IgM antibodies in hospitalized children with febrile illness during an inter-epidemic period of measles, in Somalia

Background: In the context of the measles elimination programme, endorsed b y the expanded programme on immunization of the World Health Organization, the identification of infections which may be confused with measles is a ma jor challenge. Objective: To determine the causes of febrile illness in children in an int er-epidemic period of measles in a Somalian hospital. Study design: Serological tests were performed on sera from 23 Somali child ren with febrile illness and from 23 age matched children, to measure the s pecific IgM and IgG antibodies against measles virus, mumps virus, rubella virus, human herpes-6 virus, Epstein Barr virus, parvovirus B19, dengue vir us, Mycoplasma pneumoniae and Rickettsia conorii. Results: In about one third of the cases of febrile illness viral, mycoplas mal and rickettsial agents could be identified serologically as the probabl e cause of the disease. Conclusions: Although febrile illness with rash in children needing hospita lization is usually assumed to be due to measles, there are several other i mportant virological causes of this condition which need to be considered i n the differential diagnosis. Moreover there is a growing need to develop a simple, sensitive, specific and ready to use test to identify each case of measles, if this disease is to be eliminated. (C) 1999 Elsevier Science B. V. All rights reserved.