Measles

Also known English measles

Measles is a highly infectious disease that is easily spread from an infected person by saliva or mucous droplets when coughing, sneezing or talking. Just being in the same room as someone with measles can lead to infection if you are not immunised.

Key points

  1. Measles is highly contagious. One person with measles can pass on the disease to 13 other people who have not been immunised.
  2. A person with measles is infectious from about 5 days before the rash appears through to about 5 days after the rash starts (about 10 days in total). Children will need to be kept home from school (and adults from work) and away from other people during this time (follow your doctor’s advice). Do not invite other children or visitors to your house during this time.
  3. Measles can cause serious complications including diarrhoea, ear infections, pneumonia and encephalitis (brain inflammation, which can cause brain damage).
  4. Vaccination with the MMR vaccine is the best way to protect against measles.

What is measles?

Measles is a viral illness that causes a skin rash and fever. It is very contagious — the virus spreads easily through the air by sneezing or coughing, and can also be spread by contact with contaminated surfaces (from an infected person’s nose and throat secretions).

What are the symptoms of measles?



Symptoms usually begin to show about 10 to 14 days after infection with the virus (though can take up to 18 days to appear) and tend to appear in 3 stages.

Stages of the illness Description
Stage 1

Also called prodromal stage. Usually lasts 3 to 4 days

  •  fever, runny nose (or blocked nose), cough, loss of appetite, and conjunctivitis (red, sore eyes)
  • tiny white/blue spots are usually visible on the inside of the mouth (called ‘Koplik spots’)
Stage 2 A rash that lasts 4 to 5 days
  • blotchy red rash appears
  • the rash starts on your head or face, often at your hairline or behind your ears, and then spreads to your body and then to your arms and legs
  • you usually feel most unwell a day or two after the appearance of the rash
Stage 3 Convalescent stage
  • the rash fades leaving a temporary brownish stain on your skin

What are the complications of measles?

Complications of measles are common and can be very serious, including ear infections, pneumonia and diarrhoea (which can also lead to dehydration). Pneumonia is the main cause of deaths from measles. Inflammation of the brain (encephalitis) occurs in 1 in 1000 measles cases, with some of these people dying and one third being left with permanent brain damage.2 The overall death rate from measles is about 1 to 2 per 1000 cases.2

Contact your doctor or get urgent medical advice if the person with measles develops any worrying symptoms, such as:
  • trouble breathing
  • stiff neck
  • feeling drowsy or you cannot wake them up
  • coughing up green or yellow thick mucous
  • backpain 
  • sore ears
  • having a fit (seizure)
  • not passing urine for 10 hours.

Measles and pregnancy

Pregnant women who become ill with measles during pregnancy are at risk of miscarriage, going into labour early (premature labour) and having babies with low birthweight. If you are pregnant and think you may have measles or if you have come into contact with someone with measles, call your doctor or lead maternity carer as soon as possible. Pregnant women should not be given the measles vaccine during pregnancy but close contacts of pregnant women can be vaccinated to help protect both the mother and unborn baby from exposure.

Who is at risk of getting measles?

Anyone who hasn’t been vaccinated for measles or who has not had measles previously is at risk of being infected. Those most at risk of getting the infection include:

  • babies less than 1 year of age because they have not yet received the MMR vaccine (a vaccine for measles that is given to babies at 15 months and children at 4 years)
  • people who are returning from international travel (due to higher risk of exposure in measles-endemic countries)
  • people born overseas in countries where appropriate vaccination is less likely.

People who are at increased risk of potentially fatal measles complications include:

  • anyone with a chronic illness or a weakened immune system
  • children younger than 5 years.

How is measles treated?

There are no specific treatments for measles and symptoms usually improve after 7 to 10 days. There are things you can do to ease your symptoms such as:

  • using pain relief, such as paracetamol or ibuprofen, to reduce pain and discomfort
  • keeping yourself hydrated, and having adequate fluids to avoid dehydration if you have a fever or diarrhoea (runny poos)
  • treating sore eyes by wiping the crustiness from the eyelids and lashes using cotton wool and water (use a separate piece of cotton wool for each eye) and avoiding bright light.

How can I prevent the spread of measles?

If you have measles

To stop spreading the virus to others, people with measles need to stay home from work, school or day care for 5 days after the rash appears. Do not invite other children or visitors to the house. If you suspect you have measles, phone your GP or Healthline free on 0800 611 116 for advice. Because measles is so infectious (easily passed on to other people), ring first rather than just turning up at your doctor’s clinic.

If you come into contact with someone who has measles

If you come into contact with someone who has measles and you have never had measles or not been fully vaccinated for it you should be in quarantine at home. This means you cannot attend early childhood centres, school, work, sporting events, social activities or shopping malls or use public transport for that time. The quarantine period starts 7 days after your first contact with an infected person, lasting until 14 days after your last contact. Read more about measles information for contacts. 

Why is vaccination so important?

Vaccination is the best way to prevent measles. No measles-only vaccine is available in New Zealand. The combination measles, mumps and rubella (MMR) vaccine protects against measles. Two doses of MMR vaccine are recommended after the age of 12 months, given at least 4 weeks apart. Having only one dose of the MMR vaccine is not adequate protection against measles.

  • Check with your GP or nurse to see if your child has received both vaccinations. If they haven’t, get them vaccinated as soon as possible. Vaccination is free.If your child was born outside of New Zealand, or if you are not sure whether you or your child has had two doses of MMR, it’s safer for you and your child to get vaccinated, as there’s no additional risk to having a third dose.
  • A small number of people who have been vaccinated will still catch measles, but they are less likely to be seriously ill.

Learn more

The following links provide more information on measles

Measles Ministry of Health, New Zealand
What is measles Auckland Regional Public Health Service
Information for people with measles Auckland Regional Public Health Service
Measles information for contacts Auckland Regional Public Health Service 
High-risk people Auckland Regional Public Health Service
Measles The Immunisation Advisory Centre, New Zealand

References

  1. Measles Immunisation Handbook 2017, New Zealand
  2. Measles: what to be aware of during an outbreak BPAC, 2014, NZ  
  3. Measles DermNet, NZ
Credits: Editorial team. Last reviewed: 28 Nov 2017