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Causes of morbilliform rash in a highly immunised English population

M Ramsay1, M Reacher, C O'Flynn

  • 1Public Health Laboratory Service, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK. mramsay@phls.org.uk

Archives of Disease in Childhood
|August 24, 2002
PubMed
Abstract

Insights

In highly vaccinated populations, morbilliform rash and fever are rarely caused by measles or rubella. Oral fluid testing for other infections aids diagnosis and surveillance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Morbilliform rash and fever are common pediatric complaints.
  • High vaccination coverage for measles and rubella necessitates investigation into alternative causes.

Purpose of the Study:

  • To identify the etiological agents responsible for morbilliform rash and fever in a well-immunized population.
  • To assess the utility of oral fluid testing beyond routine measles and rubella surveillance.

Main Methods:

  • A comprehensive laboratory investigation was conducted on children presenting with rash and fever.
  • Oral fluid samples were analyzed in primary care settings in East Anglia, England.
  • Testing included agents beyond measles and rubella.

Main Results:

  • Of 195 children, 93 (48%) had laboratory-confirmed infections.
  • Common causes included parvovirus B19 (17%), group A streptococcus (15%), and human herpesvirus 6 (6%).
  • Measles and rubella were not detected in any participants.

Conclusions:

  • Oral fluid testing for a broader range of infections improves clinical management.
  • Extended testing supports continued participation in surveillance programs.
  • This approach is crucial for maintaining effective disease surveillance in low-incidence, highly immunized populations.

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