Measles diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Case Definitions
- Clinical case definition is considered any person with fever, and maculopapular rash and cough, coryza or conjunctivitis.[1]
- A laboratory-confirmed case meets the clinical case definition and is laboratory-confirmed or linked epidemiologically to a laboratory-confirmed case.[1]
- Laboratory-confirmed is defined as at least 4 fold increase in antibody titer, or isolation of measles virus or presence of measles-specific IgM antibodies.[1]
- Epidemiological linkage is defined as direct contact with another laboratory-confirmed measles case in which rash onset occurred 7-18 days before the present case.[1]
Case confirmation flow chart Adapted from WHO Guidelines For Epidemic Preparedness And Response To Measles Outbreaks[1]
| Suspected measles case | |||||||||||||||||||||||||||||||||||
| Adequate blood specimen† | Non adequate blood specimen† | ||||||||||||||||||||||||||||||||||
| IgM Negative | IgM Positive | Epidemiologic link to laboratory confirmed case | No epidemiologic link to laboratory confirmed case | ||||||||||||||||||||||||||||||||
| Discard | Laboratory confirmed | Clinically confirmed | |||||||||||||||||||||||||||||||||
A suspected measles case that has been completely investigated, including the collection of an adequate blood specimen, and lacks serological evidence of measles virus infection can be classified as discarded. | A case that meets the clinical case definition and that is laboratory-confirmed or linked epidemiologically to a laboratory-confirmed case. | A suspected measles case that, for any reason, is not completely investigated is considered to be clinically confirmed | |||||||||||||||||||||||||||||||||
† Adequate blood sample is considered a single serum obtained at the first contact with the health care system, regardless of which day following the rash onset.