Diagnosing and notifying measles and mumps

Measles is a notifiable disease under the Public Health (Scotland) Act 2008.

Measles should be considered if the patient has:

• Fever ≥38°C AND
• Generalised maculopapular rash AND
• Either cough, coryza or conjunctivitis (ref HPS)

GPs should take a throat swab as soon as possible when measles is clinically suspected. The swab should be expressed into the Viral PCR Sample Solution vial (VPSS) and sent off to the West of Scotland Specialist Virology Centre at the GRI.  If VPSS is not available, swabs can be cut off and sent dry in a sterile container. This should be avoided whenever possible as the virus remains infectious and sensitivity is reduced. VPSS inactivates and preserves the pathogen genome for PCR testing.

TrakCare item: Adult maculopapular rash – virus PCR – Set (See WoSSVC under Rash testing – maculopapular)

TrakCare item: Paediatric maculopapular rash – virus PCR – Set 

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

Letter 1

Letter 2

GPs should notify the PHPU Health Protection Nurse by calling 0141 201 4917  

On notification, the HPN will assess the individual epidemiological features of the case: –

Immunisation history –  any known vaccination history or history of measles?     (The vaccine effectiveness of a single dose of MMR is around 90% and approximately 95% for two doses.  Although vaccine failure is rare, it can occur, particularly after a single dose)

Travel – any travel within and outside the UK during the incubation period, with an assessment of whether travel was in an area where measles is known to be circulating?

Ethnic and cultural/religious background – are there details on the patient’s ethnicity, and importantly, whether the patient is a member of an under-vaccinated population group (e.g. Charedi Orthodox Jewish community, Steiner community)?

Epidemiological link – is there a known epidemiological link with another laboratory or epidemiologically confirmed case?

If the PHPU clinician agrees that the case meets the definition of a possible measles, an oral fluid kit (MMR salivary kit) for IgM testing will be sent out – previously sent to GP surgeries, these are now being posted from the PHPU directly to patients/parents/guardians who are requested to forward the sample directly to PHE Colindale using the labelled packaging supplied. MMR kits, which meet the WHO requirements of measles investigation to satisfy elimination criteria, are sent out even if PCR testing is negative.

People with confirmed measles should be excluded from their usual place of work or study or from shared childcare facilities or any other shared space until at least four days after the rash has developed. The case should be advised to self isolate and to avoid contact with vulnerable groups during this time. For more info click on link

Mumps is a notifiable disease under the Public Health (Scotland) Act 2008.  

Oral fluid testing (MMR salivary kit) for suspected mumps cases ceased on 1^st April 2018.  

Mumps can be diagnosed clinically. However, if a GP is keen to have laboratory confirmation of suspected mumps cases, the PCR test is available from the WoSSVC.  A buccal (inner cheek) mouth swab should be expressed into the VPSS vial and sent off to the WoSSVC (GRI).  When Viral PCR Sample Solution (VPSS) is not available, swabs can be cut off and sent dry in a sterile container.  

TrakCare item:  Mumps PCR – current infection

GP electronic request (ICE / EMIS / Vision) item: Mumps PCR – current infection

Please email the WoSSVC (west.ssvc@nhs.net ) to order Viral PCR solution (VPSS) and include:

1. The requesting location address (inc. the postcode)
2. The number of VPSS vials required
3. Name, telephone number and email address of a contact in case of questions regarding the order 

Alternatively requests for VPSS can be made via the office 0141 201 8722.