Rash in Patients with Laboratory-Confirmed Influenza 2015
Since March 2015, multiple states have notified CDC of patients with morbilliform (i.e.
maculopapular) rash and laboratory-confirmed influenza (primarily influenza B), without laboratory
evidence of measles. Rash has historically been a rare complication of influenza. As of today,
Washoe County Health District (WCHD) already identified one such case. Laboratory testing for
influenza among reported suspect measles cases with negative PCR for measles is pending. More
findings will be published via Epi-News in the near future. To assist CDC in case finding, WCHD will
continue reporting cases meeting the following criteria to CDC:
1. Presence of morbilliform (i.e. maculopapular) rash AND
2. Laboratory-confirmed influenza (by rapid diagnostic test, fluorescent antibody test, enzyme
immunoassay test, RT-PCR test, or viral culture) AND
3. Negative measles testing (by IgG, IgM antibody serology or RT-PCR test) AND
4. Onset of both rash and influenza-like illness on or after October 1, 2014
Influenza-like illness is defined as fever (temperature of 100F [37.8C] or greater), and cough
and/or sore throat in the absence of a known cause other than influenza. The WCHD requests that
healthcare providers consider adding influenza testing to their normal diagnostic practice when
evaluating patients with acute rash and influenza-like illness. Additionally, these cases should also
be reported to the WCHD by faxing to 775-328-3764.