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Modified adult measles in outbreaks in Japan, 2007-2008

Makoto Nagai1, Ji Yi Xin, Naoko Yoshida

  • 1Department of Pediatrics, Tokyo Medical College, Tokyo, Japan.

Journal of Medical Virology
|April 22, 2009
PubMed

Insights

Molecular studies reveal new measles virus genotypes circulating in Japan, with a D5 genotype outbreak in 2007-2008 potentially introduced from Southeast Asia. Enhanced surveillance is recommended.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Measles virus genotypes in Japan have evolved, with C1, D3, D5, and H1 observed in distinct outbreaks since 1984.
  • A significant measles outbreak occurred in Japan in 2007-2008, primarily affecting adolescents and young adults.
  • Previous D5 genotype strains circulated in Japan between 1990-2005.

Purpose of the Study:

  • To molecularly characterize measles virus strains involved in the 2007-2008 Japanese outbreak.
  • To investigate the origin and genetic relatedness of the circulating D5 genotype strains.
  • To assess the effectiveness of diagnostic methods for detecting measles virus.

Main Methods:

  • Molecular analysis of measles virus strains isolated from clinical samples.
  • Detection of measles virus genome using reverse transcription loop-mediated isothermal amplification (RT-LAMP) and reverse transcription polymerase chain reaction (RT-PCR).
  • Genotyping and phylogenetic analysis of isolated measles virus strains.

Main Results:

  • The 2007-2008 outbreak involved measles virus genotype D5 (MVi/Bangkok.THA/93 type), distinct from the previously isolated D5 sub-cluster (MVi/Palau.BLA/93 type).
  • RT-LAMP detected the measles genome in 12 out of 18 samples, showing higher sensitivity than RT-PCR (9/18 samples).
  • Genetically similar D5 strains were found in Southeast Asia, suggesting introduction into Japan via this region.
  • A D9 genotype strain was isolated from a sporadic case in 2006.
  • Both D5 and D9 strains exhibited no antigenic differences compared to the vaccine strain.

Conclusions:

  • The 2007-2008 measles outbreak in Japan was caused by a D5 genotype strain likely introduced from Southeast Asia.
  • RT-LAMP is a sensitive method for detecting measles virus, even in mild infections.
  • Establishing a systematic laboratory-based surveillance system is crucial for effective measles virus infection monitoring in Japan.

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