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Can rash in children be due to lack of measles immunisation?

Dr PSN Menon
Consultant & Head, Department of Pediatrics
Jaber Al-Ahmed Armed Forces Hospital, Kuwait

Q: I came to Australia when my daughter was 3 months. Here I have been following the vaccine schedule that was given to me in India. My daughter, who is 11 months old now, has got many rashes on her body. They are red in colour and are projecting. It started with high fever (103 F) and the next day rashes appeared on her face, ears and on arms and shoulders. We took her to a Children's Hospital in Melbourne and they checked and said that it was due to a viral fever. This is the third day and the rashes have become very severe on her whole body. She is otherwise normal and doesn't have cough or any itching. The skin has now become flat but the redness is still there at some places and the rash is prominent in other areas. We didn't give her the measles vaccine in her 9th month as they don't do so in Australia as MMR is given only in the 15th month. We are really confused and don't know what to do?

A:First of all the illness with fever and rash does not appear to be due to measles. As diagnosed by the doctors at Melbourne, it appears to be a viral exanthema similar to rubella. Follow the advice given to you for the management by the treating physician. Second, it is prudent to follow the immunization program of the country where you reside rather than follow the schedule in India. Early immunization against measles is advised in India primarily because measles is very common in India and is a major cause of childhood mortality and morbidity. However, it is not so in Australia and hence their pediatric society advises a late immunization for measles with mumps and rubella (MMR) at 15 months like in rest of the developed world. I advise you to follow that schedule.