Measles: increased cases and what to look out for

Staff with patient on stretcher at accident and emergency

Measles cases are on the rise across England, with 196 new cases reported since February 2016. More than 10 of them are in our region.

Measles is a highly contagious infection and one of the most infectious diseases we see. It is caused by a paramyxovirus (Morbillivirus).

The figures from Public Health England have shown that initially cases were mostly unimmunised teenagers and adults (aged 13-40 years) however, cases are now covering all age groups.

Results also showed that since February, there have been 12 confirmed cases amongst health workers.

The following features are strongly suggestive of measles:

  • rash for at least three days
  • fever for at least one day, and
  • at least one of the following – cough, coryza or conjunctivitis.

If you think your patient has measles, take routine IPC precautions. The patient will need to notify their GP.

There is no specific treatment, which should be as for any flu-like viral illness. Most patients need rest and supportive treatment with paracetamol/ibuprofen as indicated. Under-12s should not be given aspirin due to the risk of Reye’s syndrome. Some patients are light-sensitive and may benefit from being in a darkened room. Eyes can be gently cleaned with damp cotton wool.

If you are leaving a patient at home, inform the patient’s GP as soon as possible (this can be done via SPOC). The patient should be isolated and IPC precautions observed. At-risk individuals should stay well away until the rash has disappeared and check their immunity. Normal ‘flu’ advice with safety netting should be given, especially to watch out for respiratory or neurological complications and to seek urgent hospital treatment if symptoms appear.

If you think you have come into contact with measles and you do not think you are immune, you should seek OH advice or advice from your GP.

The NICE Feverish Illness guidelines should be referred to, if in doubt, to ensure a thorough assessment is undertaken and no red flags are missed.

Published 5th August, 2016

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