Worried about child developing measles

¦ We have three children under 10 years of age who have all been fully vaccinated.

We are just back from a weekend away with friends and have been told that one of the children we were with has developed measles.

Do I need to get a booster vaccination for my children?

>> This is very unlikely to be a worrying situation. After the first childhood measles immunisation (given as part of the MMR: mumps, measles and rubella vaccine) at around 13 months, it’s estimated about 5-10% of children aren’t fully immune. If all your children have had their second MMR (often called a booster dose) this gives additional protection with less than 1% of children remaining at risk afterwards*.

Measles is very contagious, and cases are infectious from about four days before the rash develops until four days afterwards. The incubation period is between seven to 18 days, with an average of around 10.

This means that at-risk, or unimmunised, individuals can be successfully immunised, with another MMR vaccination, within three days of exposure. Other specialist treatment is available in high-risk cases after this point.

I’m assuming your children are fit and well. If they have any illness or are having treatment, which might affect their immune system, then you’ve probably already had advice to contact their hospital specialist if they’ve been exposed to an infection such as measles.

If your three children have had both measles immunisations and are fit and healthy, I don’t think you should be worried.

*UK Health Protection Agency.

¦ My four-year-old son has developed impetigo under his lip.

Our GP prescribed a course of antibiotics, which has stopped the infection spreading but a cluster of sores remains.

Will he need a second round of antibiotics? I am also concerned about scarring.

>> Impetigo is a common skin infection at your son’s age and it’s very easily spread to other sites on the body, or to other family members or close contacts.

It’s often treated with antibiotics.

Impetigo is usually caused by a type of bacteria called staphylococcus aureus, which responds well to antibiotic treatment.

Impetigo can appear with blisters, or simply as red, inflamed areas, but both will form a thick yellow-brown crust. This isn’t usually painful but can be itchy.

This will dry up and clear over time, although this can take a few weeks. It’s rare for impetigo to leave any scars.

It’s also unusual to need a second course of treatment, unless your son develops a second episode of impetigo.

This is often because of contact with another infected child, perhaps at a play-group or nursery.

Children can get impetigo multiple times and it’s important to keep an infected child out of contact with others until the rash is completely dry.

If your son has a persistently reddened, inflamed area under his lip then he should see your GP again.

Some conditions can look like impetigo, for example, a small patch of facial eczema.

Another similar looking rash is a cold sore, which often appears next to the lip.

These usually respond well to antiviral cream (aciclovir) but often develop again at the same site.

Dr Julius Parker is a GP with HSF Health Plan’s free 24/7 GP advice line. For more information visit www.hsf.ie or lo-call 1890 451 451.


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