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Measles

Introduction
MMR Vaccine
Red Symptoms
Amber Symptoms

Introduction

Measles is a highly contagious viral infection.

It causes a fever, cold-like symptoms and a distinctive rash on the body.

It can spread very easily through droplets in the air when an infected person coughs or sneezes. You can get measles by being in the same room as someone infected for as little as 15 minutes or touching contaminated surfaces.

Most children who get measles make a full recovery, but in some cases measles can be fatal if there are serious complications, like inflammation of the brain (encephalitis).


MMR Vaccine

The Measles, Mumps and Rubella (MMR) vaccine is the best way to prevent Measles. This is given in two doses as part of the NHS childhood vaccination programme. The first dose is given when your child is around 12 months old and a second dose is given before your child starts school, at around 3 and a half years.

If your child has had both doses of their MMR vaccine, there is almost no chance of them getting measles and this will provide your child with lifelong protection (unless they have a severely weakened immune system). Even a single dose of the vaccine provides significant protection.

Any adults or children who have missed these vaccines, it’s not too late to get them.

Click here to find out more about the MMR vaccine.


  • Why is this important now?

    There has been a sharp increase in the number of confirmed Measles cases across England since October 2023. Cases are expected to rise further and spread across the UK and Ireland.

    The number of children having the MMR vaccine has dropped in the UK, Ireland and beyond so there is a significant risk of measles outbreaks and serious illness in Northern Ireland.

  • How can you prevent your child from getting measles?

    The Measles, Mumps and Rubella (MMR) vaccine is the best way to prevent Measles. This is given in two doses as part of the NHS childhood vaccination programme. The first dose is given when your child is around 12 months old and a second dose is given before your child starts school, at around 3 and a half years.

    If your child has had both doses of their MMR vaccine, there is almost no chance of them getting measles and this will provide your child with lifelong protection (unless they have a severely weakened immune system). Even a single dose of the vaccine provides significant protection.

    Any adults or children who have missed these vaccines, it’s not too late to get them.

    Click here to find out more about the MMR vaccine.

  • What are the signs and symptoms?

    Once exposed to the virus, it can take 7-21 days (usually approx. 10 days) for symptoms to appear. Child is infectious from 4 days before symptoms until 4 days after rash.

    Measles start with:

    • Fever
    • Red, sore, watery eyes (conjunctivitis)
    • Runny nose (coryza)
    • Cough

    After a few days:

    • Small white spots may appear inside their mouth and on the back of their lips
    • A rash starts on the face and behind the ears. It then spreads all over the body. The spots of the measles rash are sometimes raised and often join together to form blotchy patches. They are not usually itchy. The rash looks brown or red on white skin. It may be more difficult to see on brown or black skin.

    Most children who have measles are unwell for 7-10 days and should start to feel better about two days after the rash appears.

    However, the cough may persist for 2 weeks.

  • What should you do if you think your child has measles?
    • There is no specific treatment for measles and most children who get measles will make a full recovery.
    • Ensure you review the information on this page to learn how you can care for your child while they are unwell and know when to seek help.
    • You can contact your GP practice to allow onward notification to the Public Health Agency – you may be asked to provide photos of the rash and mouth to confirm diagnosis.
    • Your child may not need clinically assessed unless they are high risk (unvaccinated children, suppressed immune system or a complex underlying health condition), you are concerned or they are unwell (see the Amber and Red pathways for further information).
    • Measles is a highly infectious disease so you should avoid public spaces and telephone ahead to healthcare providers (CALL AHEAD) and avoid other contacts as your child may spread their infection to others.
  • Is your child high risk?

    Your child is high-risk if any of the following applies:

    • You have been advised by a doctor that your child has a weakened immune system e.g. due to condition or medication
    • Young unvaccinated child
    • Complex conditions (if unsure, please contact your GP or Paediatrician for advice)

     

    What if you or your child have a weakened immune system (due to medicines or illness)?

    • If your child has a weakened immune system and has suspected Measles, contact your GP practice, Out of Hours GP or local Emergency Department urgently.
    • If your child with measles has been in contact with someone who has a very weak immune system, let that person know about your child’s measles. Ask them to contact their GP practice, Out of Hours GP or local Emergency Department urgently.
  • What if you are pregnant?
    • If you are pregnant and haven’t received 2 doses of the MMR vaccine, or if there are any children in your family who are under 12 months old or any child who hasn’t had 2 doses of the MMR vaccine, please inform your GP practice urgently. They might need immediate treatment to protect them from getting measles.
    • Make sure that you and your partner are up to date with your MMR vaccines before getting pregnant if possible. Measles can be extremely severe during pregnancy and can harm your unborn baby. It increases the risk of miscarriage, stillbirth or preterm delivery.
  • What can you do to help your child if they have measles?

    Most children feel miserable with measles but can be treated and looked after at home.

    There is no specific treatment for measles.

    However what you can do to help is:

    • Encourage rest.
    • To make your child more comfortable, you may want to lower their temperature using paracetamol (calpol) or ibuprofen. If you’ve given your child one of these medications and they’re still uncomfortable 2 hours later, you could try the other medication. If this works, you can alternate paracetamol and ibuprofen (every 2 to 3 hours), giving only 1 medicine at a time. Do not give more than the maximum daily dose of either medicine.
    • However, remember that fever is a normal response that may help the body to fight infection. Paracetamol and ibuprofen will not get rid of it entirely. Paracetamol and Ibuprofen bring down the temperature but do not treat the infection. Whilst your child is unwell they will continue to get temperatures once the effects of the medicine has worn off.
    • Avoid sponging your child. It doesn’t actually reduce your child’s temperature and may make your child shiver.
    • Encourage your child to drink lots of fluids. Ice lollies can be a helpful option.
    • If there are any crusts on your child’s eyes, gently clean them using cotton wool soaked in warm water.
    • Antibiotics are not given because measles is a caused by a virus.
  • When and where should you seek help?
    • Unless your child has RED features, try to stay away from public places including pharmacies, GP practices and Emergency departments as your child may spread their infection to others.
    • If your child has any of the AMBER features, urgently contact your GP or nearest Emergency Department. Make sure you let them know if you are worried your child may have Measles or your child has not been vaccinated against measles (MMR vaccine) (CALL AHEAD).
    • You should only call 999 or go to your nearest Emergency department in critical or life threatening situations. Let a member of staff know before (CALL AHEAD) or as soon as you arrive if your child has not been vaccinated against measles (MMR vaccine).

     

  • When can your child return to school or nursery?
    • Your child can spread the infection to others from the time their symptoms start until approximately 4 days after the rash appears.
    • Children cannot go back to school or nursery until 4 days after the rash has started. They should also avoid contact with babies, pregnant women, people who have not had 2 doses of the MMR vaccine and people with weak immune systems.
  • What are the complications?

    Sometimes measles can lead to a secondary infection – children may get ear infections (can lead to deafness), lung infections (pneumonia) or profuse diarrhoea and vomiting (can lead to dehydration) when they have measles.

    Rare but serious complications of measles are meningitis and encephalitis (infection and inflammation of the brain) which may lead to seizures and brain damage.

    Measles can kill.

    Watch the videos below to see some of the possible consequences from measles:


Red Symptom image

 

 

 

If your child has any of the following RED features:
  • Breathing very fast, too breathless to talk, eat or drink.
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting).
  • Coughing up blood.
  • A sharp chest pain that feels worse when breathing.
  • Breathing that stops or pauses.
  • Is pale, blue, mottled or feels unusually cold to touch.
  • Difficult to wake up, very sleepy (drowsiness) or confused.
  • Weak, high-pitched cry or can’t be settled.
  • Has a fit (seizure).
  • Has a rash that does not go away with pressure (the ‘Glass Test’).
  • Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features).
Actions to take if your child has any red symptoms
  • Your child may require emergency treatment.
  • You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
  • Let them know before (CALL AHEAD) or as soon as you arrive if your child has not been vaccinated against measles (MMR vaccine).

Amber Symptoms section

 

 

 

If there are no red symptoms, check if your child has any amber symptoms:
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not passed urine or wet nappy in last 8 hours
  • Poor feeding in babies (less than half of their usual amount)
  • Irritable (unable to settle them with toys, TV, food or hugs even after their fever has come down)
  • Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
  • Temperature less than 36°C in those over 3 months
  • Getting worse or you are worried about them
Options if your child has any amber symptoms

Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.

You can:

  • Ring your GP surgery during their usual opening hours (CALL AHEAD).
  • Contact the out of hours GP if the surgery is closed
  • If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice, contact your nearest Emergency Department.