Primary human herpesvirus-6 and -7 infections, often coinciding, misdiagnosed as measles in children from a tropical region of Brazil

• Published in: Epidemiology and infection Vol. 131; no. 2; pp. 873 - 879
• Main Authors: OLIVEIRA, S. A., TURNER, D. J., KNOWLES, W., NASCIMENTO, J. P., BROWN, D. W. G., WARD, K. N.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2003
• Subjects: Adolescent; Antibodies; Antibodies, Viral - analysis; Antibody affinity; Biological and medical sciences; Brazil - epidemiology; Child; Child, Preschool; Children; Dengue fever; Diagnosis, Differential; Diagnostic Errors; Exanthema; Female; Fluorescent Antibody Technique, Indirect; Fundamental and applied biological sciences. Psychology; Herpes viruses; Herpesviridae; Herpesviridae Infections - diagnosis; Herpesviridae Infections - epidemiology; Herpesvirus 6, Human; Herpesvirus 7, Human; Human herpesvirus 6; Human herpesvirus 7; Human viral diseases; Humans; Illnesses; Infant; Infections; Infectious diseases; Laboratories; Male; Measles; Measles - diagnosis; Measles - epidemiology; Measles virus; Medical sciences; Microbiology; Miscellaneous; Public health; Rubella; Serology; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Virology; Viruses; South America; Brazil; America; United Kingdom > UK; Rio de Janeiro Brazil; Human; Infection; Virus; Human herpesvirus 7; Microbiology; Herpesviridae; Viral disease; Measles; Human herpesvirus 6; Betaherpesvirinae; Child; Epidemiology
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268803008823

We investigated primary human herpesvirus-6 and -7 (HHV-6, HHV-7) infections as a cause of rashes incorrectly diagnosed as measles in Brazilian children. Sera from 124 patients, aged 4 months to 17 years, from the states of Rio de Janeiro and Espírito Santo, in whom measles, rubella and parvovirus B19 infections had been excluded, were studied using indirect immunofluorescence antibody avidity tests; 38 (31%) had evidence of primary HHV-6 and/or HHV-7 infections. Twenty four children had primary HHV-6 infection, either recent or coincident with the rash, and similarly 31 had primary HHV-7 infection. Remarkably, almost half (17) of primary infections were dual HHV-6 and HHV-7 infections with the majority, 12 (71%), in children less than 1 year old. HHV-7 infection occurred earlier than previously reported, perhaps due to socioeconomic and tropical conditions in this region of Brazil, and thus coincided with the HHV-6 infections. This study also highlights the difficulties of diagnosing a rash illness on clinical grounds alone.