Synopsis
Recognise three notifiable viral infections, isolate suspected measles immediately, protect vulnerable contacts and pregnancy, and use the current UK immunisation schedule accurately.
- Measles causes high fever, cough, coryza and conjunctivitis followed by Koplik spots and a blanching rash that begins on the face or hairline and spreads downwards.
- Isolate suspected measles from shared air and notify the health protection team immediately on clinical suspicion; do not wait for oral-fluid confirmation.
- MMR-containing vaccine within 72 hours of measles exposure can protect eligible susceptible contacts; selected vulnerable contacts may need human normal immunoglobulin as soon as possible and up to six days.
Key red flags
Suspected measles in a waiting room, ward or emergency department requires immediate airborne isolation and public-health notification before test confirmation.
High fever with cough, coryza, red watery eyes and malaise precedes the rash; tiny white Koplik spots may appear on the buccal mucosa.
Investigation priorities
Identify probable measles and vulnerable contacts before laboratory confirmation.
Management branches
Fever with cough, coryza, conjunctivitis or a descending rash creates clinical suspicion of measles.
- Keep the patient out of common waiting space, place them in an appropriate airborne isolation room and use respiratory protective equipment under local infection-control policy.
- Notify the proper officer or health protection team immediately, recording rash onset, vaccination, travel, exposure, pregnancy, immune status and places attended while infectious.
Key medicines
MMRV vaccine for the routine childhood programmePaediatric programme dose: give 0.5 mL of the supplied live MMRV vaccine by the authorised subcutaneous or intramuscular route; children born from 1 January 2025 receive routine doses at 12 and 18 months.
MMR vaccine for older catch-up and measles exposureGive 0.5 mL of an authorised live MMR vaccine by the product-approved route; use two valid doses at least four weeks apart for susceptible older children or adults, and give eligible measles PEP within 72 hours.