The etiological pattern of viral exanthems in children less than 4 years of age in Belarus

Republican Research-and-Practical Center of Epidemiology and Microbiology, Minsk, Republic of Belarus During successful vaccine prevention of measles and rubella, there has been an increasing role of other pathogens that cause diseases with maculopapular rash and fever; however, the significance of each of them still remains not fully clear. Objective. To assess the role of viral infections in the etiological pattern of acute exanthems in children less than 4 years of age. Materials and methods. The sera collected from 174 children aged 3 months to 3 years from all Belarusian regions in 2009-2011 were tested for IgM antibodies to measles and rubella viruses, parvovirus B19, enterovirus, adenovirus. Results. Human herpesvirus 6 (HHV-6) and parvovirus infections were common, which were verified in 17.8 and 12.4% of the examinees, respectively. IgM antibodies to enterovirus and adenovirus were detected in 8.1 and 6.9% of the children, respectively. Only 4 (2.3%) measles cases were identified during 3 years. No rubella case was confirmed in this age group. The main etiological agent of viral exanthem was HHV-6 in children less than 2 years of age and parvovirus B19, enterovirus, and adenovirus in those aged 2 and 3 years. Conclusion. The vaccination policy adopted in Belarus has made measles and rubella cases disappear practically completely in younger children; however, viral infections continue to be of considerable importance in the pattern of diseases with maculopapular rash and fever. Laboratory findings play a dominant role in the differential diagnosis of infectious exanthems.

acute infectious exanthems, children, IgM antibodies, vaccine prevention