THE HSE HAS issued a public warning after four cases of measles were reported in Dublin.

A previous alert was issued on 20 July in relation to two other cases of measles.

The HSE was notified this week that four people in Dublin developed the condition.

The two adults and two children are likely to have developed measles from contact with one of the two earlier cases at hospitals in Dublin.

Dr Helena Murray, Specialist in Public Health Medicine, said: “Measles can be a serious illness and is highly infectious. The best protection is to be fully vaccinated with two doses of MMR (Measles, Mumps, and Rubella) vaccine.”

People at increased risk of getting measles are those who are not fully vaccinated with two doses of MMR vaccine or who have not had measles in the past.

Measles is highly contagious and is spread easily. The time between exposure to measles and developing the rash is usually 14 days (range 7-21 days). People are infectious from four days before the rash starts until four days after.

If you think you may have measles, stay at home and phone your GP for advice.

Measles symptoms include:

• High fever
• Cough
• Runny nose
• Red eyes
• Red rash that starts on the head and spreads down the body – this normally starts a few days after onset of illness; the rash consists of flat red or brown blotches, which can flow into each other; it lasts about four to seven days
• Vomiting, diarrhoea and tummy pain may also happen

Measures to prevent the spread of measles if you think you may have measles:

• Do not go to work, school or crèche
• Stay at home and phone your GP; tell the doctor or nurse that you think you might have measles
• Stop visitors coming to your home
• Pregnant women who have been exposed to measles should seek medical advice as soon as possible

Risk of measles from international travel:

There are ongoing outbreaks of measles in multiple countries in Europe and worldwide. Most of the cases in the EU in 2018 were reported from Romania, France, Greece and Italy.

Most people who get measles on holiday do not know they were exposed until they develop disease, the HSE said. Unrecognised exposures to measles have occurred at airports, on planes, at concerts, in shops and in healthcare settings. In 2018, 31 deaths associated with measles have been reported in EU countries.

Advice for people travelling abroad:

Vaccination remains the most effective measure against infection. Children aged 6-11 months who are travelling to other countries and regions where measles outbreaks have been reported are recommended to get the MMR vaccine.

A dose given before 12 months of age does not replace the dose that would normally be given at 12 months of age, the HSE advised.

Older children should be age-appropriately vaccinated. Children who have missed their recommended doses should get the MMR vaccine from their GP.

Adults may be at risk of measles, particularly those under 40 years of age who have never had measles or two doses of a measles vaccine.

Complications of measles:

Measles can cause chest infections, fits (seizures), ear infections, swelling of the brain and/or damage to the brain.

Measles is a notifiable disease and GPs and hospital clinicians should immediately notify public health authorities if they suspect someone has measles.

Actions taken to prevent further cases:

The Public Health Department has sent an alert to all Emergency Departments and GPs in Dublin, Kildare and Wicklow to inform them to be vigilant about measles.

The Department has given the following advice on the most effective measures to control the further spread of this potentially serious illness:

• All children should get the MMR vaccine when they are aged 12 months; if any child aged over 12 months has missed this vaccine they should get it now from their GP
• All children should get a second dose of MMR vaccine when they are four to five years old or in junior infants at school; if any child in senior infants or older has missed this vaccine they should get it now from their GP
• Adults under 40 years who have not had measles or have not received two doses of MMR vaccine should contact their GP to get the MMR vaccine
• Adults over 40 years of age may sometimes be at risk and if such adults never had measles nor a measles containing vaccine they should consider getting the MMR vaccine from their GP