The challenges and strategies for laboratory diagnosis of measles in an international setting

Serum-based measles-specific IgM EIAs are the recommended laboratory assays for diagnosis of acute measles infections and appear to be sufficient for measles control programs. However, serum samples are not ideal for molecular characterization of measles virus. Although neither laboratory nor field-based diagnostic tests that rival the EIAs have been developed, laboratory surveillance could be improved if specimen collection were simplified. Ideally the collection method should be noninvasive, have no requirement for a cold chain, and/or have no requirement for technically sophisticated equipment. Two alternative specimen collection technologies appear promising and can be used for both diagnostics and for collecting pertinent genotyping information: oral fluid and filter paper collection methods. These methods are compared along with their respective utilities in supporting measles diagnosis and strain surveillance.