Chapter 2. The Global Measles and Rubella Laboratory Network

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The WHO Global Measles and Rubella Laboratory network (GMRLN) was established in 2000 when international efforts were aimed at measles mortality reduction. The national measles and rubella laboratories that comprise the global laboratory network developed and expanded in conjunction with regional control and elimination programmes. For example, in the Region of the Americas (AMR), national laboratories conducting measles and rubella laboratory confirmation were strengthened following the 1994 resolution for the elimination of endemic measles in the Americas. The organization and coordination of the GMRLN was modelled after the WHO Global Polio Laboratory Network. Within the framework of the GMRLN, the collective experience of all laboratories provides essential input for development of improved methodologies, testing strategies, and establishment of quality assurance programmes.

In the elimination phase, it is well established that surveillance based on clinical recognition of cases is unreliable and the laboratory confirmation of suspected cases is critical for effective surveillance. Therefore, the laboratories in the GMRLN have an increasingly important role in confirming suspected measles, rubella, and CRS cases and to monitor viral genotypes when cases occur. With international efforts focused on accelerating the elimination of measles and rubella in all WHO Regions, many laboratories will experience higher workloads. The requirements for the verification of elimination will involve greater scrutiny of laboratory data to ensure that the laboratory meets the indicators for high quality laboratory-based surveillance.