What is measles?
Measles is a highly contagious viral disease that can be contracted at any age, and that can spread widely. It is a serious disease that can lead to complications and even death.
What are the symptoms of measles?
Measles symptoms usually appear after 10-12 days of infection:
- initial symptoms resemble a cold with a runny nose, cough and a mild fever;
- the eyes become red and sensitive to light;
- on the third to seventh day, the temperature may reach up to 41 ⁰C;
- a red rash lasting four to seven days begins on the face and then spreads over the entire body;
- small white spots may also appear on the gums and the inside of the cheeks.
What are the complications of measles?
30% of children and adults infected with measles can develop complications. These can include ear infections and diarrhoea.
Pneumonia is a potential serious complication that has led to the death of some measles patients. Pneumonia is the most common cause of measles-related death.
The mortality rate for measles is 1-3 persons per 1 000 cases and highest in those younger than five years of age and among immunocompromised individuals.
About 1 measles patient in 1 000 develops inflammation of the brain tissue (encephalitis), a condition that results in permanent neurological disability in approximately one of four cases.
Very rarely, a persistent measles virus infection can produce subacute sclerosing panencephalitis (SSPE), a disease in which nerves and brain tissue degenerate progressively and which is more likely to appear if measles infection occurs at a younger age. SSPE typically appears several years after the affected patient had measles; on average it is seen 7 to 10 years after the infection. Symptoms include personality changes, gradual mental deterioration, muscle spasms and other neuromuscular symptoms. There is no cure for SSPE and it always leads to death.
How is measles spread?
The measles virus is spread via airborne droplets produced when the infected person coughs and sneezes. Virus-containing droplets can remain in the air for several hours and the virus remains infectious on contaminated surfaces for up to two hours. A person who is infected may transmit measles even before the rash appears (usually 4 days), and for about 4 days after the rash has appeared.
Measles spreads easily among unvaccinated individuals. It is estimated that one person with measles can infect on average between 12 and 18 unprotected people.
Who is at risk of measles?
Anyone who is not vaccinated against measles or who has not had the disease is at risk of getting measles at any age.
How can measles be prevented?
The only protection against measles is vaccination. The MMR (measles, mumps and rubella) vaccine is a combination vaccine that protects against measles, mumps and rubella (German measles). The MMR vaccine is safe and effective and has very few side effects. Mild reactions such as fever, redness or swelling at the injection site have been reported. Some vaccine recipients develop a non-infectious mild measles-like rash, typically 7 - 14 days after vaccination, which disappears within 1 - 3 days.
Two doses of the vaccine are needed for maximum protection. The first dose is given between 10 and 18 months of age in European countries. The second dose can be given one month or more after the first dose, in accordance with the national vaccination schedule.
The MMR vaccine may be given earlier in life during outbreaks. Infants from six to nine months of age who are in an area – or will be travelling to areas – with high risk of exposure to measles, should receive a supplementary dose of the MMR vaccine. Such dose before the age of nine months is supplementary to the two doses included in the national vaccination programme, which are aimed to give full protection.
How is measles treated?
There is no specific treatment for measles. Most people recover with supportive treatment, which can include hydration and anti-fever medicines.
A variety of measures are employed to avoid the further spread of measles, such as quarantine from school or work for both the ill person and those close contacts with uncertain vaccination status.
Antibiotics are not effective against measles because it is caused by a virus. However, antibiotics are often used to treat complications with bacterial infections that can develop because of measles, such as pneumonia and ear infections.
Note: The information contained in this factsheet is intended for the purpose of general information and should not be used as a substitute for the individual expertise and judgement of a healthcare professional.