How should I manage a suspected case of measles in an unvaccinated child?

Management of a suspected case of measles in an unvaccinated child:

• Notify immediately the local Health Protection Team (HPT) as this is a statutory duty and essential for public health surveillance and contact tracing.

• Isolate the child to prevent spread: advise to stay away from nursery, school, or other public places for at least 4 days after rash onset and avoid contact with vulnerable individuals (infants, pregnant women, immunocompromised, and unvaccinated people).

• Symptomatic care: advise rest, adequate fluid intake, and use paracetamol or ibuprofen for fever and pain relief. Avoid aspirin in children under 16 years due to risk of Reye's syndrome.

• Assess severity and risk: seek urgent medical advice if the child develops complications such as shortness of breath, uncontrolled fever, convulsions, or altered consciousness.

• Seek specialist advice urgently if the child is under 1 year old, immunocompromised, or pregnant (or if the child is in contact with these groups), as these groups have higher risk of complications and may require additional interventions.

• Vaccination: if the child is susceptible and has no contraindications, offer MMR vaccine ideally within 3 days of exposure to provide post-exposure prophylaxis; if given before 12 months, additional doses will be required later.

• Provide written information about measles symptoms and when to seek further medical help.

• Follow-up is not always necessary but consider contacting the family about a week after rash onset to ensure recovery and discuss outstanding vaccinations.