Analysis of measles epidemic regularity in Jilin Province from 2009 to 2022 / 中国生物制品学杂志

@#ObjectiveTo analyze the epidemiological regularity of measles in Jilin Province from 2009 to 2022,so as to provide evidence for measles prevention and control measures.MethodsThe representative strains of measles from 2009 to2022 in Jilin Province were sequenced,the dominant epidemic strains and their variation were analyzed by bioinformatics software Bioedit and Mega 11,and the morbidity,immunization history and age distribution of the confirmed cases were analyzed by descriptive epidemiological method.ResultsA total of 6 560 cases of measles were reported in Jilin Province from 2009 to 2022,of which 50. 17% and 27. 58% were cases with zero doses of measles vaccine and unknown immu-nization history,respectively. Children aged 0 ～ 23 months accounted for 47. 29% of the total number of cases,adult group aged ≥15 years accounted for 37. 41%. The reported incidence reached the elimination level of < 1 per million population in the last 3 years due to the impact of immunization strategies and COVID-19 pandemic. The dominant genotype of measles virus in Jilin Province was still H1a genotype. Molecular epidemiological analysis showed that two large transmission chains continued to be prevalent together,one of which was blocked in 2015.ConclusionFrom 2009 to 2022,the reported incidence of measles in Jilin Province showed a downward trend,and the age of the cases showed a "two-way shift" distribution,which was concentrated in the population with no immunization history and unknown immunization history. The basic vaccination rate should be increased continuously,the targeted enhanced immunization should be carried out,and the molecular epidemiological surveillance should be strengthened to block transmission chains in time.

Patients with type 2 diabetes mellitus and psoriasis re-infected with measles: one case report and literature analysis / 中国基层医药

Objective:To analyze the rash characteristics and diagnosis and treatment process of measles infection in patients with diabetes mellitus and psoriasis, to reduce the clinical diagnosis and treatment delay of such patients.Methods:The clinical data of a patient with diabetes combined with psoriasis and measles infection who was diagnosed and treated in The First Hospital of Yulin in April 2015 were analyzed.Results:The patient was admitted to hospital due to polydipsia and polyuria for 3 years and fever for 3 days. Hypoglycemic and anti-inflammatory treatment after admission was not good. On the third day after hospitalization, rash on the trunk and the extremities was seen. The patient had a history of measles infection. Based on clinical practice, Measles morbillivirus infection was not excluded, and Measles morbillivirus infection was confirmed by pathogen inspection. Measles reinfection was considered to be caused by variation of Measles morbillivirus. The atypical rash formed because of the patient's need for long-term treatment with Acitretin capsule and capotriol for psoriasis. After adjusting the antibiotic treatment, hypoglycemia and antiviral therapy were given, the body temperature was normal and the rash gradually subsided.Conclusion:For patients with type 2 diabetes mellitus and psoriasis, if they have a fever, they should be considered comprehensively to guard against re-infection caused by measles virus mutation. Timely etiological diagnosis is performed to avoid missed diagnosis and delayed treatment.

Effects of genomic location of foreign gene in measles virus vector on gene expression and virus replication / 中华微生物学和免疫学杂志

Objective:To investigate the effects of genomic location of a foreign gene in Shanghai-191 strain measles virus (MV) vector on gene expression and virus replication.Methods:The nucleotide sequence encoding S1 protein of SARS-CoV-2 was inserted at different positions in MV antigenome (the upstream of the N gene, between P and M genes, between H and L genes), and co-transfected into 293T cells with helper plasmids coding T7 RNA polymerase and N, P, and L proteins, respectively. The transfected cells were lysed and the supernatants were used to infected Vero cells to harvest recombinant viruses. S1 proteins expressed by the recombinant viruses were identified by RT-PCR, indirect immunofluorescence assay, Western blot and ELISA. Growth kinetics of the recombinant viruses were analyzed.Results:Recombinant viruses were failed to be rescued when the S1 protein-coding sequence was cloned into the upstream of N gene. Two recombinant viruses, MV-M-S1 and MV-L-S1, were successfully rescued when cloning the S1 protein-coding sequence into the intergenic region between P and M genes, or H and L genes, and could express S1 protein. MV-M-S1 expressed more S1 protein than MV-L-S1, but the titer of MV-M-S1 was lower.Conclusions:Inserting a foreign gene at different positions in the MV genome might have different effects on gene expression and virus replication. This study provided reference for the subsequent construction of MV vector.

Two cases of measles after vaccination with measles mumps and rubella combined live attenuated vaccine / 上海预防医学

Measles is an acute respiratory infectious disease caused by the measles virus. It is highly infectious and easy to occur in children. It causes many serious complications such as tracheitis， otitis media and pneumonia. Since the promotion of the measles vaccine in China， the measles epidemic has been effectively controlled. From June 1， 2020， the immunization procedure of measles-containing vaccine for children in Shanghai has been adjusted to one dose of measles， mumps and rubella combined live attenuated vaccine （MMR） at the age of 8 months， 18 months and 6 years. There is generally no local reaction after the injection of the MMR vaccine. A few individuals may have transient fever and scattered rash， which generally fade away by themselves. However， because it is a live vaccine， it may cause vaccine related diseases in extremely rare cases. This paper reports two cases of measles after vaccination with the MMR vaccine.

Genetic characteristics analysis of the hemagglutinin gene of measles virus in Shanghai， 2001‒2018 / 上海预防医学

ObjectiveTo analyze the genetic characteristics of the hemagglutinin （H） gene of measles virus （MeV） in Shanghai， 2001‒2018. MethodsNasopharyngeal swab specimens were collected from suspected measles cases reported in Shanghai from 2001 to 2018， and the isolation of measles virus was conducted with Vero/hSLAM cell line. RT-PCR amplification and sequencing were conducted after RNA extraction to analyze the genetic characteristics of the complete H gene. ResultsIn total， 5 665 nasopharyngeal swab samples were collected by suspected measles case surveillance from 2001 to 2018， and 1 394 measles virus strains were isolated. The homology of nucleotide acid and amino acid among 349 representative measles virus isolates was 87.4%‒100.0% and 85.1%‒100.0%， respectively. The homology of nucleotide acid and amino acid between representative measles virus isolates and China vaccine strain （S191） was 85.7%‒100.0% and 84.1%‒100.0%， respectively. All the sub-genotype H1a MeV isolates had an amino acid substitution （Ser240Asn）， which removed a predicted N-linked glycosylation site. ConclusionMost of the MeV isolates are sub-genotype H1a analyzed based on H gene， which are identical to those of the N gene. The predicted amino acid sequences of the H protein are relatively conserved at most of the functionally significant amino acid positions.

Molecular epidemiological analysis of measles virus in Beijing from 2015 to 2019 / 中华微生物学和免疫学杂志

Objective:To analyze the molecular epidemiological characteristics of measles virus (MV) in Beijing from 2015 to 2019, and to provide laboratory basis for measles elimination.Methods:Measles virus-positive throat swab samples were collected through the Beijing Measles Laboratory network from 2015 to 2019. After the viral nucleic acid was extracted, 450 nucleotide fragments of the C terminal of the N gene of MV were amplified by RT-PCR. Nucleotide sequencing was performed for the amplified products. The phylogenetic tree was constructed with the representative strains of WHO measles virus genotype D8 genotype reference strains in China and other countries. Genotype identification was conducted and the nucleotide and amino acid homology analysis was carried out. A descriptive analysis of measles cases with D8 and B3 genotypes was conducted.Results:From 2015 to 2019, the genotypes of 546 MV were identified in the city, including 531 of H1a genotype, five vaccine strains, one of B3 genotype, and nine of D8 genotype, among which eight were epidemic strains in 2019. The homology of indigenous H1a genotype MV nucleotide and amino acid was 91.5%-100.0% and 73.6%-100.0%.In 2019, all eight cases of D8 genotype measles were adults, with two being an outbreak and the remaining six sporadic cases.Conclusions:The imported D8 genotype had become the main MV genotype in Beijing in 2019. With the decrease of measles incidence in 2019, native genotype H1a was no longer dominant, while other different genotypes were imported, forming a mixed epidemic trend. It was suggested that in the elimination of measles in Beijing, efforts should be made not only to block the transmission of local measles virus, but also to prevent and control the import and continuous transmission of non-local genotype virus, so as to avoid the risk of establishing local transmission by gradually evolving into a dominant strain.

Detection of measles virus infection and proliferation by real-time quantitative PCR / 上海预防医学

Objective A SYBR-Green real-time quantitative PCR(RT-qPCR)method was set up to detect the infection and proliferation of measles virus, which could be useful in virus titer determination. Methods In this project, we used a 405 bp fragment of the N gene of measles virus as a target sequence and constructed a plasmid to establish the standard curve in absolute quantitative experiment. We then used this method to obtain the proliferation curve of measles virus and to detect the virus proliferation at different MOI. Results There was a linear relationship between the virus copy number and the titer of the measles virus reference at the range of 6 to 2 lgCCID50/mL, with a correlation coefficient (r) of 0.991(P < 0.01). Based on the analysis of virus proliferation curve, measles virus mainly proliferated intracellularly within 48 h after its entering the cell. There was no detected increase in viral RNA level in the first 24 h, suggesting the virus was in a silent period in the cell. After 24 h, the virus expanded in large numbers and entered the exponential growth phase. The intracellular viral RNA level reached the plateau phase after its peak at 96 h. The virus secreted to the outside of the cell entered the exponential growth phase starting from 48 h, peaked at 144 h, then followed by plateau phase. Conclusion A SYBR-Green RT-qPCR method is established and used to monitor virus proliferation. Our result is helpful in understanding of the proliferation and secretion of measles virus in cells and provides experimental basis for detection of live attenuated virus titers.

Synergistic Effect of NF-κB Signaling Pathway Inhibitor and Oncolytic Measles Virus Vaccine Strain against Lung Cancer and Underlying Mechanisms / 中国肺癌杂志

BACKGROUND@#Lung cancer is one of the leading causes of cancer-related morbidity and mortality. Oncolytic virotherapy is an emerging therapeutic modality that utilizes replication-competent viruses to destroy cancers. As a powerful tool to kill tumor cells with excellent safety profile, attenuated measles virus of the Edmonston strain (MV-Edm) has been widely applied in the development of tumor therapy and preclinical trials. The aim of this study was to investigate the synergistic effect of nuclear factor kappa B (NF-κB) signaling pathway inhibitor and oncolytic measles virus vaccine against lung cancer and the involved mechanisms.@*METHODS@#Using Western blot to detect MV-Edm infection of A549 and H1299 were infected by MV-Edm alone or used the NF-κB pathway inhibitor PS1145/cell autophagy related siRNA, expression level of p-IκBα, IκBα, PARP and BAX were determined by western blot. Using flow cytometry to analysis the rate of apoptosis, and using MTT [3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide] method to detect the cell survival rate.@*RESULTS@#Inhibition of cell autophagy could obviously inhibit the MV-Edm infection induced the NF-κB pathway activation in A549 and H1299. In MV-Edm infected A549 and H1299, p-IκBα level increased and IκBα level decreased over infection time, compared with control group. Inhibition of the NF-κB pathway by PS1145 could promote the apoptosis of MV-Edm infected A549 and H1299 and amplify the tumor killing effect.@*CONCLUSIONS@#The combination of NF-κB signaling pathway inhibitor pS1145 and oncolytic measles virus vaccine strains can promote the apoptosis of human lung cancer cells A549 and H1299 and enhance their oncolytic effect.

Subacute sclerosing panencephalitis: case based review

Subacute sclerosing panencephalitis (SSPE) is a chronic debilitating condition that occurs in children affected with measles. SSPE is broadly distinguished as typical SSPE, the more rampant form, occurring over a period of years following primary measles infection, while the atypical has a more rapidly progressive course over weeks to months. SSPE can present with cognitive, epileptic, autonomic, pyramidal and ophthalmologic manifestations with scholastic decline being the primary feature. The management of SSPE focuses on improvement of quality of life and prolongation of survival which can be achieved with the use of supportive care modalities and immunomodulators respectively. This is a comprehensive review which discusses several parameters of SSPE such as epidemiology, pathophysiology, clinical presentations, and detailed management protocol for this condition. As part of this review, we also discuss a case of rapidly progressive, fulminant and atypical SSPE in a five-year-old male presenting clinically with myoclonic jerks of lower extremities.

Epidemiología molecular del virus del sarampión en la región de las Américas: Panorama actual / Molecular Epidemiology Of The Measles Virus In The Region Of The Americas: Current Overview

Tras su erradicación en la región de las Américas en el 2016, ha reemergido y el número de casos va en progresivo aumento. Objetivo: Profundizar y actualizar los aspectos más importantes de la epidermiología molecular del virus sarampión en las Américas. Métodos: La búsqueda y análisis de la información se realizó en un periodo de cinco meses (primero de noviembre de 2019 al 31 de marzo de 2020) para lo cual se emplearon las siguientes palabras: measles, epidemiology molecular, América,outbreak, genotype, epidemic, en las bases de datos PubMed, Hinari, SciELO y Medline. Así mismo, se tomaron en cuenta los informes epidemiológicos de la Organización Panamericana De La Salud (OPS)y entidades gubernamentales de distintos países de América. Resultados: Dos linajes del genotipo D8están diseminándose ampliamente en la región de las Américas. Y aunque aún no podemos conocer el impacto de la actual pandemia producida por el SARS-CoV-2, la baja tasa de inmunización, los elevados movimientos migratorios antes del 2020, factores socioculturales y religiosos sumados a la crisis socia y política que afectan a algunos países de la región, están contribuyendo a que este problema sea creciente. Conclusión: La revisión brinda el conocimiento de la epidemiología molecular del virus. Su empleo y correcta interpretación permitirá establecer un adecuado manejo y medidas de contención con el fin de recuperar la condición de enfermedad erradicada en las Américas.

Introduction: Measles is one of the most contagious diseases that affect humans. After its eradicationin the Americas region in 2016, it has reemerged and the number of cases is progressively increasing..Objective: To deepen and update the most important aspects of the measles virus molecularepidermiology in the Americas. Methods: The search and analysis of the information was carriedout over a period of five months (November 1, 2019 to March 31, 2020) for which the following wordswere used: measles, molecular epidemiology, America, outbreak, genotype, epidemic, in the PubMed,Hinari, SciELO and Medline databases Likewise, the epidemiological reports of the Pan American HealthOrganization (PAHO) and government entities from different countries of America were taken intoaccount. Results: Two lineages of the D8 genotype are spreading widely in the Americas region. Andalthough we still cannot know the impact of the current pandemic produced by the SARS-CoV-2, thelow immunization rate, the high migratory movements before 2020, socio-cultural and religious factorsadded to the social and political crisis that affect to some countries in the region, they are helping toincrease this problem. Conclusion: The review provides knowledge of the molecular epidemiologyof the virus. Its use and correct interpretation will allow establishing adequate management andcontainment measures in order to recover the eradicated disease condition in the Americas.

Measles virus phosphoprotein inhibits apoptosis and enhances clonogenic and migratory properties in HeLa cells

Measles virus is the causative agent of measles, a major cause of child mortality in developing countries. Two majorproteins, coded by the viral genome, are nucleocapsid protein (N) and phosphoprotein (P). The N protein protects the viralgenomic RNA and forms ribonucleoprotein complex (RNP) together with P protein. MeV-P protein recruits the largeprotein (L), i.e. viral RNA-depended RNA polymerase (RdRp), to ensure viral replication in host cell. Apoptogenicproperties of N protein of Edmonston vaccine strain have been established in our lab previously. We investigated the role ofMeV-P protein of Edmonston vaccine strain as modulator of apoptosis in cervical cancer cell line (HeLa) and found thatMeV-P protein is anti-apoptotic and enhances cell proliferation. Measles virus is considered to be innately oncotropic virus.However, the anti-apoptotic property of MeV-P protein raises important concerns while adopting this virus as an anti-cancertherapeutic tool.

The first outbreak of measles virus caused by imported genotype D8 in Jiangsu province of China

ABSTRACT Here we reported the outbreak of measles cases caused by the genotype D8 measles virus for the first time in Jiangsu province in China, which was possibly imported by a foreign student from Laos. Throat swab specimens were collected, and used to isolate virus. 634-bp fragment of the N gene and 1854-bp fragment of H gene were amplified by reverse transcription-PCR and sequenced, respectively. Phylogenetic results indicated that they belonged to genotype D8 measles virus. Further epidemiology investigation showed that the adults with D8 measles virus infection did not receive measles vaccine before having measles. In China, almost all D8 genotype MeV only infected those population without receiving measles vaccine immunization. Therefore, it is still necessary to implement the supplement activity of measles immunization target adult with immunity gap.

Molecular characterisation of the emerging measles virus from Roraima state, Brazil, 2018

Measles is a human infectious disease of global concern that is caused by the measles virus. In this study, we report the complete genome sequencing of one measles virus isolate, genotype D8, that was obtained directly from a urine sample in Boa Vista city, the capital of Roraima state in Brazil. Phylogenetic reconstruction grouped the genome described in this study with that of samples from Australia, South Korea, and Italy. To our knowledge, this is the first complete genome sequence of a wild-type measles virus reported from Latin America. Therefore, the present data strengthen the current knowledge on the molecular epidemiology of measles worldwide.

Genetic characteristics of nucleoprotein of the epidemic measles virus in Xi’an, 2013-2017 / 中华实验和临床病毒学杂志

Objective@#To know the genetic characteristics of nucleoprotein(N)of wild type measles virus in Xi’an, 2013-2017.@*Methods@#We used the pharyngeal swab specimens of suspected measles cases which were tested positive for measles virus (MV) nucleic acid by Real-time RT-PCR to isolate MV strains with Vero-SLAM cells, extracted RNA of the strains, amplified the N genes of MV strains and the pharyngeal swab specimens which had lower Ct values by One-Step RT-PCR, and analyzed the result after sequencing.@*Results@#Thirty carboxyl terminal sequences of the N genes of MV endemic strains were obtained and identified as genotype H1a. The nucleotide and amino acid homology among the epidemic strains were 97.3%-100% and 96.7%-100%, among the epidemic strains and S191 were 91.3%-92.2% and 87.3%-90.0%, while among the epidemic strains and C47 were 92.2%-92.7% and 88.0%-90.7%. The nucleotide homology among the epidemic strains and wild strains of same period in Anhui, Gansu, Shandong, Henan, Jilin were higher than that in Shanxi, Sichuan, Hunan and Guangdong. The most different amino acid sites among the epidemic strains and the two vaccine strains which had high level of entropy were 422, 457 and 497, secondly 467, thirdly 500. The mutations at the 467 site only existed in 2017. dN/dS=0.199 and no positive selection site was found.@*Conclusions@#The dominant genotype of the epidemic MV strains in Xi’an was H1a in 2013-2017, the genetic diversity of viruses decreased in 2016-2017. We should strengthen the surveillance of etiology of MV to provide evidence for elimination of measles.

Analysis on the hemagglutinin genetic characteristic of 7 measles virus isolated in Henan Province in 2017 / 中华预防医学杂志

Objective@#Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017.@*Methods@#Swab samples collected from 7 lab confirmed measles cases, and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT-PCR), then the PCR products were sequenced and analyzed.@*Results@#The age of the 7 measles confirmed cases were between 1 and 50 years old, and all of them were males. All the 7 measles viruses were identified as H1a genotype, and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai-191/China-vaccine, there were some changes in isolated virus, such as 240th, 397th and 381st sites in the amino acid sequence.@*Conclusion@#The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai-191/China-vaccine in the nucleotides sequence of H gene, which suggested that it′s necessary to strengthen the monitor the variation of measles virus.

Isolation and identification of the first D8 genotype measles virus in Liaoning province / 中华实验和临床病毒学杂志

Objective@#To analyze the gene characterization on the first imported D8 genotype measles virus in Liaoning province.@*Methods@#In this study, Vero/Slam cells were used to isolate measles viruses from throat swabs. Fragments of the H gene (1854 nucleotides) and N gene (450 nucleotides) were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were sequenced and analyzed.@*Results@#The measles virus isolates and World Health Organization (WHO) D8 genotype reference strain (MVi/Manchester.GBR/30.94) belonged to the same branch in the genetic relationship tree. The nucleotide homology of the N and H gene was 98.9%. Phylogenetic trees were constructed with reference strains of the genotype D8 measles virus of China downloaded from GenBank. The result showed that the nucleotide similarities between the measles virus isolated in this study and the D8 genotype measles virus prevalent in Hong Kong from 2012 to 2016 and MVi/LosPatios.COL/11.18/D8 in Columbia was 100%.@*Conclusions@#It is the first time to do surveillance for the D8 genotype measles virus since measles virus surveillance was carried out. It was of great significance to accumulate the bases of measles virus molecular epidemiology in Liaoning province, and helpful to analyze and trace the transmission of measles virus in the whole country and the world.

Role of CD46 and Nectin-4 on Measles virus (MV) infecting human pulmonary alveolar epithelial cells / 中国免疫学杂志

Objective:To investigate the role of CD46 and Nectin-4 on Measles virus (MV) infecting human pulmonary alveolar epithelial cells (HPAEpiC),and the interaction between CD46 and Nectin-4.Methods: Measles virus was divided into pre-infection group and 2 h-infection group,HPAEpiCs treatment with anti-CD46 antibody and/or anti-Nectin-4 antibody as experimental groups,and untreated HPAEpiCs as a control.The variation of viral replication level was detected.A Co-immunoprecipitation assay (Co-IP) was used to explore whether CD46 and Nectin-4 had interactive relationship in MV infection.Results: Compared with the control group,MV titers were reduced in HPAEpiCs of the pre-infection group treated with anti-CD46 and anti-Nectin-4 respectively (48.03% and 49.53%).Furthermore,virus titers showed a more reduction in which treated with anti-CD46 and anti-Nectin-4 antibodies (27.15%,P<0.01).Western blot and Real-time PCR showed that anti-CD46 antibody and anti-Nectin-4 antibodies decreased the rate of MV infection.In the 2 h-infection group,however,the treatment with anti-CD46 and anti-Nectin-4 could significantly reduce the MV titer and NP protein in HPAEpiCs.The Co-IP assay showed that there were interaction between CD46 and Nectin-4.Conclusion: CD46 and Nectin-4 mediated MV infecting HPAEpiCs.Moreover,CD46 and Nectin-4 may play a synergetic role in MV infection,which could enhance the infection effect.

Molecular genotyping of measles viruses in Yancheng area in 2016 and analysis of the genetic characterization of hemagglutinin genes / 中华实验和临床病毒学杂志

Objective@#To analyze the genotypes and the genetic evolution of the hemagglutinin genes of measles viruses in the city of Yancheng in 2016.@*Methods@#Using a set of primers and probes for screening positive for measles viruses, specimens of throat swab were detected using the method of real time RT-PCR. The sequences of the nucleoprotein and hemagglutinin genes of measles viruses were amplified through one step RT-PCR method and the PCR products were sequenced. The sequences of nucleotide and amino acid of the nucleoprotein and hemagglutinin genes of measles viruses were analyzed and the evolutional trees were generated using bioinformatics software.@*Results@#The genotypes of measles viruses in the Yancheng area in 2016 included subgenotype H1a and genotype D8. Phylogenetic trees analysis showed that the five representative strains of subgenotype H1a in Yancheng area and Jiangxi representative strain (KJ136545) clustered into independent evolutionary branches, belonged to the clade of H1a -1 evolutionary genes. The seven representative strains of genotype D8 in Yancheng area were clustered with the American representative strain in 2009 (JN635404), belonged to the D8-3-2 small clade genes. Compared with vaccine strain of Shanghai S191, the amino acid site in 240thof the five representative strains of subgenotype H1a in Yancheng area mutated from serine to asparagine, leading to a loss of the N-glycosylation site NLS238-240. The seven representative strains of genotype D8 in Yancheng area had no change in N-glycosylation.@*Conclusions@#In 2016, the prevalent strains of measles viruses in Yancheng area were mainly Chinese H1a dominant subgenotype and D8 imported genotype. In addition to a loss of the N-glycosylation site NLS238-240in 240thof the five representative strains of subgenotype H1a, most of the major neutralizing antigen sites of hemagglutinin gene of measles viruses in Yancheng area did not mutate. The Chinese vaccine of Shanghai S191 can effectively prevent infection caused by subgenotype H1a and subgenotype D8 strains.

Viral co-infections among children with confirmed measles at hospitals in Hanoi, Vietnam, 2014

Objective To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak. Methods Throat swabs were collected from 54 pediatric patients with confirmed measles, and molecular diagnostics performed for 10 additional viral respiratory pathogens (Influenza A/H1N1pdm09; A/H3N2 and influenza B; Parainfluenza 1, 2, 3; Respiratory Synctial Virus, RSV; human Metapneumovirus, hMPV; Adenovirus and Picornavirus). Results Twenty-one cases (38.9%) showed evidence of infection with other respiratory viruses: 15 samples contained measles plus one additional virus, and 6 samples contained measles plus 2 additional viruses. Adenovirus was detected as a predominant cause of co-infections (13 cases; 24.1%), followed by RSV (6 cases; 11.1%), A/H1N1pdm09 (3 cases; 5.6%), PIV3 (3 cases; 3.7%), Rhinovirus (3 cases; 3.7%) and hMPV (1 case; 1.96%). Conclusions Viral co-infections identified from pediatric measles cases may have contributed to increased disease severity and high rate of fatal outcomes. Optimal treatment of measles cases may require control of multiple viral respiratory pathogens.

Viral co-infections among children with confirmed measles at hospitals in Hanoi, Vietnam, 2014

OBJECTIVE@#To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak.@*METHODS@#Throat swabs were collected from 54 pediatric patients with confirmed measles, and molecular diagnostics performed for 10 additional viral respiratory pathogens (Influenza A/H1N1pdm09; A/H3N2 and influenza B; Parainfluenza 1, 2, 3; Respiratory Synctial Virus, RSV; human Metapneumovirus, hMPV; Adenovirus and Picornavirus).@*RESULTS@#Twenty-one cases (38.9%) showed evidence of infection with other respiratory viruses: 15 samples contained measles plus one additional virus, and 6 samples contained measles plus 2 additional viruses. Adenovirus was detected as a predominant cause of co-infections (13 cases; 24.1%), followed by RSV (6 cases; 11.1%), A/H1N1pdm09 (3 cases; 5.6%), PIV3 (3 cases; 3.7%), Rhinovirus (3 cases; 3.7%) and hMPV (1 case; 1.96%).@*CONCLUSIONS@#Viral co-infections identified from pediatric measles cases may have contributed to increased disease severity and high rate of fatal outcomes. Optimal treatment of measles cases may require control of multiple viral respiratory pathogens.