Causes of morbilliform rash in a highly immunised English population.
OBJECTIVE
To determine the causes of morbilliform rash and fever in a population with high vaccination coverage for measles and rubella.


METHODS
Comprehensive laboratory investigation additional to routine oral fluid testing of children presenting to primary care physicians in East Anglia, England.


RESULTS
Laboratory confirmation of infection was obtained in 93 (48%) of 195 children: parvovirus B19 in 34 (17%); group A streptococcus in 30 (15%); human herpesvirus type 6 in 11 (6%); enterovirus in nine (5%); adenovirus in seven (4%); and group C streptococcus in six (3%) (four individuals tested positive for two agents). None had measles or rubella.


CONCLUSIONS
Oral fluid testing to cover infections additional to measles and rubella aids clinical management and is likely to maintain uptake of testing, which is essential for measles and rubella surveillance in highly immunised low incidence populations.
Public Health Laboratory Service, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK. mramsay@phls.org.uk
M
M
Ramsay
M
M
Reacher
C
C
O'Flynn
R
R
Buttery
F
F
Hadden
B
B
Cohen
W
W
Knowles
T
T
Wreghitt
D
D
Brown
D000257:Adenoviridae Infections / Q000175:diagnosis; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004769:Enterovirus Infections / Q000175:diagnosis; D016731:Erythema Infectiosum / Q000175:diagnosis; D005076:Exanthema / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005334:Fever / Q000382:microbiology*; D006801:Humans; D007114:Immunization; D007223:Infant; D007231:Infant, Newborn; D008457:Measles / Q000175:diagnosis / Q000517:prevention & control; D010614:Pharynx / Q000382:microbiology; D012409:Rubella / Q000175:diagnosis / Q000517:prevention & control; D012463:Saliva / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis; D013290:Streptococcal Infections / Q000175:diagnosis