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 that lives in the nose and throat mucus of an infected person. It can easily spread to others through coughing and sneezing. Measles can cause serious complications in children and adults. These include ear infections, pneumonia, encephalitis (swelling of the brain) and death. About 1 in 10 people with measles will need hospital treatment.
 
(Immunisation Advisory Centre, NZ, 2017) 

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.

  • Very few people who are fully vaccinated still get measles. 
  • The vaccine is called the measles, mumps and rubella (MMR) vaccine. No measles-only vaccine is available in 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. 
  • The vaccine is free.
  • 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.

By getting vaccinated, you can help people at risk

Measles can cause serious complications in children and adults, especially in: 

  • anyone with a chronic illness or a weakened immune system
  • children younger than five years who are not immunised
  • babies younger than 12 months who are too young to receive the first dose of the MMR vaccine
  • pregnant women.

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 and it most especially protects pregnant people and children younger than 12 months cannot get vaccinated. Read more about the MMR vaccine and reasons to vaccinate.

What are the symptoms of measles?

Symptoms usually take around 7 to 10 days to appear after you have caught the virus.

Symptoms of measles

Usual symptoms in the first few days of being unwell

  • Fever (temperature above 38°C)
  • Runny nose (or blocked nose)
  • Cough
  • Loss of appetite
  • Sore and watery pink eyes
  • You may also get white spots inside your mouth.

3 to 7 days after the first symptoms people start to develop a rash 

  • 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 will fade after about a week, leaving a slight mark on the skin, but this will not be permanent. You are no longer at risk of passing on measles to others 4 days after you developed your rash.

If you catch measles, you’re infectious (can spread the virus) from 4 days before the rash appears and for 4 days after the rash appears.

Image credit: Auckland Regional Public Health Service – Te Whatu Ora

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, and 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.

If you or your child:

  • have trouble breathing
  • have a stiff neck
  • feel drowsy or cannot be woken up
  • are coughing up green or yellow thick mucous
  • experience backpain
  • have sore ears
  • have a fit (seizure)
  • do not pee for 10 hours.

For your child if:

  • they become floppy, very drowsy or are difficult to wake
  • their breathing becomes very fast or noisy
  • they become very pale or have blue lips or gums.

Always call first if you need to visit a medical practice or hospital.

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. Read more about measles and pregnancy.

Who is at risk of getting measles?

You are considered to be at risk of getting measles if you were born after 1 January 1969 AND:

  • have not had measles before
  • have not had 2 doses of the MMR vaccine at or after 12 months of age
  • aren’t sure if you’ve had the MMR vaccine.

If you are at risk of getting measles and come into contact with someone who has measles, you are regarded as a close contact – see I am a close contact of somebody with measles. What do I do?

How is measles treated?

People with measles need to get plenty of rest. If you have medicine you take normally, continue to have this. To ease your symptoms you can:

  • use pain relief, such as paracetamol or ibuprofen, to reduce pain and discomfort
  • drink plenty of water or other fluids to avoid dehydration 
  • treat 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.

About 15% (15 in every 100) of people with measles will 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.
  • Don't 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.
  • Read more about information for people with measles.  

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

Read more about measles information for contacts and check the 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.