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Immunity

Last week the UK Health Security Agency confirmed an outbreak of measles at Barlby Primary School, W10 where there are currently 14 confirmed cases, of which 4 are hospitalised. These cases are mainly from Y5 and Y6 age groups. The London Authority have held measles and vaccination awareness sessions and have witnessed a lot of hesitancy, misinformation and parents wishing to delay vaccination due to perceived risk of autism. The school has a history of antivax sentiment and hesitancy. These cases will move the Royal Borough of Kensington and Chelsea into ‘Level 3 – widespread transmission’.

What is measles?

Measles is a highly contagious viral infection. It primarily affects the respiratory system and can lead to severe complications, particularly in young children and individuals with weakened immune systems. While many people recover from measles without complications, the infection can lead to serious health issues especially in those who have not been immunised.  Complications include:

  • Brain inflammation (encephalitis). This is a rare but very serious complication. It occurs in about 1 in 5,000 cases. It typically causes drowsiness, headache and being sick (vomiting) which start about 7-10 days after the onset of the measles rash. Encephalitis may cause brain damage. Some children die from this complication.
  • Liver infection (hepatitis).
  • Pneumonia. This is a serious complication that sometimes develops. Typical symptoms include fast or difficult breathing, chest pains and generally becoming more ill.
  • Squint is more common in children who have had measles. The virus may affect the nerve or muscles to the eye.
  • A very rare brain disease called subacute sclerosing panencephalitis can develop years later in a very small number of people who have had measles. This can sometimes occur several years after getting measles. This condition is always fatal.

How is it spread?

Physical contact, coughing and sneezing can spread the infection. In addition, infected droplets of mucus can remain active and can be passed on by touching (they are contagious) for around two hours. This means that the virus can live outside the body – for example, on surfaces and door handles.

The incubation period is typically around 10 to 12 days but can vary from 7 to 21 days. Patients are infectious four days before & after the onset of rash.

What should I look out for?

Fever of 39ºC or more without taking paracetamol or ibuprofen, a rash which goes away with pressure and at least one of the following: cough, runny nose, and conjunctivitis.

A measles-like rash – red spots non-itchy, sometimes raised and joined together to form blotchy patches. The rash starts three to four days after the initial symptoms behind the ears, then the face, trunk of body and limbs.

Small white spots on the inside of the cheek (koplik’s spots).

Am I at risk if I come into contact with measles?

Some people have not been immunised against measles and therefore are at greater risk of catching it. Some people are more prone to complications if they get measles, these include:

  • Pregnant women
  • Babies under the age of 12 months
  • People with a poor immune system – i.e those on chemotherapy or taking steroids

How can I protect myself and my family?

You can protect yourselves with vaccination.

Immunisation is routine in the UK as part of the measles, mumps and rubella (MMR) vaccine. Two doses are usual – the first for children aged between 12 and 13 months and the second usually given at age 3 years and 4 months to 5 years. Immunisation gives excellent protection to prevent measles and so measles is now rare in the UK.

Unfortunately, measles is becoming more common again in children in some areas of the UK. This is due to some children not being vaccinated against measles as they have not receiving the MMR vaccine. Measles immunisation can be given at any age and is sometimes offered to older children during outbreaks. Parents often refuse the measles vaccine because they mistakenly think that the MMR vaccine can cause their child to have autism. This suggestion, first made in 1998, has been categorically disproved and the doctor who suggested it was removed from the medical register and found to have significant financial interests in single vaccines, which had not been declared. It is very important that parents understand that if a child is not vaccinated against measles and they catch it, their life may be at risk.

What should we all do now that there is an outbreak?

  1. Ensure your vaccinations are up to date. If you are born in 1980s there is a good chance that you only had once vaccination. Please check your records as you might need to come in for the second one.
  2. Avoid contact with infected individuals.
  3. Monitor for symptoms if you’ve been exposed.
  4. If you suspect you or your child may be infected do contact us. We can diagnose measles with a simple saliva swab and we are happy to help with diagnosis and treatment.

To book an appointment, please use our online booking system here or give us a call on 0207 245 9333.

References:

National measles guidelines 

https://www.gov.uk/government/publications/measles-the-green-book-chapter-21

https://cks.nice.org.uk/topics/measles/

https://patient.info/skin-conditions/viral-rashes/measles

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