Measles is a highly infectious viral illness that can lead to serious complications. Vaccination with the measles, mumps and rubella (MMR) vaccine is the best way to protect against measles. You need 2 doses to be fully immunised.
On this page, you can find the following information:
Measles is highly infectious — it spreads very easily from one person to another
Measles is easily spread – just being in the same room as someone with measles can lead to infection if you are not immunised.
A person with measles is infectious from 5 days before and until 5 days after the rash appears (about 10 days in total).
During this time the infected person needs to stay away from other people. Children need to be kept home from school and adults from work, do not invite other children or visitors to your house.Calculate your quarantine period
If you suspect you have measles, it is important to see your doctor but phone ahead first. This helps to ensure people with measles do not end up sitting in a waiting room, potentially spreading the illness to others. You can get free health advice from a registered nurse 24 hours a day from Healthline on 0800 611 116 if you have any questions.
What is measles?
Measles is a viral illness that causes a skin rash and fever. The 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).
One person with measles can pass on the disease to 13 other people who have not been immunised.
Why is vaccination so important?
Vaccination is the best way to prevent measles
The combination measles, mumps and rubella (MMR) vaccine is highly effective at preventing measles. Just one dose of MMR gives you a 95% chance of being protectedagainst measles, two doses increased this to 99%. No measles-only vaccine is available in New Zealand.
MMR vaccine is funded for all children from 12 months of age and adults, born on/after 1 January 1969, who have not completed a two-dose course of MMR vaccine.
Having only one dose of the MMR vaccine is not adequate protection against measles – you need to have two.
If your child has been infected with measles, they can have the MMR vaccine once they feel well. They don't have to wait for a specific time before having it.
Herd immunity helps protect the vulnerable in our community
Some people in our community can't be vaccinated. This might be because they are too young or too sick. You can help protect these vulnerable people by keeping your and your family’s vaccinations up to date. When enough people in the community are vaccinated, the spread of a disease slows down or stops completely. If enough people are vaccinated, the disease can't spread. This is called herd immunity.
The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if you’ve already had the MMR vaccination. Either your doctor or a nurse can give the vaccination.
What are the symptoms of measles?
It usually takes about 10 days from contact with someone with measles to getting the first symptom but it can take from 7 to 18 days. The symptoms tend to appear in 3 stages.
Stages of the illness
Description
Stage 1
Prodromal stage. Usually lasts 3–4 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
Blotchy red rash appears that lasts 4–5 days.
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?
Most people will recover from measles after 7–10 days, 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. It is estimated that complications resulting from measles infection lead to death in approximately 1–2 per 1000 measles cases.
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 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 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 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.
Who is considered to be immune to measles?
If you have had two doses of the MMR vaccine, have had the measles previously or were born before 1969, you are considered to be immune to measles.
Children aged 12 months or older are considered fully immunised against measles when they have two documented MMR vaccinations, received when aged 12 months or older.
Adults born in 1969 or later are considered fully immunised against measles when they have two documented MMR vaccinations, received when aged 12 months or older. Don’t rely on memory – if you have no record of receiving both the MMR vaccines from 12 months of age and a minimum of 28 days later, it’s recommended you get catch-up MMR vaccinations.
Adults born before 1969 are considered immune to measles as the disease common at that time and 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. 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 adequate 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.
How can I prevent the spread of measles?
If you have measles, it’s important to reduce the risk of spreading the infection to others. You should do the following:
Stay home from work, school or daycare for 5 days after the rash appears.
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.
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 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.
Vaccination is particularly important if you are planning to travel overseas as there may be outbreaks in those countries.
If you have been overseas, or had contact with an overseas visitor in the last 3 weeks and develop the symptoms described above, you could have measles.
Learn more
The following links provide more information on measles
Credits: Health Navigator Editorial Team. Reviewed By: Dr Osman David Mansoor, Medical Officer of Health, Tairawhiti DHB
Last reviewed: 01 Oct 2019
redirect to measles, mumps and rubella (MMR) vaccine
Frequently asked questions about measles
Why is measles a serious problem?
Measles can cause serious complications in children and adults. These include ear infections, pneumonia and encephalitis (swelling of your brain) and death. About 1 in 10 people with measles will need hospital treatment. Measles is highly contagious. One person with measles can pass on the disease to 13 other people who have not been vaccinated. An infected person can spread measles to others even before knowing they have the disease.
What are the symptoms of measles?
Measles symptoms include a high fever, runny nose, cough and sore red eyes, followed by a rash starting behind your ears and spreading around your body a few days later. If you think you have measles, it’s important to call before visiting your doctor to avoid spreading the virus in the waiting room. If you catch measles, you're infectious from 5 days before and until 5 days after the rash appears.
How can I protect myself and my family against measles?
The best way to prevent measles is to be vaccinated on time, with 2 free MMR vaccinations for all children at 15 months and 4 years, as per the immunisation schedule.
Why do I need two doses of the MMR vaccine?
To get the best protection from the MMR vaccine, its important to have two doses of the MMR vaccine. One dose of vaccine is 95% effective against measles and 2 doses are 99% effective. The reason for a second dose is to make sure the 5% who need this second vaccine get immunity.
If you are between the ages of 15 and 29 years, you should check your immunisation records to make sure you received 2 doses of the MMR vaccine as a child.
If you didn’t receive 2 doses, or can’t confirm whether you did or not, you should visit a clinic for a free measles vaccine. There are no undue effects from being vaccinated even if you are immune.
Where can I get vaccinated?
The best place to go for vaccination is your family medical clinic. They have your medical records and can check to see if you’ve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.
How long does it take for the vaccination to work?
It can take around 2 weeks for a person to be fully immune after a vaccination.
How do I know if I have immunity?
You are deemed as having immunity if you:
were born before 1 January 1969 (you are presumed to be immune following exposure to the wild virus)
have documentation of immunity or previous infection
have documentation of 2 doses of measles vaccine.
If in doubt, talk to your GP about getting vaccinated, as there are no undue effects from being vaccinated even if you are immune. Read more
Could I still get measles if I am fully vaccinated?
Very few people (about 3 out of 100), who get 2 doses of measles vaccine will still get measles if exposed to the virus. Experts aren’t sure why. It could be that their immune systems didn’t respond as well as they should have to the vaccine.
But the good news is that fully vaccinated people who get measles are much more likely to have a milder illness. And fully vaccinated people are also less likely to spread the disease to other people, including people who can’t get vaccinated because they are too young or have weakened immune systems.
I'm pregnant. Can I get vaccinated against measles?
If you were not immunised against measles before becoming pregnant, you should not receive the MMR vaccine during pregnancy. If you are of childbearing age you should avoid pregnancy for 1 month after having a dose of the MMR vaccine. If you are breastfeeding (and not pregnant) you can receive the MMR vaccine safely. If you were vaccinated against measles prior to becoming pregnant you are almost certainly protected. Read more about measles and pregnancy.
I have been exposed to someone with measles. What should I do?
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), phone first rather than just turning up at your doctor’s clinic. You should:
stay at home as soon as you notice any measles symptoms (flu-like symptoms)
stay home from work, school or daycare for 5 days after the rash appears
not invite other children or visitors to the house
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 and remind others in your home to do the same.
If you are pregnant
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.
Note: This resource is from overseas so some details may be different in New Zealand, eg, phone 111 for emergencies or, if it’s not an emergency, freephone Healthline 0800 611 116.
Information for healthcare providers on measles
The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
Nikki Turner discusses the management of measles in New Zealand. Nikki is an academic general practitioner and an associate professor in the Department of General Practice and Primary Care, University of Auckland. She works part time as a GP in Wellington and is director of the Immunisation Advisory Centre (IMAC).
Video
Ben Harris, a medical microbiology scientist talks about the following topics:
Can you be fully vaccinated and still catch measles?
When was measles vaccination introduced to NZ?
Why do people born before this date in NZ not have to get vaccinated?\
What are Koplik spots?
What is the measles incubation time?
When is someone with measles infectious?
(Mobile Health, NZ, 2019)
Measles update by Dr Nikki Turner
(The Immunisation Advisory Centre, NZ, 2019)
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