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Patient safety alert

Risk of measles in healthcare settings

Priority 1 - Urgent action required
Issued on: 28/03/2024

Who needs to take action?

This is a safety critical HSE National Patient Safety Alert (NPSA).

This HSE NPSA is relevant to all staff and is for action by Regional Executive Officers, Hospital Group CEOs and Managers, Community Healthcare Organisations Chief Officers, Directors/General Managers/Leads of Quality and Patient Safety, all relevant Clinical and Non-clinical staff and Managers with responsibility for Emergency Departments, Outpatient Departments, Hospital Day Services, Primary Care Services/General Practice, Community Services, Nursing Homes and all other services that welcome patients or service users from the community on a daily basis.

What is the issue?

Measles is a highly infectious disease that causes considerable morbidity, 1 in 5 measles cases will require hospitalisation. Measles is a significant risk to patients and staff that do not have immunity.

How to take action?

  1. Be prepared and review up-to-date processes (1) within your service to ensure that patients, service users or staff presenting or reporting with clinical signs and symptoms suggestive of measles are rapidly identified and managed appropriately.
  2. Advise all healthcare staff (clinical and non-clinical) to check if they are immune to measles (see pg. 2).
  3. Promote the availability of free MMR vaccine to patients, healthcare workers and their families (i.e. during clinical visits, newsletters, website pages, etc.). Information on how to book an MMR vaccine appointment (2) is available on the HSE Website.
  4. Ensure clinical staff are aware of signs and symptoms of measles (3). Display available measles posters (4) and resources highlighting signs and symptoms of measles prominently in your departments and include Public Health messages on video screens in public areas where available.
  5. Provide non-clinical staff (e.g. staff on patient registration desk) with information on early recognition of measles and instructions (5) on how to alert clinical staff to suspected cases.
  6. Isolate suspected measles cases immediately and notify Public Health (6).
  7. If you suspect you could have measles, contact your line manager for advice before returning to work.

When does action need to be completed?

Actions should be completed by the 2nd April 2024 and require ongoing attention

Read the Full Alert

Why is this action required?

Measles has been a notifiable disease in Ireland since 1948. There has been a surge in measles cases across Europe in 2023. Measles is an acute, viral infectious disease. It is highly contagious, and it is estimated that almost 100% of non-immune people exposed to an infective case will contract the disease. Current immunisation levels are not sufficient to protect the population.

The virus is transmitted from person to person when infected people cough and sneeze. Virus-containing droplets can remain in the air for several hours and on contaminated surfaces for up to two hours.

Measles transmission can cause harm to the individual (patient/service user/staff). A healthcare facility measles outbreak would have considerable impact, not only on vulnerable patients and staff, but also on staffing levels, isolation facilities and bed availability.

All Healthcare Workers in HSE and HSE funded facilities are being asked to check that they know their status of immunity against measles. Evidence of immunity includes at least one of the following:

i. Written documentation of two doses of MMR vaccine or,

ii. Having serological evidence of measles immunity (i.e., detectable measles specific IgG) or,

iii. Being born in Ireland before 1978. Most adults born in Ireland before 1978 are likely to have had measles infection and are therefore immune. However, they may be offered a vaccine if they are considered high risk of exposure, following a risk assessment, and cannot provide evidence of points i or ii.

If in doubt about your vaccination status check in with your local Occupational Health where available.

What evidence supports the issuing of this HSE NPSA?

What stakeholders were involved in issuing this HSE National Patient Safety Alert?

This alert has been developed collaboratively by the following groups:

  • HSE Measles Incident Management Team (IMT) including representatives from:
    • Health Protection Surveillance Centre
    • Public Health
    • Acute and Community Operations
    • Children and Young People
    • Infectious Diseases
    • General Practice
    • Occupational Health
  • National Emergency Medicine Programme
  • HSE National Patient Safety Alerts Committee
  • National Quality and Patient Safety Directorate

References

Appendix A

Think Measles Poster

Download the alert as a PDF

What does it mean for me?

is a HSE NPSA supporting infographic that uses non-technical language in plain English to explain; what a HSE NPSA is, why it is being issued and what it means for patients, service users or their families.

It also outlines what (if anything) the patient, service user or their family may need to do if the alert is relevant to their care.

Download the infographic 'What does it mean for me as a patient or service user?'

Download the HSE NPSA Local Action Plan

Back to HSE National Patient Safety Alerts