Etiology of measles suspect cases reported in 2006-2007 in Poland.

To achieve measles elimination, an efficient surveillance system for rash illnesses is necessary. The aim of the present study was to ascertain which viruses, other than measles, are causing measles-like illnesses (MLIs) in Poland. Serum samples (n=278) collected from MLI cases and submitted to the National Reference Laboratory during 2006-2007 were investigated for anti-measles (MeV), rubella (RUBV), parvovirus B19 (B19V), Epstein-Barr (EBV) and herpesvirus type-6 (HHV-6) IgM presence. Age was strongly associated with MLIs etiology. In the youngest age group, 0-4 years, MeV and HHV-6 infection were prevailing, while in group of 5-9 years--RUBV and B 19V. Measles was confirmed more often in patients with high fever (p < 0.001) and with rash lasting longer than 5 days (p < 0.001). The type of rash was not significantly associated with MeV infection. Our results strongly suggest that according to WHO EURO strategic plan, Poland is close to elimination phase. High number of MLIs were caused by pathogens other than measles. Addition of anti-B 19V IgM testing to routine MLIs screening protocol may improve system performance in the more advanced stages of measles elimination.