Information for Medical Practitioners

Government of Samoa

Ministry of Health

MEASLES INFORMATION FOR MEDICAL PRACTITIONERS

Key Points

Measles activity remains high in many districts with many severe cases in infants.
MoH Compulsory Measles Vaccination Campaign target groups: all children and teenagers aged 6 months to 19 years, and all non-pregnant women aged 20 to 35 years.
Please encourage your patients who are eligible to be vaccinated.
Encourage patients with mild symptoms to be cared for at home. Inform them of danger signs and the need to seek medical attention urgently if these develop.
We request please to use the MoH Measles Clinical and Surveillance Form to record and report cases.

Measles diagnosis and management

Measles is one of the most highly communicable infectious viral diseases, and transmitted by direct contact with infectious droplets or airborne spread. The incubation period is typically 10 after exposure (range 7 to 18 days).
Measles typically presents with a 2 to 4 day prodromal illness with fever, cough, coryza, and conjunctivitis. A maculopapular rash then begins on the face and neck and becomes generalised.
Measles in previously vaccinated people may present atypically, with milder symptoms and a slower progression to the rash
Cases are infectious from 4 days before the prodromal to 4 days after the onset of the rash.
Routine laboratory testing for measles is not recommended during widespread outbreaks.
Patients with moderate to severe symptoms and signs should be referred to hospital. In Apia, the TTM APCC (outpatients) is open 24 hours for measles cases.
Patients with milder symptoms can be cared for at home but family members need to be made aware of the danger signs that should prompt urgent medical review.

Vaccine – live attenuated vaccine and is highly efficacious. It generally well-tolerated. The risk of complications is low compared to the risk of complications from the disease, and 95% of the population is required for herd immunity

Complications :

Occurs in 10% of cases – including pneumonia, otitis media, croup and diarrhoea
Development of encephalitis in 1 in every 1000 patients, of whom 15% die
Approximately 30% have permanent neurological damage
Other complications include bronchiolitis, sinusitis, myocarditis, corneal ulcerations, mesenteric adenitis, ITP, and hepatitis
Measles in pregnancy can cause miscarriage, stillbirth and pre-term delivery