Measles

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 5 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.

Signs and symptoms

Measles begins with symptoms such as fever, tiredness, cough, runny nose and/or red inflamed eyes. These symptoms usually become more severe over 3 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 6 days.

Treatment

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.

Control

People with measles should be excluded from work, school or childcare centres for at least 4 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.

Transmission

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 5 days before the onset of the rash until about 4 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.

Prevention

Immunisation

Protection against measles is given through a combined MMR or MMRV vaccine. Two doses are needed to provide a high level of protection.

Immunisation against measles is recommended as part of the National Immunisation Program Schedule. Measles vaccination is funded for:

  • all children at both 12 months and 18 months of age
  • all people born during or since 1966 who have not received 2 doses of measles-containing vaccine, particularly
    • healthcare workers
    • childhood educators and carers
    • people who work in long-term care facilities
    • people who work in correctional facilities
    • people who plan on travelling overseas.

    Women planning a pregnancy should discuss whether they should be vaccinated against measles with their doctor. If so, they should be vaccinated with a MMR containing vaccine at least 28 days before becoming pregnant or immediately after the birth of the baby.

    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 fine red rash which is not infectious, drowsiness and tiredness. If side effects occur, they usually appear 7 to 10 days after immunisation and last 2 or 3 days. More serious side effects are extremely rare and can include severe allergic reactions. Contact your usual healthcare provider, general practitioner or hospital if you or your child has a reaction following vaccination which you consider serious or unexpected.

    Help and assistance

    You can be vaccinated at your local doctor or vaccine service provider. 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.

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    Other Resources

      References

      Heymann, D., ed. 2008. Control of Communicable Diseases Manual, 19th edition. American Public Health Association: Washington.

      The Australian Immunisation Handbook online version.