Diane Waku-Kouomou

High Genetic Diversity of Measles Virus, World Health Organization European Region, 2005–2006

Importation of viruses from other continents caused prolonged circulation and large outbreaks in the WHO European Region.

Co-Circulation of Multiple Measles Virus Genotypes During an Epidemic in France in 2008

In 2008, measles reappeared in France in a series of outbreaks. During this period, 604 measles cases were reported to a routine surveillance system and 305 (50%) of these cases were then confirmed in the laboratory. To understand better the current epidemiological situation and the circulation of different measles strains, a phylogenetic characterization of 113 (19%) of the measles cases from these outbreaks was performed. All measles cases met the WHO clinical criteria and were confirmed either by laboratory detection of measles‐specific IgM and/or by detection of the virus genome by polymerase chain reaction (PCR) and viral isolation. PCR products generated from blood, oral fluid, urine, or nasopharyngeal‐swab samples were sequenced for molecular epidemiology studies. Phylogenetic analysis showed a co‐circulation of genotypes D4 and D5 during the first measles outbreak in the city of Reims in early 2008. Over the course of the year, the A, B3.2, D8, and D9 genotypes also appeared. The data from this study show the simultaneous circulation of several measles genotypes in France and describe genotypes D8 and D9 for the first time in this country. The data also suggest that there are still many pockets of unvaccinated individuals helping to maintain the circulation of measles virus in the population. Phylogenetic studies allowed the corroboration of epidemiologic links and showed that nosocomial transmission can create significant risk for measles dissemination. Finally, the pattern of changes in viral genotypes during 2008 suggests a regular introduction of measles strains from abroad. J. Med. Virol. 82:1033–1043, 2010.

Re-emergence of measles among young adults in Marseilles, France

A total of 89 cases of measles were diagnosed in southeastern France between January and June 2003. Nation-wide epidemiological investigations suggested that this outbreak was restricted to southeastern France, and most likely reflected the endemic circulation of measles virus due low vaccination coverage. Genetic analysis identified genotype D7 strains as the cause of the outbreak.

Genotyping Measles Virus by Real-Time Amplification Refractory Mutation System PCR Represents a Rapid Approach for Measles Outbreak Investigations

ABSTRACT Real-time PCR has been developed to genotype measles virus (MV) isolates. MV strains circulating in epidemics in Gabon in 1984, Cameroon in 2001, Morocco in 2003, and France in 2004 were investigated. We developed a real-time amplification refractory mutation system PCR (RT-AMRS PCR) using SYBR green fluorescent dye. Six pairs of primers for RT-ARMS PCR were designed to specifically amplify genotypes A, B2, B3.1, B3.2, C2, and D7. Genotypes could be differentiated by melting curve analysis. All strains were also confirmed by direct sequencing. Using the result obtained by direct sequencing and phylogenetic analysis as the reference, the accuracy of MV by RT-ARMS PCR and melting curve analysis was 97%. However, the latter method is more rapid and sensitive than the former method. This method could be a useful tool for molecular epidemiological studies of MV, providing an efficient alternative for large-scale studies.

Molecular characterization of measles virus strains causing subactute sclerosing panencephalitis in France in 1977 and 2007

Measles virus strains from two subacute sclerosing panencephalitis (SSPE) cases diagnosed in 1977 (Laine strain) and in 2007 (Hoedts strain) were studied. Phylogenetic analysis based on C‐terminal part of the nucleoprotein and the entire H gene showed that Hoedts strain, circulating in France presumably in the 1980s, belonged to genotype C2. However, Laine strain, suspected to have circulated between 1940s and 1960s, could not be assigned to any known measles virus genotypes. Sequences analysis of the Laine strain suggested that it originated from a measles virus that may have circulating at the same period as the Edmonston strain. The analysis of the whole genome of both SSPE strains revealed biased hypermutations in M, F, and H gene. Some of these mutations like the L165P found in the M protein sequence of the Laine strain, the amino acid position 94, where a mutation M94V was found in the F protein sequence of the Hoedts strain are known to play an important role in the glycoprotein interaction and to impair the ability of measles virus strain to produce cell‐free infectious viral particles.This is the first study on molecular characterization of the entire coding region of measles virus isolated from SSPE cases in France. J. Med. Virol. 83:1614–1623, 2011.

Rotavirus Epidemiology in Bangui, Central African Republic, 20081

To the Editor: Infection with group A rotavirus is among the leading causes of gastroenteritis in children, especially in sub-Saharan Africa (1). Data with regard to the incidence of rotavirus-A disease in the Central African Republic are limited (2). To estimate the prevalence of rotavirus-A disease among young children before introduction of rotavirus-A vaccine in Bangui, the capital of the Central African Republic, we performed a prospective study during February–September 2008. The target sample size, based on an expected 20% prevalence of rotavirus diarrhea and a 5% significance level, was 250 cases. All patients were children 0–5 years of age, who were hospitalized for acute diarrhea at the Complexe Pediatrique, Bangui, the main hospital for children in the Central African Republic, and all had an illness that met the World Health Organization definition of a suspected case of rotavirus-A gastroenteritis (www.who.int/nuvi/surveillance/RV_Case_Defs.pdf). After informed consent and epidemiologic and clinical data had been obtained, a fecal specimen was collected from each child. Samples were transported to the Institut Pasteur de Bangui, where they were tested for rotavirus-A antigen by using the VIKIA Rota-Adeno test, (VIKIA Rota-Adeno; bioMerieux SA, Lyon, France). Results were immediately reported ​​ to the referring physician.

Assessment of National Public Health and Reference Laboratory, Accra, Ghana, within Framework of Global Health Security

The Second Year of Life project of the Global Health Security Agenda aims to improve immunization systems and strengthen measles and rubella surveillance, including building laboratory capacity. A new laboratory assessment tool was developed by the Centers for Disease Control and Prevention to assess the national laboratory in Ghana to improve molecular surveillance for measles and rubella. Results for the tool showed that the laboratory is well organized, has a good capacity for handling specimens, has a good biosafety system, and is proficient for diagnosis of measles and rubella by serologic analysis. However, there was little knowledge about molecular biology and virology activities (i.e., virus isolation on tissue culture was not available). Recommendations included training of technical personnel for molecular techniques and advocacy for funding for laboratory equipment, reagents, and supplies.