Key points to remember about measles

• measles is a potentially serious disease caused by a virus
• it's very infections – measles can spread very easily from one person to another
• it usually takes 10 - 12 days from contact with someone with measles to the first symptom
• if you think your child might have measles, phone Healthline on 0800 611 116 or your GP (general practitioner) as soon as possible for advice – make sure to phone your GP before visiting
• if your child has measles, keep them resting at home until they are well again – your GP will advise you about the safest time for your child to return to school or childcare
• children and adults with measles often develop complications like pneumonia
• immunisation is the only way to prevent measles – see Immunisation: Measles
  

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What is measles?

Measles is a potentially serious disease caused by a virus. It's very easily spread from one person to another. Measles is also known by the names morbilli or rubeola.


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What are the signs and symptoms of measles?

It usually takes 10 – 12 days from contact with someone with measles to the first symptom appearing but it can take up to 18 days. This is called the incubation period.

The illness begins with the following, which last for two to four days:

• high fever
• cough
• runny nose
• loss of appetite
• sore red eyes (conjunctivitis or “pink eye”)

You can usually see small white spots (Koplik spots) inside the mouth near the back teeth early in the disease. (See the top photo).

 

A rash follows and the white spots inside the mouth fade. The rash appears on the head and gradually spreads down the body to the arms and legs. It lasts for up to one week. (See the bottom photo).

A person who has measles is most infectious in the early stages of their disease - from when the symptoms first appear to four days after the appearance of the rash.

Children usually look and feel quite unwell and miserable with measles. They are most unwell during the first day or two after the appearance of the rash.

For additional photos see the following website:

• DermNetNZ (New Zealand Dermatological Society)
  

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How easy to catch (contagious) is measles?

Measles is very easy to catch. It's spread through the air by infectious droplets through coughing and sneezing. Measles can also be spread by direct contact with the secretions from the nose or throat of a person infected with measles, and by touching things or surfaces contaminated by these secretions.


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Can I do anything to prevent my child catching measles?

Immunisation given on time is the only way to prevent measles. Two doses of the measles, mumps, rubella (MMR) vaccine is 99 percent effective in preventing measles.

See the following fact sheet on this website:

• Immunisation: Measles including the section How do you prevent measles?
  

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What should I do if I think my child has measles?

Phone Healthline on 0800 611 116 or your GP (general practitioner) as soon as possible for advice. Make sure to phone your GP before visiting.


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How do I prevent measles spreading?

If your child has measles, keep them at home and away from school or early childhood services and community gatherings until they are cleared to return. This is until the end of the infectious period - until at least four days after the appearance of the rash. Your GP (general practitioner) can give you advice about this.


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What is the treatment for measles?

Because measles is caused by a virus, there is no specific treatment – the virus just has to run its course.

Antibiotics are not helpful for measles and will not be prescribed by your doctor unless your child develops a bacterial infection as a complication of measles.

In severe cases of measles, particularly when there are more serious complications, hospital treatment may be necessary.


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How can I care for my child at home?

• give paracetamol for pain or discomfort if needed. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose
• don’t give your child aspirin
• see How do I treat a fever? in the fever fact sheet on this website
• give your child water, fruit juice or milk often, to prevent dehydration. (If your child will not take fluids or is drowsy, don't force it. Seek medical or health professional advice immediately)
• use saltwater drops (saline) to treat a stuffy nose
• damp cotton wool can be used to clean away any crustiness around the eyes. Use one piece of cotton wool per wipe for each eye. Gently clean the eye from inner to outer lid
• keep your child at home and resting until they are well and your GP (general practitioner) advises that they can return to school or daycare

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Can there be any complications?

Complications from measles are common - they occur in at least ten percent of people with the disease. Some of these include:

• ear infections (otitis media)
• pneumonia
• croup
• diarrhoea and dehydration
• bronchiolitis
• ulcers of the eye (corneal ulcers)

A more rare but serious complication is acute inflammation of the brain (encephalitis) which occurs in one in 1,000 children and adults with measles.

Children under five years of age and adults over 20 years of age are more at risk of complications. Children with a higher risk of developing severe measles and complications are those who are malnourished, have chronic (long-lasting) diseases or a weakened immune (infection-fighting) system.


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When should I seek help?

You should see a doctor urgently if your child:

• has trouble feeding or is not able to drink fluids
• is weeing less than normal (for infants, their nappies remain dry or there are fewer than three wet nappies in 24 hours)
• has difficulty breathing
• is very irritable and is not wanting to be held
  
• is becoming more tired, sleepy or drowsy
• develops a worsening headache
  
• improves and then suddenly becomes worse
• doesn't seem to be improving or you are concerned for any reason

Dial 111 for urgent medical help if:

• your child becomes floppy, very drowsy or is difficult to wake
• your child's breathing becomes very fast or noisy
• becomes very pale or has blue lips or gums

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Where to go for more information

On this website
Immunisation: Measles

Immunisation Advisory Centre www.immune.org.nz

For questions on immunisation, vaccination-preventable diseases or a specific vaccine, you can contact the Immunisation Advisory Centre.
Call free on 0800 IMMUNE (0800 466863), weekdays 9am-4.30 pm
Email: imac@auckland.ac.nz
 

Ministry of Health www.moh.govt.nz

The immunisation section of the Ministry of Health website includes a Measles section which provides access to the latest measles updates and alerts, and also:

• the New Zealand National Immunisation Schedule
  
• The Immunisation Handbook 2011 which includes a chapter on measles. The handbook provides detailed information for health professionals and may be of interest to those parents who want more comprehensive information

World Health Organisation (WHO) National Measles Laboratory, New Zealand www.cdhb.govt.nz/measles
In March 2005 Canterbury Health Laboratories was designated the NZ National Measles Laboratory. This was in response to a request from the Ministry of Health for New Zealand's active participation in WHO's global measles programme.


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Acknowledgements

References
Immunisation Advisory Centre. 2010. Measles - for parents and caregivers. Immunisation Advisory Centre. University of Auckland.
http://www.immune.org.nz/site_resources/2010%20Resources/Measles_factsheet_May_2010.pdf  [Accessed 30/06/2011]

Ministry of Health. 2011. Immunisation Handbook 2011.
Wellington: Ministry of Health. http://www.moh.govt.nz/moh.nsf/Files/immunise-handbook/$file/ImmunisationHandbook2011.pdf [Accessed 30/06/2011]

Images
The photos on this page are reproduced courtesy of the Centers for Disease Control and Prevention, US.

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Endorsement

This fact sheet was endorsed by PSNZ - 30/06/2011

Copyright

Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012

The Paediatric Society of New Zealand http://www.paediatrics.org.nz

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