Measles: Resurgence and Rapid Diagnostics


Measles is a highly contagious viral disease with significant impact to public health worldwide, with cases rising sharply due to reduced vaccination rates. This reduction in routine vaccinations has resulted in susceptibility among children and adults, increasing outbreaks and complications.​

Why Are Measles Cases Rising?
Once considered largely eliminated in many regions due to widespread vaccination, measles cases saw a dramatic comeback beginning in 2022. Disruptions during the COVID-19 pandemic led to millions of children missing essential doses of the measles vaccine.1,2 Regions with high numbers of unvaccinated individuals accelerate the rapid spread of the virus,3 leading to more severe and fatal outcomes, particularly within young and immunocompromised populations.

Recognizing Measles: Classic Symptoms and Complications4,5,6

  • Symptoms start 7–14 days after exposure and typically begin with high fever (often >104°F), cough, runny nose, and watery, red eyes.
  • Koplik spots (tiny white spots inside the mouth) may appear and are very suggestive of measles before the rash develops.
  • The classic measles rash begins near the hairline and spreads downwards, often accompanied by a second fever spike.​
  • Complications include pneumonia, diarrhea, ear infections, encephalitis, and, unfortunately, death in vulnerable patients.

PCR Diagnostics
Recent surges in measles cases underscores the importance of rapid, reliable diagnostics. Modern multiplex real-time PCR has become the gold standard for laboratory confirmation due to its sensitivity, speed, and ability to quickly screen circulating strains.

BioGX’s multiplex PCR assay (BioGX REF 450-114-LMP) enables rapid screening of measles genotypes. ( A, B1*, B2, B3, C1, C2, D1*, D2, D3, D4, D5, D6, D7, D8, D9, D10, D11, E*, F*, G1*, G2, G3, H1, H2). It is designed for flexible deployment and can be validated for use with ThermoFisher-ABI QuantStudioTM Series, Bio-Rad CFX Series and BD MAXTM system.

* Strains currently not in circulation.

Diagnostics of Measles Infections
Measles, a highly contagious viral disease, requires rapid diagnosis for isolation and monitoring. A brief overview of clinical manifestations and testing approaches are defined below to highlight the importance of rapid diagnostics of suspected cases of measles. Speed of diagnosis allows for effective use of supportive care and public health interventions.

Diagnostic Strategies
Measles cases are highly contagious and spread through respiratory droplets. A majority of cases have occurred globally, with recent increases observed in regions with lower vaccination rates. Clinical manifestations include fever, cough, coryza, conjunctivitis, and a characteristic maculopapular rash. To prevent severe complications such as pneumonia, encephalitis, and death, rapid testing and isolation are crucial.

Current diagnostic tests for Measles include:

  • PCR of nasopharyngeal or throat swabs or urine
  • Serology (IgM and IgG antibodies)
  • Viral culture (less common due to turnaround time)
  • Clinical diagnosis based on characteristic symptoms and epidemiological link

References

  1. Wang, W., Wang, Q., Zhao, S., Zhou, X., Crooke, S. N., Salje, H., Jit, M., & Yu, H. (2025). COVID-19 pandemic and waning immunity disrupted measles population immunity and strategies to close immunity gaps. Nature communications, 16(1), 10966.
  2. Misin, A., Antonello, R. M., Di Bella, S., Campisciano, G., Zanotta, N., Giacobbe, D. R., Comar, M., & Luzzati, R. (2020). Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients. Microorganisms, 8(2), 276.
  3. Sanyaolu, A., Okorie, C., Marinkovic, A., Ayodele, O., Abbasi, A. F., Prakash, S., … & Chan, H. (2019). Measles outbreak in unvaccinated and partially vaccinated children and adults in the United States and Canada (2018-2019): a narrative review of cases. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56, 0046958019894098.
  4. Lucas J. (1790). An Account of Uncommon Symptoms Succeeding the Measles; with Some Additional Remarks on the Infection of Measles and Small Pox. The London medical journal, 11(Pt 4), 325–331.
  5. Gould, D. (2015). Measles: symptoms, diagnosis, management and prevention. Primary Health Care, 25(1).
  6. Battegay, R., Itin, C., & Itin, P. (2012). Dermatological signs and symptoms of measles: a prospective case series and comparison with the literature. Dermatology, 224(1), 1-4.
  7. Dunn, J. J., Baldanti, F., Puchhammer, E., Panning, M., Perez, O., & Harvala, H. (2020). Measles is back–considerations for laboratory diagnosis. Journal of Clinical Virology, 128, 104430.


Disclaimer: Information in this blog is provided for educational and informational purposes only. It is not intended to provide diagnostic or treatment recommendations. Readers are encouraged to consult appropriate scientific and public health sources.