What is measles?
- Measles is a viral disease that may have serious complications.
- In the past, measles infection was very common in childhood. Most people born before 1966 will have been infected with measles as a child and are likely to be immune.
- Thanks to immunisation measles is now rare in Australia.
- Measles remains common in many parts of the world, and large outbreaks continue to occur in a number of countries. This is why it is important to make sure you are fully protected against measles prior to overseas travel.
What are the symptoms?
- The first symptoms are fever, tiredness, cough, runny nose, sore red eyes and feeling unwell. A few days later a rash appears. The rash starts on the face, spreads down to the body and lasts for 4-7 days. The rash is not itchy. Young children (especially infants) may also experience diarrhoea.
- Up to a third of people with measles have complications. These include ear infections, diarrhoea, and pneumonia, and may require hospitalisation. About one in every 1000 people with measles develops encephalitis (swelling of the brain).
How is it spread?
- Measles is usually spread when a person breathes in the measles virus that has been coughed or sneezed into the air by an infectious person.
- 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.
- People with measles are usually infectious from just before the symptoms begin until four days after the rash appears. The time from exposure to becoming sick is usually about 10 days. The rash usually appears around 14 days after exposure.
Who is at risk?
People are at risk of measles if:
- they have never had measles infection or
- they have not had two doses of measles containing vaccine or
- they have a weakened immune system (e.g., people who are receiving chemotherapy or radiotherapy for cancer or people who take high-dose steroid medications) even if they have been fully immunised or have had past measles infection and
- they have had contact with someone with measles infection
How is it prevented?
- The best protection against measles is immunisation with two doses of measles containing vaccine, given at least 4 weeks apart.
- In Australia two doses of measles containing vaccine are offered to children under the national Immunisation Program (NIP). The first dose is scheduled at 12 months of age as measles-mumps-rubella (MMR) vaccine. The second dose is scheduled at 18 months of age as measles-mumps-rubella-varicella (MMRV) vaccine. These vaccines provide protection against mumps, German measles, and chicken pox as well as measles.
- People planning travel with children between 6* and 18 months of age should discuss their travel plans with their GP, as the schedule can be adjusted for children travelling to areas with a high risk of measles.
- Anyone born during or after 1966 who has never had measles infection should see their doctor to make sure that they have had two doses of measles containing vaccine at least four weeks apart. If not the vaccine is free in NSW.
- It is safe to have the vaccine more than twice, so people who are unsure should be vaccinated.
- People with measles should stay at home until they are no longer infectious (i.e. until 4 days after the rash starts) to reduce the possibility of spreading it to other people.
* The national recommendations for early measles vaccination of infants prior to travel have recently been updated - previously the lower age limit for vaccination was 9 months of age.
How is it diagnosed?
Measles is suspected when a person feels unwell, has a cough, runny nose or sore eyes and a fever followed by a rash.
Whenever measles is suspected, samples from the nose, throat, and urine should be collected to confirm the diagnosis. A blood test may also be performed. Confirmation of the diagnosis is important as it allows prompt public health follow-up of other people who are at risk of measles.
How is it treated?
People with measles infection are normally advised to rest, drink plenty of fluids, and take paracetamol to treat the fever. There is no specific treatment.
What is the public health response?
Doctors, hospitals and laboratories, schools and childcare centres must notify cases of measles to the local public health unit. Public health unit staff will interview the doctor and patient (or carers) to find out how the infection occurred, identify other people at risk of infection, implement control measures (such as immunisation and restrictions on attending school or work) and provide other advice.
The Measles: Information for Contacts form contains useful information for clinicians to provide to measles contacts, following assessment and/or provision of post exposure prophylaxis.
For more information
For further information please call your local Public Health Unit on 1300 066 055