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Protecting and improving the nation’s health

NWL HPT ref: S151749
To: Staff and parents of children attending
school and early years settings in Hounslow

North West London
Health Protection Team
61 Colindale Avenue
London, NW9 5EQ
T +44 (0)20 8327 7181
F +44 (0)20 8327 7206

5 February 2015
Dear Staff, Parent or Guardian,
05th February 2015
The North West London Health Protection Team is aware of five confirmed cases of measles
in Hounslow, which have occurred since mid-January 2015. The majority of these cases had
not had any MMR vaccine, and have all occurred in persons of school-going age.
Measles is a highly infectious viral illness caught through direct contact with an infected
person through droplets when an infected person speaks, coughs or sneezes. Even trivial
contact may be sufficient for the virus to spread. It is important to remember that measles
can cause serious illness, and it is easily spread in unimmunised children and adults.
Measles, mumps, rubella (MMR) immunisation is the safest way that parents can protect
their children against measles, mumps and rubella, which are diseases that can have
serious consequences for babies, young children and their families. Two doses of measles
MMR vaccine offers full protection against the three illnesses. In the UK the first dose of
MMR is given at 12 months of age and the second dose from 3 years 4 months (pre-school).
The North West London Health Protection Team has given the following advice in
relation to protecting your child / children from this illness:
 If your child has not had any MMR, and is over 3 years 4 months of age, they should
have the first dose as soon as possible followed by a second dose 1 month later.

If your child has already had two doses of MMR there is no need for any further dose.
If your child has only had one dose of MMR and is under 3 years 4 months of age,
they should receive the second dose at the usual scheduled time.
 If your child has had only one dose of MMR, and is over 3 years 4 months of age,
they should have a second dose as soon as possible.
 If your child has had the single antigen measles vaccine (unlicensed in the UK) then
protection is not guaranteed and they should receive the full course of MMR.
 There is no upper age limit for receiving MMR.
Please contact your GP / Practice Nurse to arrange the immunisations without delay.
Pregnant and immunocompromised contacts
Contacts of measles at higher risk of complications include those who are pregnant (without
having had measles infection or vaccine in the past), children under 6 months of age, and
those who are immunosuppressed due to chronic illness or medical treatment. If you are


Protecting and improving the nation’s health

concerned that you/your child is in one of these risk groups, and has been in contact with a
case of measles, please call your GP for advice.
Parents who are health care workers
If you, as a parent, work in a healthcare setting and are unimmunised or unsure of your
MMR immunisation status, please contact your Occupational Health service immediately for
advice. Vaccination is available from your GP or Occupational Health service and should be
sought as soon as possible. Please show this letter when seeking vaccination.
What are the symptoms of measles?
 Symptoms typically develop 9–14 days (usually 10 days) after becoming infected.
 Initial symptoms include cold-like symptoms, e.g. runny nose, cough, red eyes, aches
and pains, tiredness, irritability and high fever, which may peak at 40°C / 104°F.
 Tiny greyish-white spots (called Koplik's spots) may appear in the mouth and throat.
 Initial symptoms are followed by a red-brown spotty rash, which develops a few days
 The rash usually starts behind the ears and spreads over the face, neck and body.
 Spots are initially small but quickly get bigger and often join together.
How soon should a child be back at school after measles?
 Measles is most infectious from 4 days before the appearance of the rash until 4
days after.
 Children should be kept off school for 5 days after the onset of the rash.
You should contact your GP as soon as possible if you suspect that your child has
measles. It is best to phone before your visit as your GP surgery may need to make
arrangements to reduce the risk of spreading the infection to others.
If you need any further information, or have concerns or queries, please contact NHS 111,
and/or visit the following websites:
Yours sincerely

Dr Margaret Meltzer
GMC No. 2242833
Consultant in Communicable Disease Control
North West London Health Protection Team