Measles

Measles is a serious and highly contagious viral illness that is caused by the measles virus.

Measles can be a severe disease and lead to serious complications. Measles is not common in Australia because of high levels of immunisation.

Symptoms

Measles usually begins with:

• a fever
• tiredness
• cough
• runny nose
• sore eyes.

A characteristic rash appears 3–7 days after the onset of symptoms and will usually begin when the fever is still present. This rash is usually flat, red, blotchy and covered with small bumps. The rash usually starts on the face, head or neck then spreads down to the body and lasts for 4–7 days. Small white spots may occur on the inside of the mouth (Koplik spots).

Up to a third of people with measles may develop complications, including ear infections and pneumonia, and require hospitalisation. About one in every 1,000 people with measles develops encephalitis (inflammation of the brain). A very rare but fatal condition called subacute sclerosing panencephalitis (SSPE) may develop several years after a measles infection.

How measles is spread

Measles is usually spread when an infected person coughs or sneezes. It can also be spread by direct contact with respiratory secretions or with soiled articles (such as dirty tissues). Measles is one of the most easily spread of all human infections. Just being in the same room as someone with measles can result in infection.

It is important that a person infected with measles avoid contact with others to reduce the risk of spreading the disease. They should be excluded from school, childcare or work until they are no longer considered infectious.

Infectious period

People with measles are usually infectious from just before the symptoms begin (about 4 days before the rash appears) until 4 days after the rash appears.

Who is at risk of infection

People are at risk of measles if:

• they have never had measles infection
• they have not had two doses of measles containing vaccine
• they have a weakened immune system even if they have been fully immunised or have had past measles infection. This includes people who are receiving chemotherapy or radiotherapy for cancer or people who take high-dose steroid medications
• they have had contact with someone with measles infection.

Measles remains common in many countries and large outbreaks often occur. People travelling overseas are at risk of measles if they are not immune.

Close contacts

It usually takes about 10 days after coming into contact with measles for symptoms to develop. The rash usually appears around 14 days after exposure to measles.

Find out more information for close contacts.

Diagnosis

A doctor may suspect measles based on the person’s signs and symptoms. A blood test, throat swab or urine specimen is necessary to confirm the diagnosis.

Treatment

There is no specific treatment for measles. People with measles should have plenty of fluids and rest, see their doctor and treat symptoms as they occur.

Immunisation

Vaccination is the best way to prevent being infected with measles. MMR vaccine is offered to all children under the funded National Immunisation Program at 12 months of age and then again in combination with the chickenpox vaccine (MMRV) at 18 months of age. To be fully vaccinated, people need to receive two doses of a measles containing vaccine at least four weeks apart.

Vaccinations and immunity

If you were born prior to 1966 in Australia, it is likely that you had measles in your childhood and are now immune. If you were born during or after 1966, and have not had measles, you should have received two doses of a measles containing vaccine at least four weeks apart to be considered immune. However, if you are unsure, it is safe to have the vaccine more than twice.

Vaccination side effects

The MMR vaccine is generally well tolerated and any side effects are usually mild. Side effects may include fever, tiredness, localised swelling at the injection site, swollen glands and feeling unwell. This vaccine is not recommended for people who are immune-suppressed or for pregnant women. Pregnancy should be avoided for 28 days following vaccination. MMR vaccination may also need to be delayed if you have had a recent blood transfusion or blood product.

More information

Measles is a notifiable condition. For more information about measles, contact your GP or call the Health Protection Service, Communicable Disease Control Information Line during business hours on 02 5124 9213.

Acknowledgements

• Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.
• Australian Technical Advisory Group on Immunisation (ATAGI). The Australian Immunisation Handbook 10th ed (2017 update). Canberra: Australian Government Department of Health, 2017.
• Australian Government, Department of Health, Measles SoNG 2015.