Measles

This is spread through the spray of saliva produced by coughing or sneezing. It is infectious from the first symptoms (cough, conjunctivitis, fever and a miserable child), until five days after the rash starts. The rash is small red spots, often starting behind the ears. This spreads down the body and the spots join up.

The incubation period is seven to 21 days.

A classic sign is Koplik’s spots, which look like large grains of salt, and appear inside the mouth. However they have often faded by the time the rash appears.

Complications are rare but can include fits, pneumonitis (lung inflammation), meningitis (inflammation of the brain coverings) and encephalitis (brain inflammation). Without complications, recovery is usually complete.

Measles is rare nowadays, thanks to the national immunisation program. In the days before this, complications of the illness were seen occasionally. Because measles is now so rare, many younger doctors find it hard to recognise: they may never have seen it.

The vaccination against measles is a part of the standard immunisation offered to all children in the UK. Although complications to the vaccine exist, they are far rarer than the complications of the illness itself, and usually less serious.

What to do

Contact your doctor for diagnosis and advice and treat with general measures for a fever:

• Sponge your child down gently with tepid water, all over. Allow the body heat to dry the skin rather than towelling it dry. This can be repeated as often as necessary. Although your child may protest while you are doing this, he will feel much better afterwards, and the fever can be reduced by as much as one degree centigrade
• Give regular doses of sugar-free paracetamol syrup to help reduce fever, and combat aches and pains. Calculate the dose according to the manufacturer’s instructions, or ask your pharmacist
• Keep your child as undressed as possible to allow heat to be lost
• Encourage your child to take small, frequent sips of anything they will drink (though preferably clear fluids like water or squash rather than milky drinks)