Haematology transplant patients and measles

Patients with measles or those who have come into contact with measles will be isolated, to prevent spread to others.

If you come to hospital with the symptoms below, we will screen you for measles, alongside our routine investigations.

• Fever
• Rash
• Cough
• Cold
• Flu

There is no specific treatment for measles, but we may need to offer supportive treatment. This may or may not require hospital admission.

As you have had a stem cell transplant (SCT) or CAR-T therapy, you are vulnerable to vaccine preventable diseases, such as measles, until you can be re-vaccinated.

Symptoms of measles are detailed on the NHS website and include:

• High temperature
• Flu or cold symptoms
• Conjunctivitis
• A rash after four days
• Rarely it can cause confusion

• NHS website: measles

People with measles are infectious from four days before the rash, until four days after it disappears. Immunocompromised people may not show the usual signs and symptoms, and often have cold like symptoms or pneumonia. They may also be infectious for longer.

To protect you, we recommend that all your family, friends and contacts have received two doses of the MMR vaccination. This is the most important factor in reducing the chance of you and your family having a measles contact.

Your vaccination status

Given the current outbreak of measles, we recommend MMR vaccination as follows:

SCT or CAR-T therapy more than two years ago

If you underwent SCT or CAR-T therapy more than two years ago and:

• have not required any chemotherapy (including rituximab) within the last six months
• you do not have graft-versus-host disease or require ongoing immunosuppression
• you are not receiving regular immunoglobulin treatment

Please contact your GP with the information on this webpage to book your MMR vaccination.

SCT or CAR-T therapy one to two years ago

If you underwent SCT or CAR-T therapy one to two years ago and:

• do not have graft-versus-host disease or require ongoing immunosuppression, and
• are not receiving regular immunoglobulin treatment

You will be invited to have your immunity assessed with a blood test. If you do not have evidence of immunity to measles and have sufficient immune recovery, we will recommend that you have the MMR vaccination.

SCT or CAR-T therapy within one year

Patients who do not meet the above criteria, and those within one year of SCT or CAR-T therapy should not receive MMR vaccination, as it is a live vaccine, and there is a low chance of viral activation.

If you:

• develop symptoms of infection following MMR vaccination, please contact your specialist nurse
• are within one to two years of SCT or CAR-T, we will contact you four weeks following vaccination to check how you are

Contact with a confirmed case of measles

If you have come into contact with a confirmed case of measles:

• Patients with more than two years following SCT or CAR-T have the same risk as the general public following at least one MMR vaccine, and no further action is required
• Patients with one to two years following SCT or CAR-T, who have responded to MMR vaccination require no further action
• Patients within one year of SCT or CAR-T, or those one to two years out, who have not responded to MMR vaccination, should inform their specialist nurse as soon as possible. Preventative treatment with intravenous immunoglobulin should be given within six days of exposure

More information

If you have any questions, please contact your clinical nurse specialist.