REPORT ON MEASLES IN CONSULTATION WITH HMPPS & UKHSA

Like all infections, a national problem becomes a bigger problem within the prison system because of the close proximity we have with each other and with prisoners.

During 2023, we saw a resurgence of measles across the UK, with 44% of positive cases being in the West Midlands and 33% in London. There is a significant risk of measles outbreaks in prisons because a) measles is highly infectious; b) there may be many prisoners and staff who are vulnerable to infection, and c) even a single infectious person could result in many more cases.

WHAT IS MEASLES?

Measles is a very contagious viral infection most commonly found in young children who have not been immunised. However, adults can also catch measles if they have not had it before or have not been immunised against it. Measles is an unpleasant illness and easily passed from one person to another. In some people it can cause complications, such as an ear infection, chest infection and even pneumonia. In very rare cases, some people who get measles can develop serious complications, which can be fatal.

HOW DOES MEASLES SPREAD

• Measles is highly contagious; about 90% of people in contact with a person who has measles will catch it if not vaccinated or naturally immune.
• It begins with a fever, cough, runny nose and conjunctivitis (red, sore eyes) that last for two to four days.
• After a few days, a red-brown spotty rash will appear. This starts on the face and upper neck, spreading down the upper body and then to the arms, hands, legs and feet. After about five days, the rash starts to fade.
• The measles virus lives in the nose and throat of infected people. A person with measles is infectious for eight days: four days before rash onset until four days after the rash appears.
• Measles is caught through direct contact with an infected person or through the air when they cough or sneeze.

CAN YOU PREVENT MEASLES?

Yes. Measles can be prevented by a highly effective vaccine. This is part of the measles, mumps and rubella (MMR) childhood immunisation programme with a first dose at 12 months and a second dose at three years, four months. However, it is never too late to have the vaccine. If you haven’t had it or are unsure then you can be vaccinated as an adult to protect you against measles.

CAN YOU TELL IF YOU’RE PROTECTED AGAINST MEASLES?

• People who have had measles in the past are unlikely to get it again.
• People born before 1970 are likely to have been exposed to measles as a child and have natural immunity.
• People born after 1970 are less likely to have natural immunity and unless they have had two doses of MMR (or another vaccine containing measles) they may be at risk.
• People who have had two doses of MMR are very unlikely to get measles.
• If there is any doubt, it is better to have an extra dose than to risk not being fully protected.

WHAT IF I AM PREGNANT?

• Measles can be very serious in pregnancy. If you have had two doses of MMR in the past, you and your baby are protected against measles, mumps and rubella.
• You can’t be given the MMR vaccine if you are pregnant; if you think you have been in contact with someone with measles, let your GP know as soon as possible.

WHAT IF YOU HAVE A WEAKENED IMMUNE SYSTEM?

• If you have a weakened immune system you should seek medical advice from your GP if you suspect you have come into contact with someone with measles.

DO I NEED TO GET THE VACCINE?

• If you have documented evidence of two previous doses of MMR or have previously had measles, you will be protected.
• You should get vaccinated if you were born after 1970 and do not have documented evidence of two previous doses of a measles-containing vaccination or have not previously had measles. Although the risk of developing measles is smaller in those born before 1970, vaccination for this age group is still available on request, if you have not previously been vaccinated. Your local GP practice should be able to provide you with the vaccine. 

JACKIE MARSHALL
NEC