Measles spreads very easily among those who are unvaccinated, especially in nurseries and schools, and can be a very unpleasant illness and in some children can be very serious and lead to hospitalisation – and in rare cases tragically can cause death. Vaccines are our best line of defence against diseases like measles and help stop outbreaks occurring in the community.
The UK Health Security Agency (UKHSA) has declared a national incident over a surge in measles cases across the country (1). There have been more than 140 suspected cases of measles reported so far in 2024 - after 1,603 suspected cases were recorded last year compared to 735 in 2022 (2). The World Health Organization (WHO) warns of an "alarming rise" in the spread of the disease across Europe.
Following UKHSA modelling published in 2022 (3), a joint letter from UKHSA and NHS England was sent to health professionals and Directors of Public Health in England to remind colleagues of the risk of a measles outbreak in London due to the sub-optimal uptake of the MMR vaccine in the capital. The letter also notes that outside of London, there is high risk of cases linked to overseas travel in specific population groups (4).
Measles usually starts with cold-like symptoms (a high temperature, a runny or blocked nose, sneezing, a cough, red, sore, watery eyes), followed by a rash a few days later. Some people may also get small (Koplik) spots in their mouth (5).
Paramedics who are assessing suspected measles via remote consultation should consider the benefits of bringing patients into face-to-face assessment and offer supportive treatment as there’s no specific medical treatment for measles.
If you are seeing any patient with fever and a rash is potentially infectious and should be directed to a side room on arrival of the surgery and/or contact receiving units before transportation to reduce the risk of spreading infections to other vulnerable patients.
UKHSA has produced a new poster for health professionals in identifying measles, what to do if they suspect measles and ensuring staff are fully vaccinated. Health professionals can download and order the poster for free via the health publications website. Think Measles Poster for A&E, Walk-in and GP Centres - Health Publications
If you suspect measles call your local UKHSA Health Protection Team (HPT) to notify and conduct a joint risk assessment, contact details for the local HPT could be found here: Contacts: UKHSA health protection teams - GOV.UK (www.gov.uk)
Isolation and exclusion advice should be provided to all suspected/confirmed measles patients to avoid close contact with babies and anyone who is pregnant or has a weakened immune system. Children should stay off nursery or school for at least 4 days from when the rash first appears.
Further information and guidance on the public health management of measles and its outbreaks could be found here: National measles guidelines January 2024 (publishing.service.gov.uk)
Having two doses of the Measles, Mumps, Rubella (MMR) vaccine is the best way to prevent Measles. MMR vaccine is one of the routine childhood vaccinations and children are offered the first dose of the MMR vaccine when aged one year and the second dose aged 3 years 4 months. So most children are already vaccinated against measles.
We should encourage all parents and guardians to make sure their children are up to date with their 2 MMR doses. To see if the child is up to date with their MMR vaccines, check your child’s personal child health record (PCHR), known as the red book, or contact the GP practice.
It is never too late to catch up. The MMR vaccine is free on the NHS, whatever your age. If anyone has missed one or both doses of the MMR vaccine, contact your GP practice to book an appointment.
References
(1) Measles outbreak could spread warns UKHSA Chief Executive - GOV.UK
(2) Notifiable diseases: causative agents reports for 2024 - GOV.UK
(3) Measles: risk assessment for resurgence in the UK - GOV.UK (www.gov.uk)
(4) Measles resurgence - Letter for professional organisations 31.10.23.pdf (govdelivery.com)
(5) Scenario: Management | Management | Measles | CKS | NICE
(6) National measles guidelines January 2024 (publishing.service.gov.uk)