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Disease

Measles

Page last updated on 23 March 2020

Measles is a highly infectious viral infection that can cause serious illness, particularly in young children and adults.2–4 

Typically, measles begins with fever and common cold-like symptoms (runny nose, red eyes and cough), followed by the ‘measles rash’, which tends to start on the face and then begins to spread all over the body.2,5 Most people recover from measles without complications, however for some, severe complications may occur, which can be fatal.2,6 There is no specific treatment for measles, but the infection is preventable by vaccination.5 

Measles outbreaks are now rare in Australia due to routine vaccination programs. However, anyone who is not immune is at risk of contracting measles, as there is a risk that infection can be brought in by travellers arriving from overseas.3,4 In 2017, there was a measles outbreak in western Sydney after a traveller who contracted the disease in Indonesia brought the virus back home.7
 

Key disease information

What is the measles virus?

Measles is a highly contagious infection caused by a virus known as Morbillivirus. It causes a skin rash, which usually begins on the face and the spreads down to cover the entire body, and flu-like symptoms, including fever, cough, and runny nose.

Measles can be a severe illness – serious complications are much more common in young children (under 5 years of age), in the chronically ill and in adults. 60% of deaths from measles are caused by the development of pneumonia, especially in the young, and from encephalitis (brain swelling), particularly in adults. Measles during pregnancy can cause miscarriage, premature labour, and/or babies may have a low birth weight. In a small number of cases, measles may also be fatal.

Is measles contagious?

Yes. Measles is highly contagious – so much so, that around 90% of non-immune people who are exposed to the measles virus are thought to become infected. Once exposed, symptoms occur around 10-14 days later.

How is measles spread?

The measles virus is spread when a person breathes in the measles virus that has been by coughed or sneezed into the air by an infected person. In fact, measles is one of the most easily spread disease of all human infections – by just being in the same room as an infected person can result in you contracting the virus yourself.

The virus can survive in airspace where an infected person has coughed or sneezed for up to two hours – so people can contract the measles by breathing in that same contaminated air, or by touching a contaminated surface, then touching their own mouth, nose or eyes.

The measles can spread to others from four days before the rash appears, through to four days after it appears.

What does measles look like?

While measles is probably best known for its full-body ‘measles rash’, the first symptoms of the infection are usually cough, runny nose, high fever, red eyes and generally feeling unwell (malaise). Koplik's spots (small red spots with blue-white centres) may also develop inside the mouth.

The measles rash breaks out about 2–4 days after symptoms start, starting on the face and moving down the body. The rash is made up of flat red spots, and is not itchy. Sometimes, small, raised spots may also appear on top of the flat spots. In most people the rash will last 4–7 days before fading. A case of measles without complications usually lasts around 14 days.

In some cases, complications may arise, including middle ear infection, diarrhoea, pneumonia (lung infection), encephalitis (brain swelling), and for a minority, the infection may be fatal. There is also an exceptionally rare risk of Subacute Sclerosing Panencephalitis (SSPE), which may appear approximately seven years after the initial measles infection. SSPE causes progressive brain damage which is often fatal. These complications are generally more common in those with existing chronic (long-term) illness, young children (<5 years of age), and adults.

Can measles be prevented?

Measles is a vaccine-preventable disease. In Australia, immunisation against measles is provided as part of the National Immunisation Program (NIP).

  • Children at 12 months - the first dose of measles vaccine is given in combination with mumps and rubella (as MMR vaccine)
  • Children at 18 months - the second dose of measles vaccine is given in combination with mumps, rubella and varicella (chickenpox)

If you were born during or after 1966 and do not have evidence of having received 2 doses of a measles-containing vaccine, you may no longer have immunity against the disease and may need an additional dose. It is also recommended that any young adolescent or adult who does not have evidence of receiving two doses of a measles-containing vaccines or other evidence of immunity should talk to their doctor about vaccination for measles.

For further information regarding vaccination against measles, speak with your healthcare professional.

How do you treat measles?

There is no specific medical treatment for measles and if infected, the virus has to run its course. 

If you do have symptoms of measles, you should see your GP as soon as possible, but call ahead to allow staff to limit your contact with other people in the clinic. The symptoms of measles are usually treated with bed rest, fluids, and other appropriate treatments.

You should also stay home and away from other people. This way, you lower the chances of spreading the virus to other people.

In the case of complications of a measles infection, you may require urgent treatment, which may include hospitalisation.

As there is no cure for measles, the best preventative measure is vaccination.

Who is at risk of catching the measles virus?

Anybody who has not been vaccinated against the measles virus, nor has natural immunity, is at risk of catching the virus and becoming ill.

 

In addition to this, people at higher risk of catching the measles virus include:

  • People with weakened immune systems, such people receiving chemotherapy or radiotherapy, or people who take high-dose steroids, even if they have been fully immunised or have had measles infection.
  • People who are travelling overseas from Australia and have not been vaccinated or do not have natural immunity.

VaccineHub offers general information only. Please see a healthcare professional for medical advice

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Sources & Citations

  1. National Notifiable Diseases Surveillance System. Number of notifications of Measles, Australia, in the period of 1991 to 2019 and year-to-date notifications for 2020. Available at: www9.health.gov.au/cda/source/cda-index.cfm (accessed 10 March 2020).
  2. World Health Organisation. Measles. Available at https://www.who.int/news-room/fact-sheets/detail/measles (accessed 10 March 2020).
  3. Australian Government, Department of Health. The Australian Immunisation Handbook. Measles. Available at: https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/measles (accessed 10 March 2020).
  4.  Victoria State Government. Better Health Channel. Measles. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/measles?viewAsPdf=true (accessed 10 March 2020).
  5. NSW Government. Measles Fact Sheet. Available at: https://www.health.nsw.gov.au/Infectious/factsheets/Factsheets/hepatitis-a.pdf (accessed 10 March 2020).
  6. Centers for Disease Control and Prevention. Measles – Complications of Measles. Available at https://www.cdc.gov/measles/symptoms/complications.html(accessed 12 March 2020).
  7. NSW Government, Measles outbreak – April 2017.  Available at http://www.health.nsw.gov.au/Infectious/alerts/Pages/april-measles.aspx (accessed 10 March 2020).
  8. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C. Public Health Foundation, 2015.
  9. healthdirect Australia. What does measles rash look like? Available at: https://www.healthdirect.gov.au/blog/what-does-measles-rash-look-like (accessed 10 March 2020). 
  10. National Centre for Immunisation Research and Surveillence. Measles vaccines for Australians. Available at: http://ncirs.org.au/sites/default/files/2019-07/Measles%20vaccines%20for%20Australians%20fact%20sheet_July%202019.pdf (accessed 12 March 2020).

SPANZ.SAPAS.18.04.0133(2) - Date of preparation March 2020

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