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If it's measles there's a cough

I refer to the article 'Are there any sure signs of measles?' (Answerback, February 24).

I witnessed a measles outbreak in our practice in the late 1980s, immediately prior to the introduction of MMR vaccine.

It is important to realise that measles is primarily a respiratory infection, with coryza, conjunctivitis and cough.

The presence of cough is particularly useful in distinguishing measles from other viral rashes.

To quote Nelson's textbook of paediatrics: 'The diagnosis of unmodified measles should not be made in the absence of cough.'

Dr Andy Ross

Birmingham

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