Measles is an acute, highly infectious illness caused by the measles virus. Measles can cause serious complications such as pneumonia (lung infection) and encephalitis (inflammation of the brain). It may also cause middle ear infection.
Measles should not be regarded as a simple mild disease. Deaths occur mainly in children under five years of age, primarily from pneumonia, and occasionally from encephalitis. Complications are more common and more severe in people with a chronic illness and very young children.
Measles begins with symptoms such as fever, tiredness, cough, runny nose and/or red inflamed eyes. These symptoms usually become more severe over three days. The cough is often worse at night and the affected person may wish to avoid light because of sore eyes. At this stage of the illness, there may be small white spots on a red base in the mouth on the inside of the cheek (Koplik’s spots). This is then followed by a blotchy, dark red rash usually beginning at the hairline. Over the next 24 to 48 hours, the rash spreads over the entire body, during which time the person generally feels very unwell. Typically with measles, the fever is present and the person feels most unwell during the first couple of days after the rash appears. The rash usually disappears after six days.
There is no specific treatment for measles. The symptoms of measles are usually treated with rest, plenty of fluids, and paracetamol to lessen pain or fever. Do not use aspirin for treating fever in children.
People with measles should be excluded from work, school or childcare centres for at least four days after the appearance of the rash.
People who have not been vaccinated against measles and those who have any condition that compromises their immune system and have been in contact with a person with measles should be excluded from school and childcare for 14 days from the day the rash appeared in the person diagnosed with measles.
If unvaccinated contacts receive the measles mumps rubella (MMR) vaccine within 72 hours of their first contact with the original person with measles, they may return to childcare, school or work.
Measles virus is very contagious. The virus is spread from an infectious person during coughing and sneezing or through direct contact with secretions from the nose or mouth. A person may be infectious from about five days before the onset of the rash until about four days after the rash appears. The time from contact with the virus until onset of symptoms is about 10 days but may be from 7 to 18 days.
Immunisation against measles is recommended as part of the National Immunisation Program Schedule and the vaccine is available free for:
- all children aged 12 months and 18 months
- children at 4 years of age who have not previously received a second dose of measles, mumps, rubella (MMR)
Adults born during or since 1966 who have not received two doses of MMR vaccine or had the diseases are also eligible for funded vaccine.
Protection against measles is given through a combined MMR vaccine. Two doses are needed to provide a high level of protection.
Vaccination is also recommended (but not funded) for:
- healthcare workers
- people who work with children.
Women planning a pregnancy should discuss whether they should be immunised against measles with their doctor. If so, they should be vaccinated with MMR vaccine at least 28 days before becoming pregnant or immediately after delivery.
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of the MMR vaccine may include discomfort where the injection was given, fever, a rash which is not infectious, drowsiness and tiredness. If side effects occur, they usually come on seven to 10 days after immunisation and last two or three days. More serious side effects are extremely rare and can include severe allergic reactions. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.
You can be immunised at your local doctor or medical centre. Check with your local council, community child health and community health centre regarding free immunisation clinics. For further information, contact your local doctor, community health centre or nearest public health unit.
Heymann, D., ed. 2008. Control of Communicable Diseases Manual, 19th edition. American Public Health Association: Washington.
Australian Government, 2013. The Australian Immunisation Handbook (10th Ed.)