1. Measles Outbreak in Cornwall Mary-Ann McKibben Regional Public Health Group Government Office for the SW

2. Measles Outbreak in Cornwall: Management of Cases Development of measles action checklist Ensure consistent collection of information Clarity of recording Collects information about high risk contacts Avoids returning to case for more information once confirmed BUT Significant additional workload which may later prove unnecessary Advice to GPs about risks of cases in surgery

3. Measles Outbreak in Cornwall: High Risk Contacts No single source of guidance, wide range of reference texts Brought together in clinical decision trees Risk assessment using decision trees Designed to be used as clinical record No clear guidance on balance of risks and benefits of HNIG Liaison with paediatricians about immunosuppressed children

4. Measles Outbreak in Cornwall: Supplies of Testing Kits and HNIG Salivary testing kits Labelling of kits/ samples Adequate supplies to each practice HNIG Small supply HNIG stored Truro Hospital Automatic reordering system

5. Measles Outbreak in Cornwall: Laboratory Testing Urgent processing of initial samples and samples from pregnant women Testing of frozen antenatal bloods for pregnant women where possible Delays in lab receiving samples/ labelling Delays in processing samples – weekly run Implications for managing outbreak Increased role for Truro lab

6. Measles Outbreak in Cornwall: Media Handling Important role in encouraging MMR uptake Media response included focus on MMR/ autism links Lesson to anticipate negative coverage and refer to research supporting safety of MMR/ refuting links to autism

7. Measles Outbreak in Cornwall: Immunisation Strategy Immediate response to encourage vaccination as part of outbreak management Short and longer term strategy: Stage 1 – affected schools Stage 2 – nearby schools Stage 3 – schools low coverage/ high risk children Stage 4 – Cornwall-wide awareness raising Stage 5 – raise awareness among professionals Value of PCT child health data