Measles

There has been a recent rise in measles cases in the UK (May 2023).

Measles is spread when an infected person coughs or sneezes. It can spread very easily.


You can protect your child by making sure they get 2 doses of the MMR vaccine.
Normally the 1st is given at 12 months and the 2nd around 3 years 5 months old.
Even if you or your children have missed these vaccines, it’s not too late to get them.
Contact your GP practice today.


If your child has had both doses of their MMR vaccine, there is almost no chance of
them getting measles (unless they have a severely weakened immune system).


There is more information about the MMR vaccine and other childhood
vaccinations.


 

Measles usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth.

Cold-like symptoms

The first symptoms of measles include:

  • a high temperature
  • a runny or blocked nose
  • sneezing
  • a cough
  • red, sore, watery eyes

Spots in the mouth

Small white spots may appear inside the cheeks and on the back of the lips a few days later. These spots usually last a few days.

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The measles rash

A rash usually appears a few days after the cold-like symptoms.

The rash starts on the face and behind the ears before spreading to the rest of the body.

The spots of the measles rash are sometimes raised and join together to form blotchy patches. They're not usually itchy.

The rash looks brown or red on white skin. It may be harder to see on brown and black skin.

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If your child has any of the following features:

  • Breathing very fast, too breathless to talk, eat or drink
    ● Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
    ● Breathing that stops or pauses
    ● Is pale, blue, mottled or feels unusually cold to touch
    ● Difficult to wake up, very sleepy or confused
    ● Weak, high-pitched cry or can’t be settled

    ● Has a fit (seizure)
    ● Has a rash that does not go away with pressure (the ‘Glass Test’)
    ● Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)







You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following features:

Breathing a bit faster than normal or working a bit harder to breathe
● Dry skin, lips or tongue
● Not had a wee or wet nappy in last 8 hours
● Poor feeding in babies (less than half of their usual amount)
● Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
● Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
● Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
● Temperature less than 36°C in those over 3 months
● Getting worse and I am still worried







You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS Wales 111 - dial 111

If none of the above features are present

Watch them closely for any change and look out for any red or amber symptoms


● If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.

● Additional advice is also available to young families for coping with crying of
well babies.







Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS Wales111 – dial 111

What should you do ?

If you think your child has measles, let your GP practice know.

● Measles usually starts to get better in about a week.

● To make your child more comfortable, you may want to lower their temperature using paracetamol (calpol) or ibuprofen.

If you've given your child one of these medications and they're still uncomfortable 2 hours later, you

could try the other medication. If this works, you can alternate paracetamol

and ibuprofen (every 2 to 3 hours), giving only 1 medicine at a time. Do not

give more than the maximum daily dose of either medicine.

● However, remember that fever is a normal response that may help the body to

fight infection. Paracetamol and ibuprofen will not get rid of it entirely.

Paracetamol and Ibuprofen bring down the temperature but do not treat the

infection. Whilst your child is unwell they will continue to get temperatures

once the effects of the medicine has worn off.

● Avoid sponging your child. It doesn’t actually reduce your child’s temperature

and may make your child shiver.

● Encourage your child to drink lots of fluids.

● If there are any crusts on your child's eyes, gently clean them using cotton

wool soaked in warm water.

 

● Your child can spread the infection to others from the time their symptoms

start until about 4 days after the rash appears.

● Children cannot go back to school or nursery until 4 days after the rash has

started. They should also avoid contact with babies, pregnant women, people

who have not had 2 doses of the MMR vaccine and people with weak immune

systems.

 

● If you are pregnant and haven't received 2 doses of the MMR vaccine, or if

there are any children in your family who are under 12 months old or any child

who hasn't had 2 doses of the MMR vaccine, please inform your GP practice

urgently. They might need immediate treatment to protect them from getting

measles.

● If your child with measles has been in contact with someone who has a very

weak immune system, let that person know about your child's measles. Ask

them to contact their GP practice or NHS Wales 111 urgently.

● Finally, make sure that you and your partner are up to date with your MMR

vaccines before getting pregnant. Measles can be extremely severe during

pregnancy and can harm your unborn baby.

 

Where should you seek help?

Unless your child has red features (see above), try to stay away from public
places including pharmacists, GP practices and A+E departments as your
child may spread their infection to others.
● If your child has any of the above amber features (see above), urgently
contact your GP or call NHS Wales 111. Make sure you let them know if your child
has not been vaccinated against measles (MMR vaccine).


● You should only call 999 or go to your nearest A&E department in critical or
life threatening situations. Let a member of staff know as soon as you arrive if
your child has not been vaccinated against measles (MMR vaccine).

What are the possible complications of measles infection?


Even in developed countries such as the UK, around one in every 15 children with
measles will develop more serious complications. These can include:
● ear infection (otitis media) in about 1 in 12 children with measles
● pneumonia (chest infection) in about 1 in 16 children with measles
● diarrhoea in about 1 in 12 children with measles
● encephalitis (inflammation of the brain): 1 case for every 1000-2000 children
with measles. Encephalitis can lead to permanent brain damage
● measles causes death in about 1 in 5000 children with measles


In rare cases, measles can lead to a condition called SSPE (subacute sclerosing
panencephalitis). This causes progressive destruction of the brain resulting in
dementia, loss of motor function, fits (epilepsy), and eventually death. There is
unfortunately no cure for SSPE.

Unless your child has red features (see above), try to stay away from public places including pharmacists, GP practices and A&E departments as your child may spread their infection to others.

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS Wales 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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Improving the physical and emotional health and wellbeing of expectant mothers, infants, children and young people throughout Aneurin Bevan University Health Board Area.

(N.B: The Family and Therapies team at ABUHB is NOT responsible for the content on the webpage links that we refer to in our resource sections and linked information to external sites. All information was accurate and appropriate at the time the webpage was created.)

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