Discussion and conclusion
To the best of our knowledge, we report the first observation of measles and influenza co-infection in the world. Recently, co-infections of SARS-CoV-2 and measles have been reported in symptomatic measles patients. The mixed infection are clinically important as the patients referring to the hospital with measles may be silent carriers of other respiratory viruses such as SARS-CoV-2 and influenza virus. There is a report from Brazil in 2021 detecting a co-infection of measles and SARS-CoV-2 [12] , but co-infection of measles and influenza virus case has not been reported elsewhere in the world. No studies have clearly investigated the impact of this simultaneous infection on the severity and transmissibility of these diseases.
In conclusion, all respiratory samples of patients suspected of measles infection should be screened for influenza virus and SARS-CoV-2 during the COVID-19 pandemic and influenza epidemic. These findings are critical for preventing and breaking the chain of infection in pandemic and epidemic circumstances that can provide new perspectives and insights regarding treatment strategies in patients with co-infections compared to those with single infection.