15 August 2007

"Doctors in the Wigan Borough urged to be on Alert for Measles Cases

Ashton, Leigh and Wigan Primary Care Trust is urging family doctors in the Wigan and Leigh areas of Greater Manchester to be on the alert for cases of measles after six young people have recently been diagnosed with the infection. The young people concerned were not protected by MMR vaccine.

Dr Rona Cruickshank, Director of Public Health for the Primary Care Trust said:

“We have informed local GPs about the recent cases and have asked them to be alert for and to notify immediately any potential cases.  We strongly recommend that where possible, sick patients with a rash should be seen at a time and place where contact with other patients can be minimised, preferably at home or at the end of surgery without any time spent in the waiting room.”

GPs are advised to:

• Offer MMR vaccine to susceptible patients within three days of exposure to a suspected or known case of measles.
• Ensure that all children registered with their practices are fully immunised by two doses of MMR vaccine before reaching school age.
• Advise parents to keep children with suspected measles away from school or nursery for five days after the onset of the rash.

Dr Cruickshank went onto say  “the Primary Care Trust would urge all children and young people to have two doses of the MMR (Measles, Mumps and Rubella) vaccine to ensure protection against these serious infections”.

……………………….………….end…………………….…………….

The MMR vaccine was introduced into the UK immunisation schedule in 1988 and protects against Measles, Mumps and Rubella (German Measles).  Full protection requires two doses of the vaccine at appropriate time intervals.

Measles is a viral illness that used to affect up to 800,000 people per year.  Since the introduction of measles vaccine, and especially since the introduction of MMR vaccine in 1988, numbers of cases have been reduced to very low levels.

Measles is a very infectious disease that is usually transmitted by direct person-to-person spread. There is evidence that the measles virus can remain in the air for at least two hours after an infectious patient has left the room. This has implications for transmission to healthcare staff and patients in health care settings, including GP surgeries.

Symptoms of measles may include:

• A generalized rash lasting three or more days.
• A temperature of at least 38.3 degrees centigrade.

Although most people will get over measles without too many problems, a significant number will go on to develop serious complications. The numbers in the brackets indicate how common each complication is.

• Ear infection (1 in 20)
• Pneumonia/bronchitis (1 in 25)
• Convulsion (1 in 200)
• Diarrhoea (1 in 6)
• Hospital admission (1 in 100)
• Meningitis/encephalitis (1 in 1,000)
• Late onset: SSPE(Subacute sclerosing panencephalitis (SSPE) is a rare, degenerative neurological condition that can develop some years after natural measles infection and causes brain damage and death. The risk is greatest in those who were infected at a young age. The average interval from measles infection to onset of SSPE is around 8 years. Death invariably follows. Since the introduction of live attenuated measles vaccine in the 1960s, the incidence of SSPE has dramatically decreased and we expect the death rate from SSPE to fall even further. Measles vaccine directly protects against SSPE.) (1 in 8,000 children under 2 years old)
• Death (1 in 2,500-5,000)

Complications are more likely in those who have a weakened immune system or in infants under the age of 1 year. Measles can also cause problems in pregnancy. People in these categories who are recent contacts of a definite case of measles and who are not immune may be offered vaccination.

There is no specific treatment for measles. Treatment is based on symptoms such as reducing fever (aspirin must NOT be used in those under the age of 16 years). Occasionally, antibiotics may be needed for a secondary bacterial infection. 

People are infectious from just before the time that they become unwell to around 4 days after the onset of the rash. Those affected should stay off school or work for 5 days from the onset of the rash.

Sources (and further information):
http://www.hpa.org.uk/infections/topics_az/measles/menu.htm
http://www.mmrthefacts.nhs.uk/
http://www.mmrthefacts.nhs.uk/library/thediseases.php
http://www.nhsdirect.nhs.uk/en.aspx?articleId=243&sectionId=6822

……………………….………….end…………………….…………….

Editors Note

For further information please contact:
Pauline Harrison
Head of Communications
Ashton, Leigh and Wigan PCT
e-mail pauline.harrison@alwpct.nhs.uk
on 01942-482709