DETECTION OF MEASLES-VIRUS FROM CLINICAL-SAMPLES USING THE POLYMERASE CHAIN-REACTION

Objective: To evaluate the usefulness of the polymerase chain reaction to detect the measles virus sequence using clinical samples. Design: Centers for Disease Control and Prevention case definition of measles with or without IgM serology as a standard. Setting: A laboratory in the Department of Pediatrics of the Hokkaido University Hospital, Sapporo, Japan. Patients: Thirty-two serum samples, 16 throat swab samples, and nine cerebrospinal fluid samples from 32 patients with measles, including four patients with central nervous system involvement, and one serum sample and two throat swab samples from two patients with modified courses of measles were obtained. Ten serum samples, 10 throat swab samples, and 10 cerebrospinal fluid samples were obtained from patients without apparent measles infection as negative controls. Measurements and Main Results: Sensitivity an specificity were comparable with those as obtained by culture or other methods reported in the literature. The polymerase chain reaction was positive in 24 (75.0%) of 32 by serum samples and in 13 (81.3%) of 16 by throat swab samples from the patients with measles, in contrast to none within the negative control group. In three of the four patients with central nervous system involvement, the measles virus sequence was detected in cerebrospinal fluid samples obtained within 1 day following the onset of the manifestations. All three samples from the patients with modified measles yielded positive results. Conclusions: The polymerase chain reaction can be used with sufficient sensitivity and specificity to detect the measles virus sequence using clinical samples. Transient and direct invasion of the central nervous system by this virus at the initial stage of the central nervous system involvement was strongly suggested.