A couple in their early forties have twin two-year-old girls, Elisa and Elizabeth, as well as a five-year-old daughter, Eowin. The twins attended daycare, and all children were current in their vaccinations. Both parents had standard vaccinations as children. One day, Elizabeth seemed a little bit under the weather. By the next day, she was complaining that the inside of her mouth hurt. Elisa had a bit of a fever and was crabby. It was the weekend, so the girls were not in daycare for a few days. No one was ill enough to take to the pediatrician, and the girls seemed fine a few days later. Over the weekend, their mother noticed a maculopapular rash on her hands. She was prone to sensitive-skin conditions, and she was extremely sensitive to poison ivy. When the twins were born, she had experienced severely itchy feet and had to seek help from a dermatologist to resolve the problem (dyshidrosis). The oldest daughter did not appear to exhibit any symptoms and neither did the father. By early the following week, a health notice was posted at the daycare to report that cases that sounded similar to what the family was experiencing were documented in some of the other children attending the daycare. Part A Which of the following should be excluded from the differential diagnosis (DDx)? Please select all applicable answer choices. There may be more than one correct answer. View Available Hint(s) Hint 1. Description of the MMR vaccine The MMR vaccine stimulates active, artificial immunity to measles, mumps, and rubella.
Enterovirus infection
Chickenpox
0 Measles
Smallpox
Hand, foot, and mouth disease
Rubella
