Rash after measles vaccination: laboratory analysis of cases
reported in Sao Paulo, Brazil.
Oliveira MI, Curti SP, Figueiredo CA, Afonso AM, Theobaldo M, Azevedo RS,
Durigon EL.
Servico de Virologia, Instituto Adolfo Lutz, Sao Paulo, SP, Brasil.
OBJECTIVE: The clinical differential diagnosis of rash due to viral infections
is often difficult, and misdiagnosis is not rare, especially after the
introduction of measles and rubella vaccination. A study to determine the
etiological diagnosis of exanthema was carried out in a group of children after
measles vaccination. METHODS: Sera collected from children with rash who
received measles vaccine were reported in 1999. They were analyzed for IgM
antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19)
using ELISA commercial techniques, and human herpes virus 6 (HHV 6) using
immunofluorescence commercial technique. Viremia for each of those viruses was
tested using a polimerase chain reaction (PCR). RESULTS: A total of 17 cases of
children with exanthema after measles immunization were reported in 1999. The
children, aged 9 to 12 months (median 10 months), had a blood sample taken for
laboratory analysis. The time between vaccination and the first rash signs
varied from 1 to 60 days. The serological results of those 17 children suspected
of measles or rubella infection showed the following etiological diagnosis:
17.6% (3 in 17) HPV B19 infection; 76.5% (13 in 17) HHV 6 infection; 5.9% (1 in
17) rash due to measles vaccine. CONCLUSIONS: The study data indicate that
infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to
measles vaccination. Therefore, it is important to better characterize the
etiology of rash in order to avoid attributing it incorrectly to measles
vaccine.
PMID: 12045795 [PubMed - as supplied by publisher]
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-- Albert Einstein, letter to a friend, 1901
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