Measles contact: what to do after exposure in the UK

Measles is not a cold with a rash. It is spread by breathing, coughing and sneezing and can lead to pneumonia, meningitis, blindness and seizures, and the risk is highest in babies and in people with weakened immune systems. In pregnancy the NHS says it can cause miscarriage, stillbirth, premature birth and low birthweight.

UKHSA notes that measles is a notifiable disease in England and Wales, so doctors must tell local health protection teams about suspected cases. The team is the route by which contacts are traced and advised.

The NHS describes the infectious period as starting when symptoms first appear, about four days before the rash, and lasting until four days after the rash begins. That means a person can be spreading measles while they still think they have a heavy cold, with fever, runny nose, sneezing, cough and red, watery eyes.

Small white spots inside the cheeks can appear a few days into the illness. The rash then begins on the face and behind the ears and spreads to the body; it may be harder to see on brown and black skin. It is unlikely to be measles in someone who has had two doses of MMR or MMRV or has previously had the infection.

The NHS asks the following people to get an urgent GP appointment or call NHS 111 after contact with measles:

• a baby under 1 year old who has come into contact with someone with measles

• a pregnant woman or anyone with a weakened immune system who has been in close contact

• anyone who has not had measles or two doses of MMR or MMRV and has been in close contact

• anyone, contact or not, who thinks they or their child may have measles

Phone ahead rather than turning up at the surgery, because a waiting room is exactly where measles can spread. Have the vaccination record to hand; your GP surgery can tell you which vaccines you have had. The GP or the health protection team will decide whether any post-exposure protection is appropriate.

UKHSA lists guidance on when immunoglobulin is used and on vaccination given inadvertently in pregnancy, which clinicians consult for pregnant and immunosuppressed contacts. Contacts without immunity should also avoid babies, pregnant women and anyone with weakened immunity while the position is clarified.

Anyone born on or before 31 December 2019 who missed MMR can be vaccinated, with two doses at least one month apart, and the NHS singles out children, teenagers, young adults, people who could become pregnant, travellers, healthcare workers and people born between 1970 and 1990. Babies of 6 to 11 months can be given an early dose if they have been in close contact with measles, are travelling to a higher-risk area, or live in an outbreak.

MMR is a live vaccine, so it is not suitable for pregnancy or for a weakened immune system. Protection starts within about two weeks.

Illness usually begins improving in about a week. Rest, fluids, paracetamol or ibuprofen, and gentle eye cleaning with cooled boiled water are the home measures. The NHS says to call 999 or go to A&E for seizures, severe breathing difficulty, being unable to stay awake, sudden confusion, a limp or floppy child, a non-fading rash, a stiff neck or discomfort in light. Do not drive yourself; ask someone else or call an ambulance.