{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:48:40Z","timestamp":1776725320473,"version":"3.51.2"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u20106) and 7 (HHV\u20107), parvovirus B19 (B19V), enterovirus (EV), Epstein\u2212Barr virus (EBV), human adenovirus (HAdV), cytomegalovirus (HCMV), and SARS\u2010CoV\u20102. Differential diagnosis was carried out on 289 discarded cases by multiplex real\u2010time PCR assays. At least one pathogen was detected in 188 cases (65.1%) with HHV\u20107 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\u20106, EV, HAdV, and HCMV\u2010positive cases were found in children aged 0\u22124 years and HHV\u20107 was most frequent in the 15\u221239 age group. In light of the World Health Organization\u00a0measles 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\u2010positive 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.<\/jats:p>","DOI":"10.1002\/jmv.29141","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:07:22Z","timestamp":1696536442000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Differential diagnosis of fever and rash cases negative for measles and rubella to complement surveillance activities"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-5531","authenticated-orcid":false,"given":"Clara","family":"Fappani","sequence":"first","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Department of Clinical Sciences and Community Health Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6478-2791","authenticated-orcid":false,"given":"Maria","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-9408","authenticated-orcid":false,"given":"Silvia","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Terraneo","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Bilardi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4079-1957","authenticated-orcid":false,"given":"Daniela","family":"Colzani","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4119-701X","authenticated-orcid":false,"given":"Elisabetta","family":"Tanzi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Centre for Multidisciplinary Research in Health Science (MACH) Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9959-128X","authenticated-orcid":false,"given":"Marta","family":"Canuti","sequence":"additional","affiliation":[{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Centre for Multidisciplinary Research in Health Science (MACH) Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-8977","authenticated-orcid":false,"given":"Antonella","family":"Amendola","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections) Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Centre for Multidisciplinary Research in Health Science (MACH) Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31463-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir065"},{"key":"e_1_2_10_4_1","unstructured":"World Health Organization. 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