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Differentiating the wild from the attenuated during a measles outbreak.

Lindsay Nestibo¹, Bonita E Lee, Kevin Fonseca

¹Communicable Disease Control, Alberta Health Services;

Paediatrics & Child Health

|April 2, 2013

Summary

A child immunized against measles developed a rash and shed vaccine-type virus in urine. Nucleic acid testing helped differentiate this from wild measles strains during an outbreak.

Keywords:

Measles PCR Secondary transmission Vaccine

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Area of Science:

Virology
Immunology
Public Health

Background:

Measles outbreaks pose significant public health challenges.
Differentiating post-vaccination rashes from wild-type measles infections can be clinically difficult.
Immunization is a key strategy in measles control.

Observation:

A recently immunized child presented with a measles-type rash during a local measles outbreak.
The child was investigated for the cause of the rash.
Urine samples were collected for analysis.

Findings:

Nucleic acid testing confirmed the presence of a vaccine-type measles virus in the child's urine.
This indicates shedding of the attenuated measles virus strain.
Clinical presentation alone was insufficient for definitive diagnosis.

Implications:

This case highlights the importance of considering vaccine-type virus shedding in post-immunization rashes.
Nucleic acid testing is a valuable tool for distinguishing between wild and attenuated measles virus strains.
Accurate diagnosis is crucial for effective outbreak management and public health communication.