Measles update for primary care contractors
Staff vaccinations
It is important that all primary care contractors check to see if staff members have been vaccinated. If any members of your team are not vaccinated, they should be encouraged to contact their GP practice to arrange this. Please note that the isolation period for staff who have not had two MMR vaccinations or proven serological immunity (a positive blood antibody test for measles that shows a level reached for immunity) who come into contact with a measles case is 21 days, so from a business continuity perspective it is important as many people as possible are protected from infection.
Measles toolkit for primary care
A useful clinical toolkit has been developed to support diagnosis and referral pathways for measles patients. This includes information for primary care assessment, fever pathway, and secondary care referral for the four Lancashire and South Cumbria trusts.
Prevent transmission
In health care settings, suspected measles cases should be triaged and isolated immediately to protect other patients. Ensure Infection Prevention and Control measures are in place.
- Fever > 39°C in the absence of antipyretics
- Conjunctivitis
- Cough and/or coryza
- Generally very unwell
- Koplik spots (small red spots with bluish-white centres) inside the mouth
- Generalised maculopapular rash – appears after prodromal phase usually on the face and upper neck and spreads to the rest of the body
Risk factors for measles
To inform clinical diagnosis consider:
- Age of the case
- Vaccination (two doses measles mumps rubella (MMR) vaccine = fully immunised)
- Travel within and outside the UK
- Member of an under-vaccinated population group
- Link with a confirmed case of measles
Diagnostic testing
Clinicians should take an urgent diagnostic PCR test (unless confirmed measles is endemic – widely circulating within the region). This supports management of cases, and minimises impact on close contacts, the community and health care services.
How to take a sample for measles PCR:
- A mouth swab (ideally in viral transport medium; usually available from your local laboratory) OR
- A dry swab can be used to swab the inside of the mouth, use the swab from a charcoal transport medium pack but DO NOT place in the charcoal transport medium. Please use a plain sterile container such a universal container used for urine samples OR
- Where mouth swabs or dry swabs are not available, a urine sample; please use a plain sterile urine container without preservative.
Please send these samples urgently to the UKHSA Virology lab at MFT via your local laboratory. Results will generally be available within 48 hours of sample receipt in the lab.
If urgent PCR samples are dispatched in hours inform the duty virologist by both phone T: 0161 276 8836 and email duty.virologist@mft.nhs.uk. If out of hours call via MRI Hospital switchboard T: 0161 276 1234 and email duty.virologist@mft.nhs.uk. Do not include patient identifying information.
To obtain urgent results please contact the Virology Results line on: 0161 276 8854 Monday – Friday 8.30am-5pm and Saturday 8.30am -12.00pm
Notification
Measles is a notifiable disease and clinicians must inform local UKHSA health protection teams of suspected cases to facilitate timely public health action and urgent risk assessment of any vulnerable contacts.
Useful resources and downloads
This measles symptoms poster
Think measles poster
British Islamic Medical Association measles poster
GP Practice Action Check List to support the National MMR catch up ‘Call and Recall
NW Measles information for health professionals
Vaccine and porcine gelatin leaflet
Translated invite for the measles, mumps and rubella (MMR) vaccination – child
Translated invite for the measles, mumps and rubella (MMR) vaccination – adult
Easy read version of invite for the measles, mumps and rubella (MMR) vaccination – adult (Word)