Document Detail

Surveillance of measles in England and Wales: implications of a national saliva testing programme.
MedLine Citation:
PMID:  9509623     Owner:  NLM     Status:  MEDLINE    
The impact of a mass vaccination campaign against measles-rubella in England and Wales was assessed using the results of a saliva test for measles-specific IgM, which was offered to all notified cases of measles. By means of clinical data supplied by the reporting doctors, we estimated the sensitivity and specificity of various clinical case definitions in predicting a confirmed case. A saliva sample was obtained within the appropriate time period for 3442/7574 (45.4%) of notified cases; the proportion confirmed by saliva testing was low and fell from 67/681 (9.8%) at the start of the campaign to 1/373 (0.3%) after 35 weeks. The specificity of all clinical case definitions was low, but was highest at 41.1% (95% confidence interval, 39.2-43.0%) for the definition similar to that recommended in the USA. Extrapolating from cases observed during ongoing surveillance permits estimation of an annual notification rate for nonmeasles rash and fever illness. For countries with good measles control, a clinical case definition is too nonspecific for accurate surveillance. Laboratory confirmation of suspected measles cases is required and saliva testing is an acceptable method. The continued sensitivity of measles surveillance in England and Wales requires that the incidence of notified rash and fever illness and the proportion of cases in which measles infection was excluded by laboratory testing be monitored.
M Ramsay; R Brugha; D Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin of the World Health Organization     Volume:  75     ISSN:  0042-9686     ISO Abbreviation:  Bull. World Health Organ.     Publication Date:  1997  
Date Detail:
Created Date:  1998-05-20     Completed Date:  1998-05-20     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7507052     Medline TA:  Bull World Health Organ     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  515-21     Citation Subset:  IM    
Immunisation Division, PHLS Communicable Disease Surveillance Centre, London, England.
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MeSH Terms
Child, Preschool
Disease Notification
England / epidemiology
Immunoglobulin M / isolation & purification
Measles / epidemiology*,  immunology,  prevention & control,  virology
Measles Vaccine
Population Surveillance
Predictive Value of Tests
Program Evaluation
Saliva / virology*
Sensitivity and Specificity
Wales / epidemiology
Reg. No./Substance:
0/Immunoglobulin M; 0/Measles Vaccine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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