Measles Lab Manual from the World Health Organization

Manual for the Laboratory Diagnosis of Measles and Rubella Virus Infection, 2nd edition, August 2007 from the World Health Organization (WHO)

This manual provides information about the WHO Laboratory Network for Measles and Rubella including detailed protocols for cell culture, virus isolation, collection and handling of specimens for the isolation and identification of measles virus. There is also information on biosafety and international shipping regulations. These techniques have been used successfully at the Centers for Disease Control and Prevention for investigation of measles outbreaks.

The development and progress of the WHO Measles and Rubella Laboratory Network was summarized in a 2005 article in CDC’s Morbidity and Mortality Weekly Report.

The WHO Measles Lab Manual is available in two languages:

• English:
  - Measles & Rubella Laboratory Manual [1.19 MB, 119 pages]
• Spanish:
  - Spanish version of measles and rubella lab manual [1.38 MB, 106 pages]
  Manual para el diagnóstico de laboratorio de la infección por los virus del sarampión y de la rubéola

Sections of the manual include:

• Abbreviations and acronyms
• Acknowledgements

1. Purpose
2. Introduction

   2.1 Global health burden of measles and rubella
   2.2 Measles
   2.3 Rubella
   2.4 WHO global strategies for measles control and CRS prevention

3. Role and function of the laboratory in measles control and CRS prevention

   3.1 Role of the laboratory in measles and rubella surveillance
   3.2 Structure and activities of the laboratory network in measles
   and rubella surveillance
   3.3 Coordination of the network
   3.4 Molecular epidemiology and genotyping

4. Specimen collection, shipment, receipt and processing

   4.1 Documenting sample collection
   4.2 Serological samples for antibody detection
   4.3 Samples for virus isolation
   4.4 Samples for RT-PCR
   4.5 Alternative sampling techniques (dried blood samples and oral fluid)
   4.6 General safety precautions on receipt of samples

5. Laboratory diagnosis of measles and rubella

   5.1 IgM assays
   5.2 Tests for IgG antibody
   5.3 RT-PCR
   5.4 Virus isolation in cell culture

6. Data management and reporting

   6.1 Data management goals
   6.2 Recording receipt of specimen
   6.3 Recording results
   6.4 Reporting laboratory activity and results

7. Safe sample and isolate transport

   7.1 Planning
   7.2 Packaging
   7.3 Preparation and sending

8. Quality assurance in Network laboratories

   8.1 Establishing LQA systems
   8.2 SOPs
   8.3 Documentation
   8.4 Equipment and instruments
   8.5 Supplies
   8.6 Laboratory safety
   8.7 Annual accreditation

9. Annexes

   9.1 Example measles and rubella laboratory request form
   9.2 Extraction of measles specific IgM from dried blood specimens and detection for use in the Dade Behring indirect measles IgM antibody assay [After 39]
   9.3 Quality control and trouble shooting of measles and rubella serological assays
   9.4 Isolation and identification of measles and rubella virus in cell culture
   9.5 Packaging of specimens and virus isolates for transportation
   9.6 Composition of media and reagents

10. Suggested further reading

    10.1 Global impact of measles and
    10.2 Control strategies
    10.3 Laboratory
    10.4 Laboratory safety and sample transport

11. References