To highlight the challenges and necessary improvements in laboratory response to measles outbreaks in the US, particularly in the context of declining vaccination rates.
Approach:
Vaccination Trends: Describes the decline in national vaccination coverage due to factors such as the COVID-19 pandemic and vaccine skepticism.
Clinical Risks: Details the acute and long-term complications associated with measles, including immune amnesia and SSPE.
Laboratory Challenges: Discusses the absence of FDA-cleared assays for measles and the reliance on laboratory-developed tests.
Testing Plans: Stresses the importance of having a testing plan and communication with public health laboratories.
Advances in Diagnostics: Highlights recent advances in PCR testing for earlier detection of measles.
Key Findings:
Vaccination coverage has declined, with some communities below 50% MMR vaccination.
Measles can lead to serious complications, including immune amnesia and SSPE.
No FDA-cleared assays for measles exist, relying on laboratory-developed tests.
PCR testing can detect measles earlier than IgM serology and distinguish between wild-type and vaccine strains.
Clear communication between clinical and public health laboratories is essential during outbreaks.
Interpretation:
The article underscores the urgent need for improved laboratory capabilities and preparedness in response to measles outbreaks.
Limitations:
No FDA-approved assays for measles testing.
Limited capacity for developing and validating tests in many clinical laboratories.
Conclusion:
Laboratories must enhance their testing protocols and communication strategies to effectively manage measles outbreaks.
The assay is indicated to identify patients with advanced melanoma who have BRAF V600E or BRAF V600K variants and may benefit from FDA-approved targeted therapies.
