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Measles is a contagious viral illness that causes a skin rash and fever.
Serious and sometimes fatal complications include pneumonia and encephalitis (brain inflammation).
Measles is also known as rubeola, not to be confused with rubella.
Worldwide, measles is the fifth highest cause of illness and death in children.
Measles is rare in Australia because of the widespread use of the measles vaccine.
It is important to continue immunising children in Australia, because there is a risk that the infection can be brought in by people arriving or returning from overseas.
Symptoms of measles
The signs and symptoms of measles may include:
general discomfort, illness or lack of wellbeing (malaise)
sore and red eyes (conjunctivitis)
red and bluish spots inside the mouth (Koplik’s spots)
red and blotchy skin rash that appears first on the face and hairline, and then spreads to the body.
Causes of measles
Measles is most commonly spread when someone swallows or inhales the cough or sneeze droplets from an infected person.
The measles virus is carried inside mucus or saliva droplets and remains alive for several hours.
Infection can also occur if someone touches contaminated surfaces or objects and then touches their own mouth or nose or eats before washing their hands.
Symptoms usually occur about 10 to 12 days after infection.
Measles is very contagious.
Estimates suggest that a person with measles will infect about nine in every 10 people they have contact with who have not been immunised or previously infected with measles.
Treatment for measles
A case of measles without complications usually lasts about 14 days and most people make a full recovery.
Antibiotics don’t work because the illness is viral.
Treatment aims to ease symptoms and reduce the risk of complications.
Options may include:
plenty of fluids
paracetamol to reduce pain and fever
isolation to reduce the risk of transmission.
Occasionally, measles develops into a serious disease that requires urgent treatment and can even be life threatening.
Sometimes, people can die from complications even if they receive prompt medical attention.
Treatment depends on the complication but may include:
supportive care – for example, to maintain hydration, and to check for fever and infection
antibiotics – to treat bacterial infection.
Contact with someone with measles.
If you’ve been in contact with someone with measles and you are not immune to measles (have not been immunised or have not had a measles infection), there are different treatment options.
Speak with your doctor about your options.
Depending on your situation, these may include:
If you were in contact with someone with measles in the last 72 hours – have a measles immunisation immediately.
If you were in contact with someone with measles in the last three to seven days – immunoglobulin can be given for interim protection.
This is known as passive immunisation.
Measles vaccination, or active immunisation, should be given later to prevent further risk of infection, but not until five months after you received the immunoglobulin.
Normal human immunoglobulin is given as an injection.
Immunisation against measles
Immunisation is the best protection against measles.
A person who receives the recommended two doses of a measles vaccine has 99 per cent immunity against measles infection.
If you have been infected with measles, you will usually have lifelong immunity.
There are two types of measles vaccine.
In the first type, the vaccine is a combined measles, mumps and rubella (German measles) vaccine and is commonly known as the MMR vaccine.
In the second type (available from July 2013), the vaccine is a combined measles, mumps, rubella and varicella (chickenpox) vaccine and is commonly known as the MMRV vaccine.
Protection against measles is available under the National Immunisation Program Schedule.
In Victoria, immunisation against measles is free of charge for:
Children at 12 months – the first dose of measles vaccine is given as the MMR combination vaccine.
Children at 18 months of age – the second dose of measles vaccine is given as the MMRV combination vaccine.
All children younger than 10 years of age can receive the free National Immunisation Program vaccines.
Young people under 20 years of age can receive the free National Immunisation Program vaccines.
Children up to and including nine years – catch-up immunisations are available for children who have not been fully immunised.
Women planning pregnancy or after the birth of their child – two doses of MMR are available for women who have low immunity or no immunity to rubella.
Aboriginal and Torres Strait Islander people, refugees and asylum seekers and vulnerable people – catch-up immunisations are available for people who have not been fully vaccinated.
All people born during or since 1966, without evidence of two documented doses of valid MMR vaccine or without a blood test showing evidence of immunity to measles, mumps and rubella, are eligible for one or two doses of MMR vaccine.
(If two MMR doses are required they should be given a minimum of 28 days apart.) If you have not received the vaccine, ask your doctor about catch-up doses.
How do you prevent measles?
Immunisation given on time is the only way to prevent measles.
If you’re unsure about whether your child has had MMR immunisation, or you can’t find your records, you can check with your Well Child Tamariki Ora provider or Well Child book, or contact your family doctor.
Combined measles, mumps, rubella (MMR) immunisation is the only vaccine available to prevent measles in New Zealand.
Who should have MMR immunisation?
Babies and children
Children usually have 2 doses of MMR – one dose at 15 months of age and a second at 4 years of age.
Babies and children who have not had their MMR immunisation are at greatest risk of the disease.
Babies aged 6-11 months can have their MMR immunisation early if there is a high risk of exposure to measles (for example, travel to countries with serious outbreaks).
These babies will still need MMR at 15 months and 4 years of age because MMR immunisation tends not to work as well in young babies.