Category: Measles outbreak

In jurisdictions where measles is uncommon, a measles-like rash may be mistaken for other viral agents such as adenovirus, enterovirus or parvovirus B19. The successful genotyping and identification of the measles virus as a vaccine strain in the present child serves to remind clinicians of potential signs and symptoms following the administration of live attenuated viral vaccines . In the immediate postimmunization time period, testing patients for the specific viral agents in the attenuated vaccine by molecular assays needs to be accompanied by characterization of the detected virus because it is expected that the serological tests will be positive and not indicative of acute wild-type infection. In true wild-type measles infection, measles IgM may be negative during the first few days of the rash and in susceptible individuals with waning immunity – an observation also reported in mumps cases. Testing for measles should only be considered in specific circumstances for which there is a possible exposure history to wild-type virus. This could include travel to an endemic area and/or exposure to a confirmed case of disease. …Read the rest of this article

measles outbreak (part 4)

Discussion
The MMR vaccine contains live attenuated measles virus. It is estimated that administration of this vaccine is associated with moderate (39.4°C) fever in as many as 5% of recipients, and a rash in approximately 2% of those receiving immunization. These events typically occur approximately five to 12 days following immunization and often resolve without medical intervention. These systemic effects are likely caused by replication of the attenuated strains and host immune reaction. It has been shown that following the immunization of healthy children, the measles virus can be detected in urine as early as one day and as late as 14 days. Similarly, during acute infection by wild-type measles, the virus could be detected by RT-PCR for up to 14 days in >50% of healthy children and up to one month in >90% of HIV-infected children. …Read the rest of this article

measles outbreak (part 3)

Clinical specimens were collected and submitted for laboratory testing, which included a throat swab for Streptococcus pyogenes (group A streptococcus), a serum sample for measles immunoglobulin (Ig) M and IgG antibodies (Enzygnost Anti-Measles Virus IgM and IgG ELIZA, Siemens Healthcare Diagnostics, Germany), a urine sample and an NP swab for a measles reverse transcription polymerase chain reaction (RT-PCR) test at the Provincial Laboratory for Public Health (ProvLab) in Alberta. The child’s serum tested positive for both measles IgM and IgG antibodies. …Read the rest of this article

measles outbreak (part 2)

CASE PRESENTATION
In the spring of 2010, there was heightened awareness of measles infection in the physician community as a result of a public health notification related to several imported measles cases in Alberta. During this period, a 15-month-old child presented to his paediatrician’s office with irritability, a fever (38.8°C), a cough and conjunctivitis. The child had a five-day history of illness that began with an elevated temperature and a raised, sandpaper-like rash that originated at the occiput, and eventually spread to and covered the torso. There was mild cervical lymphadenopathy, and no rhinitis or Koplik spots. The child was not immunocompromised and had no significant medical history. …Read the rest of this article

 measles outbreak (part 1)

In the spring of 2010, several imported cases of measles were reported within the province of Alberta (population of 3.5 million in 2009). Most cases of measles in Alberta, like the rest of Canada and the Americas, are linked to an imported illness or exposure during travel. Given the infrequent occurrence of measles in Alberta, and the high potential for transmission, an advisory was issued notifying all physicians to be on high alert for patients exhibiting symptoms consistent with measles infection. …Read the rest of this article