GPs told to wear PPE when dealing with suspected measles

GPs and practice staff should wear PPE when dealing with suspected measles to stop transmission, according to new NHS guidance. 

The UK Health Security Agency has this week declared a national incident based on rising cases of measles and outbreaks in the West Midlands and Yorkshire. 

In response, NHS England is launching a catch-up campaign for children aged six to 11 who still require the MMR vaccine, and told practices to prepare for an increase in enquiries.

On Wednesday, NHSE also published new guidance on infection control measures and risk assessment for measles in healthcare settings, including general practice.

It advised GP teams that if patients with suspected measles require an in-person review, they should be separated from other patients and isolated on arrival at the practice.

Since GP practices are ‘most likely’ to be a first contact for these patients, the guidance said reception staff should be aware of the symptoms. 

‘Staff should know that any patients with fever and rash are potentially infectious and take appropriate action to stop onward transmission without delay, including PPE,’ it added. 

NHS England said that if ‘vulnerable individuals’, including unvaccinated patients and pregnant women, are exposed to suspected or confirmed measles, GP practice teams should undertake a risk assessment ‘to urgently consider need for post-exposure prophylaxis’. 

According to the guidance, any healthcare worker who has face-to-face contact of any length or spends more than 15 minutes in a confined area with a confirmed measles patient is considered to be ‘exposed’, unless they are wearing appropriate PPE. 

Those staff members who are exposed and do not have two ‘documented doses’ of a measles vaccination should be ‘excluded’ from work from the fifth day after their first exposure to 21 days after the final exposure.

UKHSA chief executive Professor Dame Jenny Harries has warned there is a ‘very real risk’ of the virus spreading in other towns and cities, beyond the outbreak in Birmingham, due to low vaccine uptake in some communities. 

In November, NHS England asked GPs to participate in a catch-up campaign for the MMR vaccine after public health officials warned of rising cases of measles – this is a requirement as part of the GP contract.

Declaration of a ‘national incident’ allows the UKHSA to ‘focus on limiting further spread of the outbreak including additional work to help protect other areas at greatest risk’.

But Pulse understands there are no further plans to incentivise GP practices to boost MMR vaccination amid the outbreaks.

NHS England will soon expand its national vaccination invitation scheme, inviting around one million children aged six to 11 who are missing their first or second MMR vaccination throughout February and March.

The scheme will be expanded further in the Midlands and London, where cases are high, to include around 1.2 million children and young adults aged 11 to 25.

The national commissioner told GPs in its recent primary care bulletin: ‘Practices should prepare to receive enquiries from their registered patients during February and March 2024 who have received a national MMR vaccination reminder, and should check immunisation records, book, and administer vaccination, if clinically appropriate.’

In September, the UK Health Security Agency (UKHSA) said it was ‘seriously concerned’ about an ongoing downward trend in uptake of childhood vaccines.

The agency’s annual figures showed that in England MMR vaccine uptake for first and second doses by five years has fallen to the lowest rates since 2010/11. 

And no vaccines met the World Health Organisation (WHO) 96% uptake target in England.