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Suspected measles with an immunosuppressed healthcare-setting contact — MRCEM SBA MCQ

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HardProfessional practice and researchSuspected measles with an immunosuppressed healthcare-setting contactMRCEM SBA

A 24-year-old man attends an emergency department in England with fever, cough, coryza, conjunctivitis and a maculopapular rash that began on his face and is spreading downwards. He has not received measles-containing vaccine. Before he is isolated, he spends 20 minutes in an enclosed waiting area with a patient receiving chemotherapy for lymphoma. The infection prevention and control team has been alerted, and a measles sample has been sent; the result is pending. The man understands the proposed notification but objects to his identifying details being shared with public health staff because he fears consequences at work. What is the most appropriate notification and public health plan?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Telephone the health protection team now; report online within 3 days; assess the exposed patient now.

The presentation is strongly suggestive of measles, which is an **urgent notifiable disease** in England. A registered medical practitioner must telephone the local UKHSA health protection team within 24 hours and submit the online notification within 3 days. Notification is required on suspicion: neither the pending test nor the patient’s objection removes the reporting duty. UKHSA guidance permits confidential patient information to be provided without consent for this purpose. ([gov.uk](https://www.gov.uk/guidance/notifiable-diseases-and-how-to-report-them)) The patient receiving chemotherapy is a potentially vulnerable contact. UKHSA’s measles guidance prioritises assessment of immunosuppressed contacts, including consideration of susceptibility and post-exposure prophylaxis, without waiting for the index patient’s laboratory result. The emergency department should initiate that assessment with its infection prevention and control team and the health protection team; the stem does not establish that prophylaxis should be given without further assessment. ([assets.publishing.service.gov.uk](https://assets.publishing.service.gov.uk/media/69cbc91fa60a12ca3913c644/ukhsa-national-measles-guidelines-version-7-march-2026.pdf)) **A** delays the contact assessment. **B** mistakes an online report for the urgent telephone notification. **C** makes a statutory notification conditional on consent. **D** correctly prioritises the call and contact assessment but incorrectly makes the online report conditional on laboratory confirmation. **E** meets all three requirements. ([gov.uk](https://www.gov.uk/guidance/notifiable-diseases-and-how-to-report-them))

Reference: UKHSA: Notifiable diseases and how to report them (Updated 19 May 2026) — https://www.gov.uk/guidance/notifiable-diseases-and-how-to-report-them UKHSA: National measles guidelines, version 8 (28 July 2026) — https://assets.publishing.service.gov.uk/media/69cbc91fa60a12ca3913c644/ukhsa-national-measles-guidelines-version-7-march-2026.pdf