characterization of MeVs is based on sequence analysis of the 450 nucleotides coding for the 150 amino acids at the carboxyl terminus of the nucleoprotein (N-450) [5,6].…”