It shocks me that measles is still a threat;1 it is an eminently eradicable disease, infecting only humans and not mutating; like smallpox, but not quite so deadly. I was proud to read that the UK had eliminated measles in 2017 and very sorry to read of its return. I want to do my bit, but the editorial is unclear as to how I can practically do this, the reason being primarily, I think, that it is written by non-GPs. It reminds me of the talk I went to by a cardiologist who encouraged us to refer ALL our chest pains to him, because it was impossible to be sure they weren’t cardiac. Knowing smirks were exchanged by the GPs present.
If we notified Public Health of all people with a fever, coryza, and a rash, they would be overwhelmed. I thought Koplik’s spots were pathognomonic but I now read they are ‘an unreliable marker’. In fact, measles may only present as a fever, a cold, and a rash, just like so many children I see every day. If they are ill I admit them; if not I give symptomatic advice. Every day I see these indefinable viral rashes.
If measles is ‘going around’ I would naturally be suspicious, but I wonder where this information comes from because I don’t think it comes from GPs. I don’t know any GP who has seen measles for years. Perhaps we have and didn’t realise it.
The single best piece of advice in the article was, of course, to establish whether or not the patient has been vaccinated. This should be a routine question and, by asking of a mother with an ill child, it should prompt parents who are holding out to do the right thing by their children.
- © British Journal of General Practice 2018
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