Measles

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Measles?

  Measles is a highly infectious acute viral disease resulting from infection with measles virus.

  Vulnerable groups include unvaccinated children/pregnant women, immunocompromised patients and the chronically ill. These groups are more at risk of developing severe complications including pneumonia/bronchitis, convulsions, diarrhoea, meningitis/encephalitis, immune thrombocytopenic purpura (ITP) and late onset subacute sclerosing panencephalitis (SSPE).

  

• How does it spread?

  Measles is one of the most contagious of all infectious diseases.. Individuals with primary measles infection are infectious from about 4 days before rash onset until 4 full days after the rash appears.

  The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes.

• What are the symptoms of Measles?

  Initial symptoms include fever, conjunctivitis, cough, runny nose and sneezing. This is followed by small grey/white spots, called Koplik’s spots, on the inside of the mouth 1 to 2 days before rash onset which may last for 2 to 4 days.

  Measles rash appears red and blotchy, developing 2 to 4 days after the onset of fever, and spreading from the head to the body over the next 3 to 4 days.

  

• Why is this important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

• IPC Precautions
  • Airborne precautions should be used
  • An FFP3 Mask should be worn.
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Eye protection should be worn.
  • Gloves and Aprons should be worn. Consider the use of a long sleeved gown if there will likely be prolonged contact with patient such as for personal care.
  • The patient should be transported via ambulance with no other patients present.
  • Laundry should be treated as contaminated, placed into an alginate bag and placed into a red laundry bag.
• What cleaning is required?

  All equipment and the ambulance should have an in-between patient clean paying particular attention to touch points.

  Leave the vehicle doors open while patient is being transferred to the receiving unit.

• Do staff need prophylaxis or follow up?

  Immediate Action: Staff should inform their line manager and the IPC team should be contacted at the earliest time able within working hours. A risk assessment will be completed to identify staff who may require follow up/prophylaxis.

  If staff have worn appropriate PPE with no breaches then no follow up is required.

  All staff should have satisfactory evidence of protection against measles to protect both themselves and their patients. Satisfactory evidence of protection includes documentation of having received 2 or more doses of measles containing vaccine and/or a positive measles IgG antibody test. Staff with satisfactory evidence of protection can continue to work normally but should be advised to report to Occupational Health (OH) if they develop prodromal symptoms or a fever between 7 days after the first exposure and 21 days after the last exposure.

  Staff who are exposed to a confirmed or likely case and do not have satisfactory evidence of protection will be referred urgently to Occupational Health.

  Staff should be excluded from work from the 5th day after the first exposure to 21 days after the final exposure. If staff are tested rapidly after exposure, they can continue to work if found to be measles IgG positive within 7 days of exposure (as this is too early to be due to infection from the recent exposure). Where MMR vaccine is given post-exposure, it is unlikely to prevent the development of measles but if they remain symptom-free for at least 14 days after MMR was given, they can return at that stage.

  Further information and advice will be given by Occupational Health.

• Link to guidance

  National measles guidelines October 2023 (publishing.service.gov.uk)