Measles is a highly contagious viral infection that can lead to serious health complications, especially in young children. Despite being preventable through vaccination, the disease has seen a resurgence in the UK in recent years, making it imperative for healthcare workers, doctors, parents, and guardians to recognise its signs and symptoms early.
Signs and symptoms of measles
Measles symptoms typically appear about 10 to 14 days after exposure to the virus and can be divided into two stages: early symptoms and the rash stage.
- Early symptoms (prodromal stage):
- High fever: One of the first signs of measles is a high fever, which can start around 10 to 12 days after exposure and can reach up to 40°C (104°F).
- Cough: A persistent cough often accompanies the fever.
- Runny nose: A common cold-like symptom.
- Red, watery eyes: Known as conjunctivitis or “pink eye,” this symptom causes discomfort and sensitivity to light.
- Koplik spots: Small white spots with bluish-white centres on a red background found inside the mouth on the inner lining of the cheek. These spots are a hallmark sign of measles and appear two to three days before the rash.
- Rash stage:
- Measles rash: A few days after the initial symptoms, a red or reddish-brown blotchy rash appears. It usually starts on the face, particularly behind the ears and hairline, before spreading to the rest of the body. The rash typically lasts for about seven days.
- General malaise: Children and adults with measles often feel very unwell and fatigued.
What clinicians should look out for
Clinicians should be vigilant in identifying the early signs of measles, especially in patients who have not been vaccinated or who have travelled to areas with ongoing outbreaks. Key signs include high fever, Koplik spots, and the characteristic rash. Laboratory confirmation through serological tests (measles IgM antibody) or PCR tests of throat or nasal swabs can confirm the diagnosis.
What parents should look out for
Parents should be aware of the following signs that might indicate their child has measles:
- A high fever lasting more than a few days
- Severe cough and runny nose
- Red, watery eyes
- Appearance of Koplik spots inside the mouth
- Development of a red rash starting on the face and spreading to the body
If parents observe these symptoms, they should seek medical advice promptly from their GP practice, or by calling NHS 111.
What to do if a GP suspects measles
If a General Practitioner (GP) suspects a patient has the signs and symptoms of measles, they should:
- Isolate the patient to prevent the spread of the virus.
- Notify local health protection teams to help trace and inform contacts.
- Confirm the diagnosis with appropriate tests.
- Advise on supportive care and monitor for complications such as pneumonia, encephalitis, or otitis media.
According to NHS guidelines, patients with measles should rest, stay hydrated, and take antipyretics like paracetamol or ibuprofen to manage fever. Those with severe symptoms or complications may require hospitalisation.
Rising measles cases in the UK
The UK has seen a rise in measles cases in recent years, primarily due to a decline in vaccination coverage. According to Public Health England, measles is highly infectious, and vaccination rates need to be above 95% to achieve herd immunity and prevent outbreaks.
Importance of vaccination
The MMR vaccine (measles, mumps, and rubella) is highly effective and safe. The NHS recommends that children receive two doses of the MMR vaccine: the first at around 12 months of age, and the second at three years and four months. Vaccination not only protects the individual, but also helps prevent the spread of the virus in the community, protecting those who cannot be vaccinated, such as infants and immunocompromised individuals.
Conclusion
Recognising the signs and symptoms of measles is crucial for early diagnosis and preventing its spread. Healthcare workers, doctors, and parents must remain vigilant, especially given the rising cases in the UK. Vaccination remains the most effective way to protect against measles, highlighting the importance of ensuring children receive their MMR vaccine according to the recommended schedule.
By understanding and identifying measles symptoms early, we can help control outbreaks and protect public health. For more detailed information, always refer to the latest NHS guidelines and consult with healthcare professionals.
If you suspect someone may have measles, please consult with your Primary Care 24 GP practice, or ring NHS 111.
