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A mother brought her 2-year-old child to the surgery complaining that the child had been irritable and had a temperature for the last 2 days. Clinical examination confirmed the temperature and the child was noted to have a runny nose and eyes. Additionally, she had a cough. There was no evidence of rash, and examination of the ears and chest revealed no abnormalities. Advice was given to the mother to use appropriate doses of paracetamol. The mother had one other child who was aged 5 and neither of her children had received their routine vaccinations because she was concerned about the "risks of side effects".
The on-call service was called that evening because the child had had a convulsion. The attending doctor noted a fine macular rash at the hairline and that the child’s temperature was 39 °C, and diagnosed a febrile convulsion.
1. What vaccines should a child of 2 years have received?
2. What is the significance of the febrile convulsions?
3. From the clinical picture described, what do you think may be the diagnosis?
4. How can the diagnosis be confirmed?
5. How could the diagnosis be confirmed by the laboratory?
6. Are there any other actions necessary?