Tuesday 1 January 2013

Measles

First things first, Happy New Year! Resolution number 1, record more of my learning!

So, the spotty 20 year old I saw before Christmas had Measles confirmed on a viral swab. I've reviewed her notes and she missed her MMR, despite it being clearly recorded she was safe to have it and should do so.

The girl has epilepsy and learning difficulties so we think that's why her carers chose not to give it. She's been registered her whole life with the surgery.

A quick look at the Medscape App reminded me of all the points I had forgotten about Measles.

The girl presented with a florid rash , I was reminded of the 3 C's, which I hadn't asked about and learnt Vitamin A can reduce symptoms but I'm not sure if that's only for deficient individuals.

I also learnt that Measles directly suppresses immune response, making secondary bacterial infection a risk, not just viral sequelae.

So learning points?

Check childhood immunisations when reviewing patients with learning difficulties, consider diagnosis in unvaccinated individuals with 3 C's

My senior colleague saw 1 case in the 80s and none since so hopefully it will be a long time before I see another!