Rapid diagnostic tests to address challenges for global measles surveillance

Abstract

Recently, a lateral flow rapid diagnostic test (RDT) with good accuracy has been described. This test enables measles specific IgM antibody detection in serum, capillary blood and oral fluid. RDTs have the potential to transform measles surveillance by allowing real-time case confirmation outside of central/regional laboratories and by facilitating a timely public health response. Measles virus genes can also be amplified and sequenced consistently from dried IgM-positive RDTs stored outside of cold chain, which will enable more complete virologic surveillance. Critical questions remain regarding operational use of RDTs as part of global measles surveillance. Projects to evaluate RDT use as part of national surveillance programs and to commercialize the RDT are underway.

Figure 1

Diversity of potential settings and implications for measles rapid diagnostic test (RDT) use.

Figure 2

Circulation of measles virus genotypes globally reported through virologic surveillance, 1970–2019. Figure shows year of first and last detection of measles wild-type virus genotypes. The first and last years of documented circulation reported to the MeaNS database (or GenBank before 2005) for all 24 measles virus genotypes are shown. First year detection determined from earliest reported reference strain and does not necessarily indicate first year of circulation. The four currently circulating genotypes (detected in 2019) are indicated in red (B3, D4, D8, H1). Measles vaccines were derived from genotype A which is not shown.