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 by the expanded programme on immunization of the World Health Organization, the identification of infections which may be confused with measles is a major challenge. OBJECTIVE: To determine the causes of febrile illness in children in an inter-epidemic period of measles in a Somalian hospital. STUDY DESIGN: Serological tests were performed on sera from 23 Somali children with febrile illness and from 23 age matched children, to measure the specific IgM and IgG antibodies against measles virus, mumps virus, rubella virus, human herpes-6 virus, Epstein Barr virus, parvovirus B19, dengue virus, Mycoplasma pneumoniae and Rickettsia conorii. RESULTS: In about one third of the cases of febrile illness viral, mycoplasmal and rickettsial agents could be identified serologically as the probable cause of the disease. CONCLUSIONS: Although febrile illness with rash in children needing hospitalization is usually assumed to be due to measles, there are several other important virological causes of this condition which need to be considered in 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.