Initially, doctors in the Tuzla Canton of the Federation of Bosnia and Herzegovina thought the rash on young Imran’s* stomach could be scarlet fever. Or maybe it was Kawasaki disease. As reported by Eurosurveillance, that was in early December 2023. By Christmas, four of Imran’s preschool classmates had been admitted to the hospital with measles. By mid-January 2024, another epidemiologically linked case – again originally misdiagnosed as the much less contagious scarlet fever – presented in a neighboring canton. Two more quickly followed. Between the last week of December and the middle of February, the Balkan nation had reported 141 new measles cases.

Barts Health Trust’s Dr. David Harrington said the misdiagnoses should not be unexpected.

“Many front-line clinicians won’t have seen measles for several years,” he told Medscape UK. “So good education and training and collaboration between public health and infection specialists with those in primary and emergency care is key.”

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