title: Viral co-infections among children with confirmed measles at hospitals in Hanoi, Vietnam, 2014.
abstract: OBJECTIVE
  To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak.
  
  
  METHODS
  Throat swabs were collected from 54 pediatric patients with confirmed measles, and molecular diagnostics performed for 10 additional viral respiratory pathogens (Influenza A/H1N1pdm09; A/H3N2 and influenza B; Parainfluenza 1, 2, 3; Respiratory Synctial Virus, RSV; human Metapneumovirus, hMPV; Adenovirus and Picornavirus).
  
  
  RESULTS
  Twenty-one cases (38.9%) showed evidence of infection with other respiratory viruses: 15 samples contained measles plus one additional virus, and 6 samples contained measles plus 2 additional viruses. Adenovirus was detected as a predominant cause of co-infections (13 cases; 24.1%), followed by RSV (6 cases; 11.1%), A/H1N1pdm09 (3 cases; 5.6%), PIV3 (3 cases; 3.7%), Rhinovirus (3 cases; 3.7%) and hMPV (1 case; 1.96%).
  
  
  CONCLUSIONS
  Viral co-infections identified from pediatric measles cases may have contributed to increased disease severity and high rate of fatal outcomes. Optimal treatment of measles cases may require control of multiple viral respiratory pathogens.
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Le Khanh Nguyen
authors.initials: LK
authors.lastname: Hang
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Loan Phuong
authors.initials: LP
authors.lastname: Do
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Thanh Thi Trieu
authors.initials: TT
authors.lastname: Van
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Son Vu
authors.initials: SV
authors.lastname: Nguyen
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Phuong Vu Mai
authors.initials: PV
authors.lastname: Hoang
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Hien Thi
authors.initials: HT
authors.lastname: Pham
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Thanh Thi
authors.initials: TT
authors.lastname: Le
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Huong Thi Thu
authors.initials: HT
authors.lastname: Tran
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam.
authors.forename: Cuong Duc
authors.initials: CD
authors.lastname: Vuong
authors.affiliation: National Institute of Hygiene and Epidemiology, No 1-Yesrsin Street, Hanoi, Viet Nam. Electronic address: lom9@hotmail.com.
authors.forename: Thi Quynh Le
authors.initials: TQ
authors.lastname: Mai
keywords: Co-infection; Measles virus; Respiratory viruses