title: Etiology of a suspected measles outbreak: preceding measles reduction activities in Pakistan.
abstract: OBJECTIVE
  To characterize patients with suspected measles, determine the magnitude of the outbreak in selected areas, and perform laboratory testing on patients with suspected measles to confirm the etiology of the outbreak.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Islamabad and Rawalpindi in June 2006.
  
  
  METHODS
  Survey and specimen collection from households was carried out in areas affected by rash and fever during the outbreak. Teams asked if household members had rash and fever and administered a detailed questionnaire of clinical signs and symptoms for measles for each person who reported a rash and fever episode. A sample of cases with fever, rash, and either cough, conjunctivitis, or coryza was laboratory tested for measles and rubella.
  
  
  RESULTS
  Of 2,225 households visited, 284 individuals met the rash and fever case definition. Laboratory testing of eleven blood specimens revealed that the rash and fever outbreak was caused by rubella in 6 and measles in 2 with three equivocal results.
  
  
  CONCLUSIONS
  Laboratory confirmation of suspected measles cases is essential during measles elimination activities in Pakistan and other countries with endemic rubella.
authors.affiliation: Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. alcohen1@cdc.gov
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.forename: Abdul
authors.initials: A
authors.lastname: Salam
authors.forename: Altaf
authors.initials: A
authors.lastname: Bosan
authors.forename: Robert
authors.initials: R
authors.lastname: Perry
authors.forename: Syma
authors.initials: S
authors.lastname: Iqbal
authors.forename: Shaista Noor
authors.initials: SN
authors.lastname: Qureshi
authors.forename: Lisa
authors.initials: L
authors.lastname: Cairns
authors.forename: Ondrej
authors.initials: O
authors.lastname: Mach
authors.forename: Frank
authors.initials: F
authors.lastname: Mahoney
authors.forename: Rehan
authors.initials: R
authors.lastname: Hafiz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D010154:Pakistan / Q000453:epidemiology; D011634:Public Health; D012307:Risk Factors; D012409:Rubella / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D018571:Sentinel Surveillance; D011795:Surveys and Questionnaires