Investigation of Measles During 2022-Outbreak in Pakistan

Abstract

Measles is a contagious disease caused by an RNA virus. Resurgence of measles after Covid 19 and its severity among children has led to many speculations about the Measles vaccination coverage and its efficacy. In this study the clinical data of children <9 years (n=19) admitted at Pakistan Institute of Medical Sciences (PIMS) in measles ward was analyzed and the biological specimens were used for the molecular detection of measles virus. The blood samples (n=19) were processed for hematology and routine biochemistry tests. Five samples of blood serum and nasal swabs were used for the RNA Extraction to carry out Reverse Transcriptase-PCR. The results obtained from blood profile were statistically analyzed using SPSS-21 software for One-Way ANOVA (for Complete Parameters (CP), Kruskal Wallis and Mann-Whitney test for Differential leucocyte count (DLC) and Biochemical parameters). A p<0.05 was considered significant. The results suggest no significant difference of Complete blood parameters (CP) among non-vaccinated, partially vaccinated and fully vaccinated patients. Among DLC Basophils level was significantly different (p=0.024), being lower in partially vaccinated than non-vaccinated patients. Biochemical parameters showed that serum urea level was significantly different (p=0.013), showing a decline in fully vaccinated patients as compared to non-vaccinated patients. Moreover, a significantly higher level of Alkaline phosphatase as compared to normal range was observed in fully vaccinated patients. However, lower levels of MCH, MCV, MCHC, RBC, Hb, eosinophils and a higher level of RDW-CV was observed overall as compared to the normal range (healthy individuals). Two samples gave positive results for PCR as the bands were visualized for ˜ 523 nucleotide region of measles virus H gene (partial). The results suggest that blood profile of patients may have certain parameters that could vary among the three studied groups (i.e., fully vaccinated, partially vaccinated and non-vaccinated individuals) and further research on measles virus (MeV) mutations, genotyping, phylogenetic analysis, and vaccine optimization could be helpful for deeper understanding of measles virus circulating in Pakistan.