Measles Outbreak
Friday, February 22, 2019

Outbreak in Westmeath

The Department of Public Health HSE Midlands has been notified of a confirmed outbreak of measles in Westmeath.

Four cases have been notified.

Any children affected have been advised to stay at home in order to prevent the spreading of the disease.

Those who may have been exposed

A spokesperson for the HSE has said that:

"Anyone who has been exposed and is not immune to measles (either through natural infection or MMR vaccination) may develop measles up to three weeks following date of exposure. People are infectious from 4 days before rash starts until 4 days after."

Symptoms of measles

Measles is a highly infectious virus. The main symptoms are fever, cough, red and painful eyes, and a rash. It can cause severe disease resulting in complications such as pneumonia and encephalitis and occasionally death. Although it is most common in young children, it can affect anyone at any age.

Some other symptoms to look out for:

  • Ear infections
  • Severe cough
  • Breathing difficulties
  • Viral and bacterial infections
  • Eye infections
  • Runny nose
  • Vomiting
  • Diarrhoea
  • Stomach cramps
  • A rash that starts on the head and spreads down the body - consists of flat red and brown blotches that blend into each other and last for around four to seven days.

Measles starts with fever, cough, runny nose and red eyes, followed a few days later by a red rash that starts on the head and spreads downwards over the face, neck and body.

Measles can cause chest infections, fits, ear infections, swelling of the brain and brain damage. Measles is worst for children under one year of age, pregnant women, and people with poor immunity.

Measles virus is highly contagious and spreads through the air through coughing and sneezing. Make sure your child is protected with measles, mumps, and rubella (MMR) vaccine. Children should get the MMR injection at 12 months of age and again at 4 to 5 years of age.

MMR Vaccine

Two doses of MMR vaccine are required to give the best protection. In Ireland, the first dose is given at 12 months by GPs and the second dose is given to Junior Infants in school by HSE vaccination teams or by a GP.

Between 5% and 10% of children are not fully immune after the first dose, so the second dose of MMR helps to increase protection. Less than 1% of children remain at risk of measles after the second dose of MMR.

Young adults and parents

Make sure you and your children are up to date with your MMR vaccines.

Please go to your GP for MMR vaccination if:

  • You have not had 2 doses of MMR vaccine
  • You have a preschool or primary school child who never had MMR vaccine
  • You have a primary school child who missed out on the 2nd dose
  • You are not sure if your child has had 2 doses of MMR vaccine

Children under 12 months of age

MMR vaccine is recommended for children aged 6 to 11 months of age only if they are travelling to other countries or regions where measles outbreaks are reported.

NOTE: If MMR vaccine is given before 12 months of age, this dose is not counted as part of the childhood vaccination programme. MMR vaccine should be repeated at 12 months of age, at least one month after the first vaccine and with a further dose at 4 to 5 years of age.

Children under 6 months of age

The MMR vaccine is not recommended before the age of 6 months as it is not effective.

Travelling Abroad

This is the current most reported reason for the recent outbreak of measles (as of April, 2019).

  • Imported cases - people travelling to other countries in Europe, contracting the disease and bringing it back in to Ireland, spreading it to others who have not been vaccinated
  • Vaccination rates have dropped - it is never too late to get the MMR vaccine. Especially if you are travelling to a foreign country this Summer, it is extremely important that you and your children have received the vaccination as you are highly likely to come into contact with the disease.

All individuals travelling to Europe and other regions experiencing measles outbreaks or where measles cases continue to occur should ensure that they receive the MMR vaccine if needed.

medical definition of measles highlighted with pink

Measles and pregnancy

If you are planning to get pregnant and you have not had measles, arrange with your GP to have the MMR vaccine. If you catch measles during pregnancy, it can be passed on to your baby, which can be very damaging or even fatal to your baby. Measles in pregnancy can cause miscarriage, premature labour or a baby with low birth weight. The MMR vaccination cannot be given during pregnancy.

Diagnosing measles

Your GP will usually be able to diagnose measles from the combination of symptoms, such as the characteristic rash and the small spots inside the mouth.

A simple blood or saliva test can confirm the diagnosis and identify the rubeola virus.

Doctors have a duty to notify the local HSE Public health Department of all reported and suspected cases of measles. They will also notify the child's school if necessary.

Your child should not return to school until at least five days after the appearance of the rash.

Treating measles

There is no specific treatment for measles. Once the rash starts, you will need to rest and treat the symptoms until your immune system fights off the virus. If there are no complications, symptoms will usually disappear within 7 to 10 days.

If your child has measles, you may find the following advice useful:

  • Use liquid baby paracetamol or ibuprofen to relieve fever, aches and pains. Do not give aspirin to children under the age of 16.
  • Closing curtains or dimming lights can help reduce light sensitivity.
  • Damp cotton wool can be used to clean away any crustiness around the eyes. Use one piece of cotton wool per wipe for each eye. Gently clean the eye from inner to outer lid.
  • Children over 12 months old may benefit from a teaspoon of lemon juice and two teaspoons of honey in a glass of warm water. Honey should not be given to babies under the age of 12 months.
  • Cough medicines are of little help and should not be given to children under the age of six.  Placing a bowl of water in the room will make the atmosphere more humid, which can help relieve a cough.
  • When small children have a fever they rapidly lose water, which makes a cough worse. Children should drink as much as possible to prevent dehydration.

In severe cases of measles, particularly when there are more serious complications, hospital treatment may be required.

Complications of measles

Complications resulting from measles are more likely to develop in certain children, for example:

  • Children with a weakened immune system, such as those with leukaemia or AIDS
  • Children with a poor diet
  • Children under the age of five

Complications are also more likely to develop in adults who are over the age of 20.

Some of the common complications of measles are:

  • Diarrhoea
  • Vomiting
  • Eye infection (conjunctivitis)
  • Inflammation of the voice box (laryngitis)
  • Inner ear infection and inflammation (otitis media), which often causes earache, may also be a complication of measles.
  • Fits that are caused by a fever (febrile convulsions) are also possible complications of measles. However, the fits, although alarming, are not usually dangerous.

Less common complications of measles are:

  • Meningitis
  • Pneumonia (lung infection), symptoms include fast, difficult breathing, chest pain and deteriorating condition
  • Hepatitis (liver infection)
  • Encephalitis (inflammation of the brain), which can be fatal. Watch for drowsiness, headache and vomiting
  • Low platelet count, which affects the blood's ability to clot
  • Bronchitis and croup (infection of the airways), characterised by a hacking or barking cough
  • Squinting, if the virus affects the nerves and muscles of the eye.

for more information please visit your local CarePlus Pharmacy

*This information has been adapted from the HSE website.