Measles – Diagnostic – PCR

*Uncontrolled print copy. Valid only on day of print: 22 March 2023.

Testing Indications

If you suspect a case of Measles, contact the Public Health Ontario laboratory or your local public health unit prior to collecting specimens.

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Measles Virus Diagnosis	General Test Requisition	Nasopharyngeal swab	One swab in transport media contained in kit	Virus Respiratory Kit order #390082
Measles Virus Diagnosis	General Test Requisition	Throat swab	One swab in transport media contained in kit	Virus Respiratory Kit order# 390082
Measles Virus Diagnosis	General Test Requisition	Urine	50 ml	Sterile container
Measles Virus Diagnosis	General Test Requisition	CSF	1 ml	Sterile container

Submission and Collection Notes

Indicate on the General Test Requisition Form if you have contacted your local Public Health Unit about this case.

If Measles encephalitis or SSPE is suspected, submit a CSF specimen.

Refer to the Virus Respiratory Kit for collection of swab specimens.

Timing of Specimen Collection

Nasopharyngeal swab or aspirate and/or a throat swab should be collected within seven days after onset of rash.

Urine should be collected within 14 days of onset of rash and submitted in a sterile container. In certain situations, such as when there is a high index of suspicion for measles (e.g. compatible illness in a returned traveler or contact of a laboratory confirmed case) it may be warranted to test beyond the above time periods when specimens could not be collected earlier in the illness- this can be discussed with PHO laboratory on a case by case basis.

Storage and Transport

Label the specimen with the patient’s full name, date of collection and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.

Special Instructions

Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection and shipped to PHO on ice packs.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Measles PCR is performed daily Monday to Friday. Turnaround time for Measles PCR is up to 3 days of receipt.

Samples that are PCR positive will be cultured. Virus Culture is observed for a minimum of 24 days; samples that are positive can be observed at any point during this period. Turnaround time for a virus culture result is up to 25 days after receipt.

TAT will vary during the winter months.

Test Methods

Measles diagnosis is performed using PCR (Polymerase Chain Reaction).

Algorithm

Samples that are positive by PCR are sent to NML, Winnipeg, MB for further testing (genotyping).

Reporting

Results are reported to the ordering physician or health care provider as indicated on the requisition.

Specimens that are positive for Measles are reported to the Medical Officer of Health as per Health Protection and Promotion Act.