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Measles

measles; rash; SSPE; encephalitis; pneumonia; vaccine; vaccination; immunise; immunisation; MMR; mumps; rubella. ;

Measles is a serious illness caused by a virus and it is very contagious - very easily spread to other people. It is usually spread by droplets (through coughing, sneezing, runny nose, or runny eyes).

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Measles is a serious infection. Although it is now rare in Australia due to immunisation, it is still common in some parts of the world, and it is a common cause of death of children in many developing countries. Before the introduction of immunisation in the 1960s, most Australians caught measles as children. Now most cases occur in young adults. 

Measles spreads very easily. A child or adult who has not been immunised is very likely to catch it if exposed to a person who has measles. Measles has been brought into Australia by international travellers, and could spread easily among people who have not been immunised.

Measles is not just one of the things that children catch and get over. Children often get very sick with measles and they can have serious health problems and even die. Adults can also become very unwell if they get measles.

Alert!

If you think a child or adult might have measles (fever, rash, cough, runny eyes) ring your doctor's clinic and talk to the staff about how best to arrange for the person to be seen by a doctor so that you don't put other children and adults at risk. Measles is very easily spread to others if they are not immune to measles.


Protecting children and adults from measles

  • Measles vaccination in the form of MMR (Measles, Mumps, Rubella) is recommended for children when they are 12 months old and when they are 4 years old (immediately after their 4th birthday is suggested or before starting school). See the topic 'Immunisation'. Almost all people who have had 2 doses of the vaccine will be protected against measles.

Exclusion

Keep a person with measles away from any people who might not be immune.

  • Exclude the person with measles from childcare, preschool, school and work, and from going out into any place where it is possible that there are other people who might not be immune, for at least 4 days after the onset of the rash. Do not go shopping, travel on public transport or visit family and friends for example. Do not take the child or adult to the doctor's surgery without first talking to staff about how to do this safely.

Exclusion periods for contacts

  • Immune or immunised contacts are not excluded.
  • Unvaccinated children and adults should be excluded for 14 days from the first day of appearance of rash in the last case. If vaccinated within 72 hours of their contact with the virus, they may then return to childcare, preschool, school or work. (A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person - and as measles is very infectious, this does not have to be 'close contact'.)

What is measles?

  • Measles is a serious illness caused by a virus and it is easily spread to other people (very contagious).
  • It is usually spread by droplets (through coughing, sneezing, runny nose, or runny eyes).
  • The first signs come about 10 to 12 days after being in contact with measles. These include a fever, cough and sore, red eyes (conjunctivitis).
  • After 2 to 3 days the measles rash appears. This is the time when the person is most unwell.
  • Fever tends to improve after 2 to 3 days and the person usually quickly recovers unless there are other problems caused by the measles, such as ear infections, bronchitis and pneumonia.
  • Measles is very infectious from just before the beginning of the first signs of being unwell (about 3 or 4 days before the rash starts) until four days after the rash comes.
  • The first signs of the illness usually start around 10 days after contact with the virus, and the measles illness starts like a cold. The rash appears about 14 days after exposure.

Signs and symptoms of measles

The first signs, before the rash comes, are likely to be:

  • Fever
  • Being 'out of sorts' or irritable
  • Runny nose
  • Sore throat
  • Cough
  • Sore, red eyes - and eyes feel uncomfortable in the light.

The symptoms usually worsen over 3 to 5 days, then the rash begins on the head and spreads down the whole body over the next day or two. The person can become much more unwell for a couple of days after the rash comes (higher temperature [up to 39.5º], cough, and the person feels and looks very unwell).

Measles

  • Rash - large flat reddish blotches that often run together and completely cover the skin
  • The rash usually starts on the forehead and moves down over the whole body
  • The skin may peel after the rash goes.

The rash lasts 4 to 7 days, and the measles illness usually lasts about 10 days. The cough may be the last symptom to disappear.

Children usually get better quickly after this, unless there are other health problems.

Health problems from measles

  • Other health problems happen often and include ear infections, pneumonia, bronchitis and diarrhoea.
  • Encephalitis (inflammation of the brain) happens in around 1 in every 1000 cases, and about 15% of these children die. A further 15 to 40% are left with permanent brain damage.
  • There are also other rarer serious health problems from measles, such as an encephalitis (subacute sclerosing panencephalitis, SSPE) which occurs several years after the measles illness and causes progressive brain damage and death. This occurs in about 1 in 25,000 cases.
  • Measles tends to be worse in older children and adults.
  • Measles is a common cause of death when children are malnourished or have other serious health problems and are unimmunised.

What to do if you or your child is exposed to measles.

  • Anyone who might have been in contact with measles should see their doctor for immunisation as soon as possible (within 72 hours), unless the child or adult has had 2 doses of measles vaccine or there is good evidence that the person has already had measles.
  • If you are uncertain whether you or your child has had 2 doses of vaccine (or had the illness) - get another dose of measles vaccine. There are no health risks in giving a dose of the vaccine to someone who is already immune.
  • Immunisation soon after exposure is likely to prevent the development of measles, because the immunisation builds up the body's defences more quickly (4 to 6 days) than the time it takes for the virus infection to develop (10 to 14 days).

More about immunisation

  • Measles vaccination in the form of MMR (Measles, Mumps, Rubella) is recommended for children when they are 12 months old and when they are 4 years old (immediately after their 4th birthday is suggested or before starting school). See the topic 'Immunisation'. Almost all people who have had 2 doses of the vaccine will be protected against measles.
  • A repeat MMR immunisation is recommended for all adults born between 1966 and 1980, who have not had 2 doses of MMR. This age group is likely to not have been immunised or have received only one injection.
  • Adults born before 1966 did not get immunised against measles and usually had the illness and are now immune.
  • The National Measles Control campaign in 1998 vaccinated all school-aged children (children born in 1981 or later).
  • The MMR immunisation is free in Australia for children when given at the usual ages. There will probably be a cost for the vaccine for older children and adults.
  • MMR immunisation does not cause autism. In 1993, one group of researchers in the UK suggested there might be a link between MMR and inflammatory bowel syndrome and autism. Extensive research has shown there is no link.

Keeping children away from school or child care

  • Keep the child away from other children and anyone who has not been immunised for at least four days after the start of the rash. This should be done, but may not prevent others getting measles, since measles is also very infectious before the rash comes.
  • Un-immunised children and adults who have been in contact with measles should be kept away from childcare, school or work for 14 days after the first day of appearance of the rash in the last case in the school or centre. They are at risk of getting the illness and they can spread the infection to others. They need to stay at home until it is either:
    • clear that they have not caught the infection and therefore cannot spread it to others or
    • they have the infection, have recovered from it and can no longer spread it to others.
  • Parents who choose not to have their children immunised should be aware that their children will be excluded from childcare, kindergarten or school during an outbreak of measles at the school or other centre.
  • If un-immunised people are immunised within 72 hours of their contact with measles they can return to school, child care or work.

What you can do

  • There is no specific treatment for measles, but complications may need treatment.
  • Children and adults with measles should be seen by a doctor. Since measles spreads so easily, a home visit by a doctor should be arranged, or ring the surgery and arrange an appointment at the doctor's rooms that does not put other people at risk.
  • The topic 'Feeling sick' has suggestions for caring for a sick child.
  • Children with measles need rest and extra drinks, and paracetamol or ibuprofen can be used for high fever (see the topic 'Using paracetamol or ibuprofen').
  • Eyes will be sensitive to light, and usually the child will feel better in lower light. Light will not harm the eyes, but it can hurt them.
  • Do not take you child out to places where other people may be exposed to your child's infection.
  • In countries or communities where a child's diet may be very low in Vitamin A, extra Vitamin A can help recovery from measles (care is needed to select the correct dose). This is rarely needed in Australia.

Resources

  • Immunise Australia Program. There is much information about immunisation and infectious diseases, including frequently asked questions:
    http://immunise.health.gov.au

References

Department of Health and Ageing, Australian Government: Australian Immunisation Handbook - 10th Edition, 2013:

SA Health: 'Measles - symptoms, treatment and prevention

World Health Organisation - 'Measles':
http://www.who.int/mediacentre/factsheets/fs286/en/

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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