Fever With Rash in Children: Measles Signs Parents Must Know

A child with a high fever, a runny nose and red eyes, and now small red spots appearing on the face, is a worrying sight. In the cooler months in Dhaka, many parents put it down to another winter cold and wait a day or two. When a fever comes with a rash, waiting is the one thing we would not advise. One possible cause is measles, a highly contagious illness that can be serious in young children.

This guide from the Salamah Care Clinical Team in Mohammadpur explains what to notice, what to do straight away and how to protect other families.

#What are the early signs of measles in children?

Measles is caused by a virus. It spreads easily through the air when an infected person breathes, coughs or sneezes. According to the World Health Organization (WHO), symptoms usually begin 7-14 days after contact with the virus. The early signs often look like a bad cold:

• Fever
• Runny nose
• Cough
• Red and watery eyes
• Small white spots inside the cheeks

The rash usually appears 3 to 5 days after these first signs. It starts on the face and upper neck, then spreads down the body over about 3 days.

Many other childhood illnesses also cause a fever with a rash, so only a doctor can tell you which one your child has. That is exactly why it is worth getting your child checked.

#Why should you not wait when a fever comes with a rash?

There is no specific medicine for measles. Care focuses on keeping your child comfortable and preventing complications, and the earlier a doctor sees your child, the earlier a complication can be spotted. WHO notes that most deaths from measles come from complications, such as severe diarrhoea and dehydration, ear infections, severe breathing problems including pneumonia, and swelling of the brain. Complications are more likely in children under 5 years and in children who are malnourished or have a weak immune system.

Measles is also very contagious. A child can pass it on from 4 days before the rash appears until 4 days after. A child who "only looks like they have a cold" may already be spreading it to brothers, classmates and neighbours. Early advice protects your whole community.

#What should you do at home while you arrange care?

• Call a child specialist the same day and say clearly that your child has a fever with a rash. This lets the clinic protect other patients when you arrive.
• Keep your child at home, away from school, nursery and visitors, and away from young children who have not had their vaccines, until the doctor says it is safe.
• Offer fluids often and keep feeding as usual. Small, frequent sips are easier than big drinks.
• Keep the room comfortable, with fresh air and light bedding.
• Do not use leftover medicines or home remedies on the rash. Ask the doctor which medicine, if any, and what dose suit your child.
• Keep the immunisation card ready so the doctor can see which vaccines your child has had.

#Which danger signs need a doctor today?

Go to a doctor or an emergency department without delay if your child has any of these:

1. Fast or difficult breathing, or the lower chest pulling inward with each breath.
2. Unusual sleepiness, floppiness, or being hard to wake.
3. A fit (convulsion).
4. Signs of dehydration: very little urine, a dry mouth, no tears when crying, or refusing all drinks.
5. Severe or ongoing diarrhoea or vomiting.
6. Ear pain or discharge, or eyes that are very sore or red.
7. A rash that does not fade when you press a clear glass against it.
8. A fever that keeps rising, or one that improves and then returns.
9. Any fever in a baby under 3 months old.

If your child is in a high-risk group, such as being under 5 years, malnourished or living with a long-term illness, do not wait at all.

#How can you protect your child and other families?

WHO states that vaccination is the best way to prevent measles, and that the vaccine is safe. Children need two doses to be fully protected. Follow the national immunisation schedule and bring your child's immunisation card to every visit. If you are not sure whether your child has had every dose, or a dose was missed, ask your child specialist what to do next. Do not blame yourself; the doctor's job is to help you catch up.

Everyday habits help too: wash hands often with soap, teach children to cough into the elbow, let fresh air into rooms, and keep sick children at home. For general fever care, see our guide to fever in children.

#What to do next

If your child has a fever with a rash, or you would like a child specialist to check your child's immunisation record, contact Salamah Care at 01327-808822 or book an appointment. You can see our child health doctors and book with them on the specialists page, including Dr. Md. Shaidur Rahman, a Neonatal, Child, Adolescent & Child Palliative Care Specialist (MBBS, BCS (Health), MD (Paediatric)). Regular check-ups are a good family habit, and they can include children's dental care too. Our team in Mohammadpur, Dhaka, can examine your child and guide you on the next step. In an emergency, go to the nearest hospital emergency department straight away.