Epidemiology and Infection

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

S. A. OLIVEIRA a1, D. J. TURNER a2p1, W. KNOWLES a3, J. P. NASCIMENTO a4p2, D. W. G. BROWN a3 and K. N. WARD a5c1
a1 Disciplina de Doenças Infecciosas e Parasitárias, Rua Marquês do Paraná, 303, 2o. andar, Niterói, Rio de Janeiro, Brazil 24030-210
a2 Department of Infectious Diseases, Imperial College School of Medicine, Hammersmith Campus, Du Cane Road, London W12 ONN, UK
a3 Enteric and Respiratory Virus Laboratory, Virus Reference Division, Public Health Laboratory Service, Central Public Health Laboratory, London NW9 5HT, UK
a4 Department of Virology, Instituto Oswaldo Cruz, Av Brasil 4365-Manguinhos, 21045 900 Rio de Janeiro, Brazil
a5 Department of Virology, Royal Free and University College Medical School, Windeyer Institute of Medical Sciences, 46 Cleveland Street, London W1T 4JF, UK

Article author query
oliveira s   [PubMed][Google Scholar] 
turner d   [PubMed][Google Scholar] 
knowles w   [PubMed][Google Scholar] 
nascimento j   [PubMed][Google Scholar] 
brown d   [PubMed][Google Scholar] 
ward k   [PubMed][Google Scholar] 


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.

(Accepted February 20 2003)

c1 Author for correspondence.
p1 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.
p2 Present address: Biomanguinhos, Fundação Oswaldo Cruz, Av Brasil 4365-Manguinhos, 21045 900 Rio de Janeiro, Brazil.