Serological and Virological Characterization of Clinically Diagnosed Cases of Measles in Suburban Khartoum

Mubarak, Hassan; Bildt, Marco W. G. van de; Mustafa, Omer A.; Vos, Helma W.; Mukhtar, Maowia M.; Groen, Jan; Hassan, A.M. El; Niesters, Hubert G. M.; Ibrahim, Safaa A.; Zijlstra, E.E.; Wild, T. F.; Osterhaus, Albert D. M. E.; Swart, Rik L. de

doi:10.1128/jcm.38.3.987-991.2000

Cited by 37 publications

(26 citation statements)

References 15 publications

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“…The laboratory diagnosis of measles was based on measurement of MV-specific serum immunoglobulin M (IgM) antibodies using two different assay systems [an in-house IgM capture enzyme-linked immunosorbent assay (ELISA) and a fluorescence-activated cell scanner (FACS)-measured immunofluorescence assay]. For patients with low MV-specific IgM responses, an MVspecific virus neutralization assay was performed and a reverse transcriptase-polymerase chain reaction test was carried out on throat swab samples to achieve a final diagnosis as described previously (El Mubarak et al 2000). All serum samples were also tested for IgM antibodies specific for a number of other infectious agents known to cause 'measles-like' clinical symptoms using commercially available assays.…”

Section: Methodsmentioning

confidence: 99%

“…We conducted a measles cohort study in which clinical and epidemiological data were collected from clinically diagnosed measles patients (De Swart et al 2001a). We previously reported the use of clinical specimens from this study to develop new methods for laboratory diagnosis on the basis of plasma and throat swab samples (El Mubarak et al 2000) or filter paper blood samples (De Swart et al 2001b). Here, we report the epidemiological and clinical characteristics of this cohort, as well as the acute and delayed impact of measles infection in children in a suburban community in Khartoum.…”

Section: Introductionmentioning

confidence: 99%

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Measles in suburban Khartoum: an epidemiological and clinical study

Ibrahim

Mustafa

Mukhtar

et al. 2002

Tropical Med Int Health

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SummaryClinical and epidemiological data were collected from 187 clinically diagnosed measles patients in Haj Yousif area, suburban Khartoum. Laboratory tests confirmed the diagnosis in 141 (75%) of the cases, but demonstrated that in 46 (25%) patients the clinical symptoms were not caused by an acute measles virus (MV) infection. According to their vaccination card, 59% of the laboratory-confirmed measles cases had been vaccinated for measles. Compared with non-measles rash disease cases, confirmed measles cases more often had severe illness (P < 0.0001), were dehydrated (P ¼ 0.01) at presentation and less likely to recover without complications [OR 0.19 (95% CI 0.09, 0.39)]. There was no difference in death rate (P ¼ 0.20). Underweight [weight-for-age Z score (WAZ) £ )2 SD] was an independent predictor of recovery with complications [OR 0.4 (95% CI 0.2, 0.99)]. Severe measles cases (those who developed diarrhoea, pneumonia, otitis media, encephalitis or haemorrhagic rash) had similar vaccination rates and time intervals since vaccination as uncomplicated measles cases. Although severe measles had lower WAZ-scores (P ¼ 0.004), none of the nutritional parameters studied were predictive of outcome. Mortality was higher in the severe measles group [OR 8.8 (95% CI 1.7, 85.2)]. In 11 of 141 confirmed measles cases serological evidence of a recent infection with another virus was found, most commonly varicella zoster virus and dengue virus; spotted fever and rubella were among the most frequent diagnoses in 17 of 47 cases of the non-measles cases.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Measles in suburban Khartoum: an epidemiological and clinical study

Ibrahim

Mustafa

Mukhtar

et al. 2002

Tropical Med Int Health

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“…The patients included in this study were sampled through a measles surveillance network that was set up in a suburban residential area (Haj Yousif) in Khartoum as described previously [El Mubarak et al, 2000;De Swart et al, 2001b]. From the end of the previous study surveillance was continued using filter paper samples only.…”

Section: Study Areamentioning

confidence: 99%

“…The RNA was eluted in 40 ml water, of which 10 ml was used in the RT-PCR assay. RT-PCR was carried out as described previously [El Mubarak et al, 2000], using the forward primer 5 0 -TTAGGG CAAGAGATGGTAAGG-3 0 (position 1090-1110), and reverse primer 5 0 -TTATAACAATGATG-GAGGG-3 0 (position 1633-1615). The amplified products were then visualised in ethidium bromide staining.…”

Section: Rt-pcr Sequencing and Phylogenetic Analysismentioning

confidence: 99%

Surveillance of measles in the Sudan using filter paper blood samples

Mubarak

Yüksel

Mustafa

et al. 2004

Journal of Medical Virology

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Dried blood spots collected on filter paper are considered potential clinical specimens for measles surveillance because of their ease of collection, storage, and transport. The usefulness of these samples for surveillance of measles was evaluated in a field setting. Blood spots were collected by finger-prick from 316 clinically diagnosed measles patients in suburban Khartoum, mostly within a week after onset of the rash. Samples were collected between October, 2000 and April, 2003, and stored at 4 degrees C. Measles virus-specific IgM antibodies were detected in 200 (63%) of the samples using an "in-house" IgM capture ELISA. For 201 samples reconstitution and IgM measurement was repeated 1 year after initial testing with essentially the same results, showing the stability of IgM in the filter paper under these conditions. In a limited number of samples (n = 38) measles virus-specific IgM was also tested with a commercial indirect IgM ELISA. Although the results of the two assays correlated well, the "in-house" IgM capture ELISA proved slightly more sensitive. Measles virus-specific reverse transcriptase polymerase chain reaction (RT-PCR) amplicons were obtained from 16 of 57 (28%) samples tested. Sequencing of the 3' 456 nucleotides of the nucleoprotein gene showed the continued endemic circulation of genotype B3 viruses identified previously in this region. Although problems related to limited sample quantities were encountered, the present study confirms the usefulness of dried blood spots for measles surveillance. The results also demonstrate that measles continues to be endemic in the Sudan.

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“…Plasma samples (n ¼ 169) were collected from Sudanese infants who complied with the WHO clinical case definition for measles, as previously described [El Mubarak et al, 2000;De Swart et al, 2001;Ibrahim et al, 2002]. Informed consent was obtained from the parents and the study was approved by the medical ethical committee of the University of Khartoum.…”

Section: Patients and Samplesmentioning

confidence: 99%

Measles virus protein‐specific IgM, IgA, and IgG subclass responses during the acute and convalescent phase of infection

Mubarak

Ibrahim

Vos

et al. 2003

Journal of Medical Virology

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The availability of new generation serological assays allowed re-evaluation of the antibody response to measles virus. IgM, IgA, total IgG, and IgG subclass responses were studied to the three major immunogenic measles virus proteins: the fusion protein (F), haemagglutinin (H), and nucleoprotein (N). Plasma samples were obtained from clinically diagnosed measles cases (n = 146) in Khartoum (Sudan) within a week after onset of the rash. Convalescent phase samples were collected from 32 of 117 laboratory-confirmed measles cases at different time points after onset of rash. Glycoprotein-specific IgM, IgG, and IgA antibody levels correlated well to the N-specific response. For IgG and IgA, responses to F were higher than to H. IgA antibody levels were undetectable in about one third of the laboratory-confirmed cases during the acute phase, but positive in all patients tested 1-4 weeks after infection. IgM levels declined rapidly and were lost 3-6 months after infection. IgA levels declined slowly during the first year but did not return to background levels during the subsequent 2 years. IgG avidity maturation was detected during a 3-6 month period after infection. The predominant IgG subclasses during the acute phase were IgG(1) and IgG(3). The latter was lost in the convalescent phase, while the IgG(4) isotype showed a slight rise afterwards. Interestingly, acute phase IgG(3) and IgA responses were associated, and were only detected in samples with high IgG. This study provides a comprehensive perspective on the antibody response to wild-type measles virus infection.

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Serological and Virological Characterization of Clinically Diagnosed Cases of Measles in Suburban Khartoum

Cited by 37 publications

References 15 publications

Measles in suburban Khartoum: an epidemiological and clinical study

Measles in suburban Khartoum: an epidemiological and clinical study

Surveillance of measles in the Sudan using filter paper blood samples

Measles virus protein‐specific IgM, IgA, and IgG subclass responses during the acute and convalescent phase of infection

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