Chapter 3. Clinical specimens for the laboratory diagnosis and molecular epidemiology of measles, rubella, and CRS

Mick Mulders


This chapter provides the best practices for collection of appropriate specimens for diagnostic and molecular investigations to support surveillance for measles and rubella. Protocols that include specific instructions for collection of adequate specimens for measles and rubella confirmation and molecular surveillance should be available in regional surveillance guidelines or field guides. These protocols should be updated and reviewed with input from both laboratory and epidemiological staff at appropriate intervals. However, when suspected cases occur, ongoing communication between the laboratory and field staff is essential to ensure that adequate specimens are provided to meet the requirements for case ascertainment and genetic characterization of outbreaks as every situation is different and alternative options may need to be adopted and implemented.

The full integration of surveillance for measles and rubella has been recommended for all Regions in the GMRLN. The investigation of suspected cases of measles or rubella should include adequate and appropriate sample collection for case classification and the genetic characterization of the virus. Ideally, samples for molecular testing from suspected cases of measles or rubella should be collected simultaneously with serologic specimens for antibody testing. Where feasible, the combination of IgM detection and RT-PCR to detect virus-specific RNA can enhance the ability to rapidly confirm suspected cases of measles or rubella.