Background:Measles is a highly contagious illness.Sri Lanka(SL)has eliminated the measles in 2019.The coun-try is at risk of importation of measles and there could be vaccine-associated measles like illnesses.Therefor...Background:Measles is a highly contagious illness.Sri Lanka(SL)has eliminated the measles in 2019.The coun-try is at risk of importation of measles and there could be vaccine-associated measles like illnesses.Therefore,it is important to investigate patients with fever,rash to differentiate the wild-type from vaccine-type exclud-ing other suspected pathogens to direct infection prevention and control strategies.The objective is to describe the laboratory investigation procedure in an immunocompetent child,developed fever,rash following measles containing vaccine in post-measles eliminated period,SL.Methods:This laboratory based investigation was carried out in National Measles Laboratory,SL.Blood and throat swab were received from a patient with fever,rash,cough and coryza developed at tenth day of receiving the measles containing live-attenuated vaccine.Samples were tested for measles,rubella,and other relevant pathogens according to the laboratory testing algorithm for an immunocompetent child with fever,rash and flu like symptoms.Results:Measles vaccine type A,Edmonston-strain virus was detected after sequencing in throat swab and measles IgM and IgG were positive at sixth-week of illness-onset.In addition,influenza A RNA was detected in throat swab at day-three with detectable parvoB19 IgM in blood sample received at sixth-week of post-onset symptoms.Conclusions:Measles like illness of this immunocompetent child who received measles containing vaccine could be due to measles vaccine-type A or influenza infection.In a measles eliminated,resource-limited setting in SL,there should be a well-defined,testing algorithm to exclude prevalent possible pathogens according to epidemiological and clinical information.展开更多
文摘Background:Measles is a highly contagious illness.Sri Lanka(SL)has eliminated the measles in 2019.The coun-try is at risk of importation of measles and there could be vaccine-associated measles like illnesses.Therefore,it is important to investigate patients with fever,rash to differentiate the wild-type from vaccine-type exclud-ing other suspected pathogens to direct infection prevention and control strategies.The objective is to describe the laboratory investigation procedure in an immunocompetent child,developed fever,rash following measles containing vaccine in post-measles eliminated period,SL.Methods:This laboratory based investigation was carried out in National Measles Laboratory,SL.Blood and throat swab were received from a patient with fever,rash,cough and coryza developed at tenth day of receiving the measles containing live-attenuated vaccine.Samples were tested for measles,rubella,and other relevant pathogens according to the laboratory testing algorithm for an immunocompetent child with fever,rash and flu like symptoms.Results:Measles vaccine type A,Edmonston-strain virus was detected after sequencing in throat swab and measles IgM and IgG were positive at sixth-week of illness-onset.In addition,influenza A RNA was detected in throat swab at day-three with detectable parvoB19 IgM in blood sample received at sixth-week of post-onset symptoms.Conclusions:Measles like illness of this immunocompetent child who received measles containing vaccine could be due to measles vaccine-type A or influenza infection.In a measles eliminated,resource-limited setting in SL,there should be a well-defined,testing algorithm to exclude prevalent possible pathogens according to epidemiological and clinical information.
