What are the key clinical features to consider when diagnosing measles in a primary care setting?

Key clinical features to consider when diagnosing measles in a primary care setting include:

• Fever, often high and persistent.
• A characteristic measles rash that typically appears a few days after the onset of fever.
• Cough, which is usually dry and persistent.
• Conjunctivitis (red, inflamed eyes) without purulent discharge.
• Other prodromal symptoms such as coryzal symptoms (runny nose, sneezing) and Koplik spots (small white spots inside the mouth) may be present but are less commonly noted in primary care.
• Patients may also report malaise and generalised symptoms of viral illness.

In addition, consider the patient's age and risk factors, as measles can be more severe in children under one year, pregnant women, and immunocompromised individuals, who require urgent specialist advice.

Notification to the local Health Protection Team is mandatory upon suspicion of measles to enable public health management.

Symptom duration is typically about a week, with the rash lasting at least 4 days, and patients should be advised to avoid contact with susceptible individuals during this period.

Symptomatic relief with paracetamol or ibuprofen is recommended, avoiding aspirin in children under 16 years.

Urgent medical advice should be sought if complications such as shortness of breath, uncontrolled fever, convulsions, or altered consciousness develop.

These features help differentiate measles from other rash illnesses and guide appropriate management and public health actions in primary care.

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