By the way . . . measles can’t be seen as ‘just a virus’

THE story in last week’s Good Health pages about the time it took for 64-year-old Josa Keyes to be diagnosed with measles reminds us once again of the value of experience, training and physical examination.

Properly trained, observant GPs will recognise the combination of symptoms with measles: a cough, coryza (inflammation in the nose and throat) and conjunctivitis.

If the patient also has a high temperature, you check for Koplik spots, which occur within the lining of the mouth, particularly inside the cheeks.

The eruption looks like a scattering of grains of salt and is visible before the characteristic skin rash of measles develops.

Two of my patients — sisters — had it after spending a weekend at Glastonbury Festival some years ago.

Neither had been immunised with the MMR (measles, mumps and rubella) vaccine and both were hospitalised as they were so ill; one of them in intensive care.

Not all doctors will be old enough or have the experience to be able to diagnose measles. But they need to smarten up. The low level of MMR uptake, along with immigration from countries where immunisation has been patchy, have contributed to an increase in the incidence of measles.

It must be something that doctors consider — challenging their own thinking, and not just assuming that a patient suffering from a high temperature merely ‘has a virus’.

As well as looking at this as part of our compulsory continuing professional development, this is a good reason why patients must be seen and examined in person and not via phone or email.