Etiology of maculopapular rash in measles and rubella suspected patients from Belarus

PLoS One. 2014 Oct 30;9(10):e111541. doi: 10.1371/journal.pone.0111541. eCollection 2014.

Abstract

As a result of successful implementation of the measles/rubella elimination program, the etiology of more and more double negative cases remains elusive. The present study determined the role of different viruses as causative agents in measles or rubella suspected cases in Belarus. A total of 856 sera sent to the WHO National Laboratory between 2009 and 2011 were tested for specific IgM antibodies to measles virus (MV), rubella virus (RV) and human parvovirus B19 (B19V). The negatives were further investigated for antibodies to enterovirus (EV) and adenovirus (AdV). Children of up to 3 years were tested for IgM antibodies to human herpesvirus 6 (HHV6). A viral etiology was identified in 451 (52.7%) cases, with 6.1% of the samples being positive for MV; 2.6% for RV; 26.2% for B19V; 9.7% for EV; 4.6% for AdV; and 3.6% for HHV6. Almost all measles and rubella cases occurred during limited outbreaks in 2011 and nearly all patients were at least 15 years old. B19V, EV and AdV infections were prevalent both in children and adults and were found throughout the 3 years. B19V occurred mainly in 3-10 years old children and 20-29 years old adults. EV infection was most common in children up to 6 years of age and AdV was confirmed mainly in 3-6 years old children. HHV6 infection was mostly detected in 6-11 months old infants. Laboratory investigation of measles/rubella suspected cases also for B19V, EV, AdV and HHV6 allows diagnosing more than half of all cases, thus strengthening rash/fever disease surveillance in Belarus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Child
  • Child, Preschool
  • Exanthema / blood
  • Exanthema / epidemiology*
  • Exanthema / etiology*
  • Female
  • Humans
  • Immunoglobulin M / blood
  • Infant
  • Male
  • Measles / blood
  • Measles / complications*
  • Measles / epidemiology*
  • Middle Aged
  • Republic of Belarus / epidemiology
  • Rubella / blood
  • Rubella / complications*
  • Rubella / epidemiology*
  • Seasons
  • Young Adult

Substances

  • Immunoglobulin M

Grants and funding

The authors wish to thank the Ministry of Cooperation and the Centre de Recherche Public de la Santé in Luxembourg for financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.