Measles

Transmission

Measles is a highly contagious viral infection primarily transmitted through respiratory droplets. When an infected person coughs, sneezes, or breathes, the virus can be released into the air and easily inhaled by those in close proximity. The virus can also survive on surfaces for a few hours, contributing to indirect transmission. Individuals are most contagious during the period before the onset of symptoms and up to four days after the appearance of the characteristic measles rash.

Symptoms

The symptoms of measles typically appear 10 to 14 days after exposure to the virus. Early symptoms may include a high fever, cough, runny nose, and red, watery eyes. Small white spots with a bluish-white centre, may appear inside the mouth. A few days later, a distinctive red rash usually begins on the face and spreads to other parts of the body. Other common symptoms include extreme tiredness and a loss of appetite.

Treatment

There is no specific antiviral treatment for measles, and management primarily focuses on alleviating symptoms and preventing complications. Bed rest, adequate hydration, and fever-reducing medications are commonly recommended. In severe cases, especially when complications such as pneumonia or encephalitis arise, hospitalisation may be necessary. Measles can be particularly severe in certain populations, including infants, pregnant women, and individuals with compromised immune systems.

Prevention

The most effective way to prevent measles is through vaccination. The measles, mumps, and rubella (MMR) vaccine provides immunity against the virus. The vaccine is typically administered in two doses, with the first dose given around the age of 1 and the second dose before starting school. High vaccination coverage is crucial to achieving herd immunity, which helps protect those who cannot be vaccinated, such as infants and individuals with certain medical conditions.

In summary, measles is a highly contagious viral infection with distinct symptoms, and while there is no specific antiviral treatment, prevention through vaccination and public health measures remains paramount in controlling the spread of the virus and reducing the impact of the disease on individuals and communities.

The vaccine is effective at preventing all three illnesses and can be given from 12 months of age. It is particularly important to check if you are vaccinated against MMR before travelling as infection is prevalent in Asia, Africa and South America.

Because the illness is easily transmitted through air, MMR immunity is necessary for certain jobs.
Book now at your local CityDoc clinic to get your MMR vaccination, whether for travel or occupational purposes.

• No valid consent
• Infants under 9 months of age
• Confirmed anaphylactic reaction to a previous dose of a measles-, mumps- or rubella-containing vaccine.
• Confirmed anaphylactic reaction to neomycin or gelatin.
• Previous allergy to eggs showing signs of anaphylactic, anaphylactoid, or other immediate reactions subsequent to egg ingestion.
• Pregnant women – pregnancy should be avoided for 1 month following vaccination.
• Vaccination should be postponed during any illness with fever >38.5°C.
• Active untreated tuberculosis.
• Blood dyscrasias, leukaemia, lymphomas of any type, or other malignant neoplasms affecting the haematopoietic and lymphatic systems.
• Family history of congenital or hereditary immunodeficiency unless the immune competence of the potential vaccine recipient is demonstrated.
• Patients with rare hereditary problems of fructose intolerance should not be vaccinated with MMR vaccines since they contain sorbitol^.
• Susceptibility to febrile convulsions or family history of convulsions
• Current neurological deterioration, including poorly controlled epilepsy, exclude until the condition is stabilised or diagnosed.

Pregnancy and Breastfeeding

The live vaccine must not be given to pregnant women. Green Book states that MMR vaccine can be given to breastfeeding mothers.

Immunosuppression and HIV

The live vaccine should not be given to those who are immunosuppressed or HIV positive.

What is MMR?

Measles, mumps and rubella are 3 virus conditions that are highly infectious and can cause acute illness.

Measles

Measles is spread by airborne or droplet transmission and characterised by a rash which usually starts at the head and covers the trunk and limbs within 3 to 4 days. In the mouth small red spots with blueish-white centres can appear on the mucous membranes, along with a runny nose, fever, and a cough.

Mumps

Mumps is another viral infection spread by airborne or droplet transmission, Infection is characterised by a swelling in the neck area. The virus frequently visits the nervous system and can lead to headache, photophobia, and neck stiffness.

Rubella

Rubella is a milder disease with a less intense rash and milder symptoms of runny nose, fever, and conjunctivitis. The rash is usually seen behind the ears and on the face and neck. Complications include maternal infection which may result in foetal loss or congenital rubella syndrome that can lead to eye defects, deafness, cardiac abnormalities and inflammatory lesions of the brain and some organs.

What is the schedule for these vaccines?

All 3 diseases are combined as a single vaccine. The standard NHS schedule is 2 doses, the first being given around the age of 12 months and the second around 3 and half years old.

The recent media reports have said the levels are below the herd immunity what does that mean?

Herd immunity is an indicator of the percentage of the population that need to be fully vaccinated to prevent the virus from spreading through the population. For measles WHO consider this to be 95% and in Autumn 2023 the UK was showing only 86%, with a risk of measles spreading through the unvaccinated population.