PMID- 37796084 OWN - NLM STAT- MEDLINE DCOM- 20231101 LR - 20231107 IS - 1096-9071 (Electronic) IS - 0146-6615 (Linking) VI - 95 IP - 10 DP - 2023 Oct TI - Differential diagnosis of fever and rash cases negative for measles and rubella to complement surveillance activities. PG - e29141 LID - 10.1002/jmv.29141 [doi] AB - In the quest to eliminate measles virus (MV) and rubella virus (Ruv), every suspected case must be properly identified and diagnosed. Since 2017, in Milan (Italy), a total of 978 measles and rubella suspected cases (fever and rash) were investigated and 310 were not laboratory confirmed (discarded cases). To improve surveillance activities, we investigated the presence in discarded cases of 8 other viral pathogens commonly associated with rash: human herpesvirus 6 (HHV-6) and 7 (HHV-7), parvovirus B19 (B19V), enterovirus (EV), Epstein-Barr virus (EBV), human adenovirus (HAdV), cytomegalovirus (HCMV), and SARS-CoV-2. Differential diagnosis was carried out on 289 discarded cases by multiplex real-time PCR assays. At least one pathogen was detected in 188 cases (65.1%) with HHV-7 being the most frequently detected virus. No difference in the number of detected infections overtime was observed and infections were identified in all age groups. As expected, most HHV-6, EV, HAdV, and HCMV-positive cases were found in children aged 0-4 years and HHV-7 was most frequent in the 15-39 age group. In light of the World Health Organization measles elimination goal, the introduction of laboratory methods for differential diagnosis is required for the final classification of clinically compatible cases. The used screening panel allowed us to increase the percentage of virus-positive cases to 87.5%, allowing us to clarify viral involvement and epidemiology, improve diagnosis, and strengthen surveillance activities. As all investigated pathogens were detected, this diagnostic panel was a suitable tool to complement MV and RuV surveillance activities. CI - (c) 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC. FAU - Fappani, Clara AU - Fappani C AUID- ORCID: 0000-0002-1573-5531 AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. AD - Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy. AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. FAU - Gori, Maria AU - Gori M AUID- ORCID: 0000-0001-6478-2791 AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. FAU - Bianchi, Silvia AU - Bianchi S AUID- ORCID: 0000-0002-1365-9408 AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. FAU - Terraneo, Mara AU - Terraneo M AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. FAU - Bilardi, Erica AU - Bilardi E AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. FAU - Colzani, Daniela AU - Colzani D AUID- ORCID: 0000-0002-4079-1957 AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. FAU - Tanzi, Elisabetta AU - Tanzi E AUID- ORCID: 0000-0002-4119-701X AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. AD - Centre for Multidisciplinary Research in Health Science (MACH), Universita degli Studi di Milano, Milan, Italy. FAU - Canuti, Marta AU - Canuti M AUID- ORCID: 0000-0002-9959-128X AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. AD - Centre for Multidisciplinary Research in Health Science (MACH), Universita degli Studi di Milano, Milan, Italy. AD - Department of Pathophysiology and Transplantation, Universita degli Studi di Milano, Milan, Italy. FAU - Amendola, Antonella AU - Amendola A AUID- ORCID: 0000-0002-0499-8977 AD - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy. AD - Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Universita degli Studi di Milano, Milan, Italy. AD - Centre for Multidisciplinary Research in Health Science (MACH), Universita degli Studi di Milano, Milan, Italy. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Med Virol JT - Journal of medical virology JID - 7705876 RN - 0 (Antibodies, Viral) RN - 0 (Immunoglobulin M) SB - IM MH - Child MH - Humans MH - Adolescent MH - Young Adult MH - Adult MH - Diagnosis, Differential MH - *Epstein-Barr Virus Infections/diagnosis MH - Antibodies, Viral MH - Immunoglobulin M MH - Herpesvirus 4, Human MH - *Measles/diagnosis/epidemiology/prevention & control MH - *Rubella/diagnosis/epidemiology MH - Measles virus/genetics MH - *Enterovirus MH - *Exanthema MH - Fever MH - *Enterovirus Infections/diagnosis MH - *Herpesvirus 6, Human/genetics MH - *Adenoviruses, Human OTO - NOTNLM OT - differential diagnosis OT - fever and rash OT - measles OT - parvovirus B19 OT - rubella OT - surveillance EDAT- 2023/10/05 12:44 MHDA- 2023/11/01 12:42 CRDT- 2023/10/05 09:43 PHST- 2023/08/09 00:00 [revised] PHST- 2023/05/08 00:00 [received] PHST- 2023/09/21 00:00 [accepted] PHST- 2023/11/01 12:42 [medline] PHST- 2023/10/05 12:44 [pubmed] PHST- 2023/10/05 09:43 [entrez] AID - 10.1002/jmv.29141 [doi] PST - ppublish SO - J Med Virol. 2023 Oct;95(10):e29141. doi: 10.1002/jmv.29141.