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

Published online by Cambridge University Press:  07 October 2003

S. A. OLIVEIRA ,
D. J. TURNER ,
W. KNOWLES ,
J. P. NASCIMENTO ,
D. W. G. BROWN  and
K. N. WARD
S. A. OLIVEIRA
Affiliation:
Disciplina de Doenças Infecciosas e Parasitárias, Rua Marquês do Paraná, 303, 2o. andar, Niterói, Rio de Janeiro, Brazil 24030-210
D. J. TURNER
Affiliation:
Department of Infectious Diseases, Imperial College School of Medicine, Hammersmith Campus, Du Cane Road, London W12 ONN, UK Present address: Department of Infectious Diseases and Microbiology, Centre for Molecular Microbiology and Infection, Flowers Building, Imperial College London, South Kensington, London SW7 2AZ, UK.
W. KNOWLES
Affiliation:
Enteric and Respiratory Virus Laboratory, Virus Reference Division, Public Health Laboratory Service, Central Public Health Laboratory, London NW9 5HT, UK
J. P. NASCIMENTO
Affiliation:
Department of Virology, Instituto Oswaldo Cruz, Av Brasil 4365-Manguinhos, 21045 900 Rio de Janeiro, Brazil Present address: Biomanguinhos, Fundação Oswaldo Cruz, Av Brasil 4365-Manguinhos, 21045 900 Rio de Janeiro, Brazil.
D. W. G. BROWN
Affiliation:
Enteric and Respiratory Virus Laboratory, Virus Reference Division, Public Health Laboratory Service, Central Public Health Laboratory, London NW9 5HT, UK
K. N. WARD
Affiliation:
Department of Virology, Royal Free and University College Medical School, Windeyer Institute of Medical Sciences, 46 Cleveland Street, London W1T 4JF, UK
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Abstract

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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.

Type
Research Article
Information
Epidemiology & Infection , Volume 131 , Issue 2 , October 2003 , pp. 873 - 879
Copyright
2003 Cambridge University Press