Measles

Measles is a highly infectious airborne virus that can cause serious complications.

Measles was once a common childhood illness and most people born before 1966 had measles as a child. Due to vaccination, measles infection is now uncommon in Australia, however it remains a common disease outside Australia. New cases continue to be brought into Australia by people who have travelled overseas.

Measles is a different disease to German measles (rubella) (external site).

The first symptoms of measles are:

• fever
• tiredness
• runny nose
• cough
• sore red eyes
• white spots inside the mouth, called Koplik spots (these are uncommon).

These symptoms usually last for a few days before a red blotchy rash appears. The rash usually starts on the face and spreads down to the body over a couple of days. The rash can last for 4 to 7 days.

The time from being exposed to someone with measles to developing symptoms is usually about 10 days. The rash usually appears around 14 days after exposure.

Complications

Up to one-third of people infected with measles will experience a complication or may require hospitalisation. This can include ear infections, diarrhoea and pneumonia (chest infection). About 1 in every 1000 people with measles develops encephalitis (swelling of the brain).

Measles is usually spread when a person breathes in the measles virus that has been coughed or sneezed into the air by a person who is infected with measles – droplets containing the measles virus can stay in the air for up to 30 minutes after a person has been in a room. It can also be spread by touching an infected person’s mouth or nose, or by touching objects contaminated with their mucous or saliva.

People who are not immune to measles can catch measles just by being in the same room as someone who has measles or entering a room within 30 minutes after they have left the room.

People with measles are usually infectious from one day before symptoms start until 4 days after the rash appears.

The measles virus cannot survive for long in the air and on objects and surfaces (less than 2 hours) and it is inactivated quickly by sunlight and heat. It's generally considered safe to enter an area where a person with measles has been (e.g. a clinic waiting area) 30 minutes after they have left the area.

If you have been exposed to someone with measles

You should monitor yourself for symptoms of measles from 7 to 18 days after last being in contact with a person with measles.

If you were born after 1965 and are not vaccinated against measles (external site), you are at risk of measles if exposed to someone with the infection. Contact your local public health unitfor advice. The public health unit will undertake an assessment and depending on the level of risk may advise the following:

• Whether you should go to work, school or daycare until the time that you could develop measles has passed.
• If it is less than 3 days since contact with a person with measles, vaccination can prevent a measles infection.
• If it is more than 3 days and less than 7 days since contact with a person with measles, an injection of antibodies against measles virus (called immunoglobulin) may be recommended. Immunoglobulin is especially recommended for children less than one year old who are not yet vaccinated against measles, non-immune people who are pregnant, and people with certain medical conditions who are at greater risk of developing complications if they catch measles.

Measles is uncommon in Australia due to vaccination programs, but cases can still occur, especially among people travelling overseas. People who are not immune to measles are at greater risk of getting measles and developing more severe disease.

People who have had contact with someone with measles are at risk of infection if:

• they are born after 1965 and have not had measles infection, or
• they have not had two doses of the measles (MMR) vaccine.

People born before 1966 are generally considered to be immune to measles due to widespread circulation of measles virus prior to that time.

People travelling overseas

People who haven't had two doses of a measles vaccine and are travelling overseas are at increased risk of infection because measles is common in many countries outside of Australia.

Two doses of vaccine given at least 4 weeks apart is recommended for optimal protection prior to travel – you can receive another measles vaccine dose if you are unsure if you have previously had two doses.  

You should get a measles vaccination at least 2 weeks before travelling, but it is best to see a GP or travel clinic at least 6 weeks beforehand to allow for the possibility of needing multiple doses and to ensure full immunity develops.

Infants aged between 6 months and less than 12 months who are travelling to countries of high measles activity can also receive a free measles vaccine from GPs and travel clinics. If an infant receives this additional measles vaccine before 12 months of age, they will still need the two doses routinely offered as part of the National Immunisation Program after 12 months of age.

Pregnant people and their babies

If a pregnant person is infected with measles, there is an increased risk of complications including miscarriage, early labour and stillbirth.

The measles vaccine should not be given during pregnancy. To protect their baby and themselves, it is important for women to get vaccinated against measles (external site) at least 4 weeks before getting pregnant.

Measles can be difficult to diagnose early in the illness because there are many other viruses that cause similar symptoms.

Whenever measles is suspected, a diagnosis should be confirmed in the laboratory through a nose or throat swab and a urine sample. Blood tests may also be performed.      

Confirming the diagnosis is important so that other people who may be at risk of measles can be identified and provided public health advice which may include vaccination.

People with measles are usually infectious from one day before symptoms start until 4 days after the rash appears, so it is important to follow public health advice to avoid spreading the infection to other people.

If you (or your child) develop symptoms of measles

• Do not attend public places (such as work, school, daycare or shopping centres) or use public transport.
• Isolate at home as best as you can.
• Seek medical advice or contact healthdirect on 1800 022 222.
• Call your GP clinic or practice before attending to alert them of your symptoms and advise you are concerned you may have measles. Your GP clinic or practice can assess your symptoms, advise on whether it may be measles, and make arrangements to assess you safely and without infecting others, which may include:
  • instructions on where to go on arrival
  • to wear a mask when attending the appointment
  • to make an appointment at the end of the day when other patients have left the clinic
  • oother appropriate ways of being seen, such as through a telehealth appointment.
• Your GP clinic or practice can arrange testing. They may be able to arrange a test to be performed in your home depending on your location. Wear a mask if attending a GP practice or pathology centre for testing.
• Continue to isolate at home until you receive a negative test result.

If you are diagnosed with measles

• Do not attend public places (such as work, school, daycare or shopping centres) or use public transport.
• Seek medical advice via a telehealth appointment. You should go to an emergency department if your symptoms are severe, or if you have a serious or life-threatening condition. Call 000 if you need an ambulance. Let the operator and hospital know prior to arrival that you have measles so they can take measures to prevent others becoming exposed.
• Isolate at home as best as you can. Restrict interaction with other people, especially those at risk of getting measles. You should not have visitors while you are infectious.

Notification of measles

• As measles is a notifiable disease doctors, hospitals and laboratories must inform the Department of Health of you or your child’s diagnosis. Notification is confidential.
• Department of Health staff will talk to you or your doctor to find out how you got the infection, identify other people at risk of infection, and let you know about immunisation and whether you or your child needs to stay away from work, school or group gatherings.

There is no specific treatment for measles. You should rest, drink plenty of fluids, and take paracetamol for fever if required.

Seek medical advice via a telehealth appointment.

You should go to an emergency department if your symptoms are severe, or if you have a serious or life-threatening condition. Call 000 if you need an ambulance. Let the operator and hospital know prior to arrival that you have measles so they can take measures to prevent others becoming exposed.

Yes, measles is a vaccine-preventable disease. Vaccines are free for persons born after 1965 who have not previously had two doses of a measles vaccine – you can receive another measles vaccine dose if you are unsure.  It is not recommended to receive the vaccine if you are pregnant or immunocompromised. Learn more about the MMR vaccine and how to access the vaccine.

Unvaccinated children who come into contact with measles and who do not receive the MMR vaccine or immunoglobulin within the recommended period following exposure, cannot attend school until 14 days after the start of the rash in the last case occurring at the school, or 18 days after the last contact with an infectious case of measles they were exposed to outside the school.