Measles

Also known as English measles

Measles is a highly infectious viral illness that can lead to serious complications. Vaccination is the best way to protect yourself, your whānau and community from catching and spreading measles.

On this page, you can find the following information:

Get vaccinated against measles
  • As COVID-19 restrictions ease, measles outbreaks are likely to happen.
  • Measles is spreads very quickly and can cause serious complications
  • Get vaccinated to protect yourself and your loved ones from catching and spreading measles.

What is measles?

Measles is a serious illness caused by the measles virus. It can cause serious complications in children and adults. These include ear infections, pneumonia, encephalitis (swelling of your brain) and death. About 1 in 10 people with measles will need hospital treatment. 

Measles is still common in many countries. Outbreaks of measles are usually started when someone brings measles into the country. In Aotearoa New Zealand, more than 2,000 people got measles in the 2019 outbreak, 700 had to go to hospital and some died. Māori communities and Pacific peoples were particularly affected.

How does measles spread?

The measles virus spreads easily through the air by sneezing or coughing. It can also be spread by contact with surfaces contaminated with an infected person’s nose and throat secretions (snot and saliva). If you are not immune, and you’ve been in the same room as someone with measles, you are very likely to catch it. It can stay in the air for 2 hours and properly fitted and worn N-95 masks are better at protecting you than surgical masks (the commonly available blue ones).

Watch a video about measles and the MMR vaccine.

(Ministry of Health, 2022)

Why is vaccination so important?

Vaccination is a very effective way of protecting against measles.

  • The vaccine is free.
  • The vaccine is called the measles, mumps and rubella (MMR) vaccine. No measles-only vaccine is available in Aotearoa New Zealand.
  • Having only 1 dose of the MMR vaccine is not enough protection against measles – you need to have 2 to complete the course. A single dose of MMR gives you a 95% chance of being protected against measles, 2 doses increases this to 99%.
  • The vaccine is part of the childhood immunisation schedule for children at 12 months and 15 months of age.
  • Some people may not be able to have the vaccine. Read more here.
  • If you're not sure you have been vaccinated against measles, it’s best to get immunised. It’s safe to have an extra dose of the MMR vaccine.
  • It can take around 2 weeks for a person to be fully immune after a vaccination.
  • Very few people who are fully vaccinated still get measles, but they are more likely to have a milder illness and are less likely to spread the disease to other people.

Image credit: Te Hiringa Hauora

By getting vaccinated, you can help people at risk

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 who are too young to receive the MMR vaccine
  • people travelling in countries/regions where there are current outbreaks of measles.
  • 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.

When enough people in the community are vaccinated (about 95% of the population), the spread of a disease slows down or stops completely. This is called herd immunity.

Read more about the MMR vaccine and reasons to vaccinate.

What are the symptoms of measles?

It usually takes about 1–2 weeks from contact with someone with measles to getting the first symptoms. The symptoms tend to appear in 3 stages.

Stages of the illness Description
Stage 1

  • Fever (temperature above 38°C), 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).
  • These symptoms usually last for 2–4 days.
Stage 2

A rash appears 2–4 days after stage 1 symptoms first start.

  • 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.
  • The rash usually lasts for up to 1 week.
  • A rash may be difficult to see on brown skin.
Stage 3
  • The rash fades leaving a temporary brownish stain on your skin.

If you catch measles, you’re infectious (can spread the virus) from 5 days before the rash appears and for 4 days after the rash appears (about 10 days in total)

Image credit: ARPHS

What are the complications of measles?

Most people will recover from measles after a week or two, but sometimes it can lead to serious complications, even death. Common complications that affect about 1 in every 15 cases include:

  • ear infections
  • diarrhoea, which can also lead to dehydration
  • fits caused by fevers (febrile seizures)
  • pneumonia – this is the main cause of deaths from measles.

Inflammation of the brain (encephalitis) occurs in about 1 in 1000 measles cases, with some of these people dying and 1 in 3 being left with permanent brain damage. 

Other complications include sclerosing panencephalitis a degenerative brain disease (which can occur in 1 in 100,000 measles cases), problems with blood clotting, inflammation of the small airways in the lungs, the heart, kidneys or liver. 

Contact your doctor or get urgent medical advice if you or someone you know has measles and develops any of these symptoms:
  • 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 peeing 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 should be vaccinated to help protect both the mother and unborn baby from exposure. 

Who is considered to be immune to measles?

You are considered to be immune to measles if you:

  • have had 2 doses of the MMR vaccine at the age of 12 months or older
  • have had the measles in the past
  • were born before 1 Jan 1969 as the measles disease was common at that time and was circulating widely prior to the introduction of a measles vaccine in 1969.

How is measles treated?

There are no specific treatments for measles and symptoms usually improve after 7–10 days. But 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
  • drinking enough water or other fluids to avoid dehydration. 
  • 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.

15 out of 100 people with measles need hospital treatment so if you feel unwell do not hesitate to seek help. Call Healthline free on 0800 611 116 any time of the day for advice.

If I have measles how can I reduce the risk of spreading the infection?

  • Stay home from work, school or day care for 4 days after the rash appears. Check this with the measles quarantine calculator.
  • Do not invite other children or visitors to the house.
  • Your public health service will tell you when your child can return to school or childcare. 
  • Wash your hands regularly. Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds then dry well. Remind others in your home to do the same.
  • You will be regularly contacted by a health professional who will provide advice and check on your wellbeing.

I am a close contact of a measles. What do I do?

Read more about measles information for contacts and measles quarantine calculator.

Learn more

The following links provide more information about measles.

Measles Manatū Hauora, NZ
Measles Auckland Regional Public Health Service, NZ
Information for people with suspected measles Auckland Regional Public Health Service, NZ
Information for close contacts exposed to measles Auckland Regional Public Health Service, NZ
Beat the bugs - quick guide to measles for ELS and schools Auckland Regional Public Health Service, NZ
Measles The Immunisation Advisory Centre, NZ 
Protecting children who can’t be immunised against measles Ministry of Health, NZ

References

  1. Measles Immunisation Handbook 2020, NZ
  2. Measles DermNet, NZ 2020
  3. Measles worldwide incidence World Health Organization
Credits: Health Navigator Editorial Team. Reviewed By: Dr Osman David Mansoor, Medical Officer of Health, Tairawhiti DHB Last reviewed: 01 Oct 2019