Intended for healthcare professionals

Letters Measles in older children and adults

Authors’ reply to Spitzer and Chalmers

BMJ 2017; 357 doi: (Published 08 May 2017) Cite this as: BMJ 2017;357:j2197
  1. Beatrice Clare Cockbain, foundation year 2 doctor,
  2. Tehmina Bharucha, specialist registrar in combined infection training,
  3. Dianne Irish, consultant virologist,
  4. Michael Jacobs, consultant in infectious diseases
  1. Royal Free Hospital, London, UK
  1. beatricecockbain{at}

Correctly identifying Koplik’s spots is not an easy feat, as noted in Spitzer’s excellent letter.12 Koplik’s spots are still thought to be pathognomonic for measles, but oral lesions, similar in appearance to Koplik’s spots, can be found in other illnesses, such as parvovirus B12 infection.3 Zenner and Nacul’s study included reporting of “Koplik’s spots” by clinicians with variable levels of experience and did not include independent assessment …

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