A rapid cytological method for the diagnosis of measles.

The fact that the laboratory diagnosis of virus infections is a lengthy process is the constant complaint of our clinical colleagues. The purpose of this paper is to call attention to the method of exfoliative cytology as a rapid method for the diagnosis of measles. It has been established that the characteristic pathological feature of measles is the appearance of large multinucleated giant cells, particularly in areas of lymphoid tissue, as first described by Denton (1925). The work of Tompkins and Macaulay (1955) has demonstrated that similar syncytial giant cells are present in sputum and may be recovered by aspirating mucus from the back of the nose. It is striking that measles virus also produces syncytial giant cell masses when growing in tissue culture on epithelial type cells (Enders and Peebles, 1954). The particular value of this method of diagnosis is that the giant cells are present during the catarrhal stage, disappearing rapidly with the onset of the rash. It is easy to obtain material which can be rapidly stained and examined in the laboratory, enabling a diagnosis to be made in a few hours. This may be valuable with suspected measles, for example, in a children's ward. Similar giant cells do not seem to occur in other diseases, although somewhat similar cells are seen in nasal mucus of ferrets infected with canine distemper virus. Also Done (1958) has recently described a similar method for the diagnosis of inclusion body rhinitis of swine. He examined nasal secretions of pigs using Giemsa or methylene blue staining. The pathognomonic cells contain intranuclear inclusions. The giant cells seen in herpes simplex and varicella are quite different from those seen in measles, having fewer nuclei, which often overlap and contain less cytoplasm.