title: Etiology of measles- and rubella-like illnesses in measles, mumps, and rubella-vaccinated children.
abstract: The viral etiology of measles- or rubella-like illnesses after MMR (measles, mumps, and rubella) vaccination was studied prospectively in 993 acutely ill Finnish children with fever and rash in 1983-1995. Their sera were tested for adeno-, entero-, and parvovirus B19 antibodies. Sera of 300 children <4 years old were also tested for human herpesvirus 6 (HHV-6) antibodies. Measles and rubella had been excluded by previous antibody testing. Serologic diagnosis of adeno-, entero-, or parvovirus infection was based on EIA (IgM or IgG antibodies) and that of HHV-6 on indirect immunofluorescence. A viral etiology was verified in 368 cases, most commonly parvovirus (20%), followed by enterovirus (9%) and adenovirus (4%). Among young children, HHV-6 infection was found in 37 (12%). Thirty-eight children (4%) had double infections. This study confirms that measles- or rubella-like illnesses in MMR-vaccinated children are often caused by other viruses. Each suspected vaccine failure requires laboratory confirmation to maintain reliable surveillance and control and to establish the specific etiology of the disease.
authors.affiliation: National Public Health Institute, Helsinki University Central Hospital,Helsinki, Finland. Irja.Davidkin@ktl.fi
authors.forename: I
authors.initials: I
authors.lastname: Davidkin
authors.forename: M
authors.initials: M
authors.lastname: Valle
authors.forename: H
authors.initials: H
authors.lastname: Peltola
authors.forename: T
authors.initials: T
authors.lastname: Hovi
authors.forename: M
authors.initials: M
authors.lastname: Paunio
authors.forename: M
authors.initials: M
authors.lastname: Roivainen
authors.forename: K
authors.initials: K
authors.lastname: Linnavuori
authors.forename: S
authors.initials: S
authors.lastname: Jokinen
authors.forename: P
authors.initials: P
authors.lastname: Leinikki
mesh_terms: D000260:Adenoviruses, Human / Q000276:immunology; D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000276:immunology; D005387:Finland; D015654:Herpesvirus 6, Human / Q000276:immunology; D006801:Humans; D007223:Infant; D008457:Measles / Q000209:etiology*; D008458:Measles Vaccine; D009108:Mumps Vaccine; D017992:Parvovirus / Q000276:immunology; D011446:Prospective Studies; D012409:Rubella / Q000209:etiology*; D012411:Rubella Vaccine
chemical_list: D000914:Antibodies, Viral; D008458:Measles Vaccine; D009108:Mumps Vaccine; D012411:Rubella Vaccine