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Measles

Checked: 28-08-2024 by Rob Adams Next Review: 27-08-2026

Overview

Measles is an important condition to diagnose due to its high infectivity, risk of complications and requirement for notification. Early diagnosis can help reduce risk of spread of the condition during the infective stage and identify contacts requiring prophylaxis.

See Clinical Knowledge Summaries for more detailed advice:

Measles | CKS | NICE

Recognition

Early symptoms can be non-specific and include fever, malaise, coryza, conjunctivitis and cough.

Measles can normally be diagnosed by appearance of a rash which should be differentiated from other viral exanthems. See PCDS - Viral exanthems - for advice on recognition.

A typical measles prodrome should also be investigated, particularly in patients with a recent contact history.

Complications

The most common complications of measles include pneumonia, ear infection, diarrhoea and convulsions. Rarely, measles can cause encephalitis and death.

Latest Updates

Measles: Frequently Asked Questions- latest advice from NHSE (April 2024). Includes advice on vaccination, isolation and PPE.
NHS England » Confirmation of national vaccination and immunisation catch-up campaign for 2023/24

Notification and testing

Measles is a notifiable disease. If measles is suspected then the local Health Protection Team (HPT) should be contacted immediately. The HPT will post an oral fluid testing kit to all possible/probable cases as part of surveillance testing.

More urgent testing can also be performed, depending on the case and risk contacts (contact HPT for advice), as follows:

A mouth (buccal) or throat swab taken in viral transport medium and sent for measles PCR testing.
Swabs can be used for PCR if collected within 6 days of the onset of rash.
If investigating a possible case more than 6 days after rash onset, please send both a mouth or throat swab and a clotted blood sample, which can be used for measles IgM testing.

A negative PCR result does not exclude a diagnosis of measles (1).

Patients should avoid public areas such as GP waiting rooms and should be seen separately away from other patient areas.

Staff who are not fully vaccinated for MMR in accordance with the UK vaccination schedule, or who are vulnerable e.g. pregnant, should not perform swabbing.

Please see the National Measles Guidelines (1) for advice on next steps.

Resources

(1) National measles guidelines - GOV.UK (www.gov.uk)

(2) Measles: post exposure prophylaxis

Patient Information

Measles - NHS (www.nhs.uk)
Measles: Symptoms, Diagnosis, and Treatment (patient.info)
UKHSA has translated their warn and inform letter into a number of community languages, and created an easy-read version that is also available online and for download.

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