Measles

Background

Consider the diagnosis of measles in all children (and adult) presenting with: fever, rash, cough, conjunctivitis

Prodromal 3Cs
- Malaise, Conjunctivitis, Cough (tracheobronchitis), Coryza
Initial fever (usually high) x4/7
Koplik spots (salt grain or bluish by 2nd molar) day 5-7
Rash day 7 (lasts 5 days)
- Starts on face ears, spreads centrifugally
- Maculopapular then confluent
- Involves palms and soles
Generalised lymphadenopathy
Hepatomegaly
Abdo. pain (appendicitis or mesenteric adenitis)
Cough often late
Resolution by day 14

Isolate patient (plus infection control)
An “oracol” oral fluid swab should be sent to the Micro. lab. Swabs are available in the paeds treatment room CUH PED cupboard (bottom shelf). Please record the date of rash onset and the vaccination history on the form when sending a swab
Ensure staff are protected (MMR, previous exposure, born before 1978)
Unimmunised children requiring admission should be immunised if no contraindications
Opportunistic MMR immunisation is encouraged in other children who attend the ED
Measles is a notifiable disease. If in the HSE South please inform on 066 7184548 of any suspect case as soon as possible. Outside of normal working hours the Public Health Doctor on call for emergencies can be contacted through the Ambulance Services at 021-4209848
For those unfortunate enough not to live in Cork, here is a list of regional medical officer contact details
Please complete a Measles - Surveillance form