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Key points to remember about measles

Aotearoa is at very high risk of a measles outbreak. Immunisation is the best protection.

If you think your child has measles, contact Healthline on 0800 611 116 or your health professional as soon as possible for advice.

  • measles can be a serious illness - it's caused by a virus
  • measles is very easy to catch
  • vaccination is the only way to prevent measles
  • if you think your child might have measles, contact Healthline on 0800 611 116 or your health professional as soon as you can for advice

Check the information about measles vaccination.

Measles Vaccination

What is measles?

Measles can be a serious illness. It's caused by a virus. Measles spreads very easily from one person to another.

Measles has caused many deaths in tamariki around the world.

Immunisation is the best protection and will help to prevent the spread of measles. 

Signs and symptoms of measles

Illustration of measles symptoms in a young child, highlighting signs such as high fever, sore red eyes, runny nose, cough, and a rash that begins on the head and spreads over the body. Inset views show details like white spots in the mouth and the characteristic body rash associated with measles.

Contact with someone with measles

It usually takes about 10 days from contact with someone with measles before getting the first symptoms. This is called the incubation period.

First symptoms

The illness begins with the following, which last for 2 to 4 days:

  • high fever
  • cough
  • runny nose
  • loss of appetite
  • sore red eyes (conjunctivitis)

You can sometimes see small white spots (Koplik spots) inside the mouth near the back teeth early in the disease. 

A rash

A rapidly spreading rash follows and the white spots inside the mouth fade.

The rash appears on the head and quickly spreads down the body to the arms and legs. It lasts for up to one week.

Photo of measles rash on young child
Photo of a boy's face with measles rash
Photo of a boy's chest with the measles rash

The infectious period

If your child catches measles, they're infectious and can spread the virus to others.

If your child has measles, your local Public Health Service or health professional can give you advice and support. 

A child with measles is infectious from 4 days before until 4 days after their rash first started to show. This means they can spread the illness to others before they are aware they have it themselves.

Feeling unwell and miserable

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

How serious is measles?

Measles is a very serious illness which can lead to complications and even death.

1 in 10 people with measles will get complications.

1 in 10 people with measles will get complications including:

  • diarrhoea
  • ear infections
  • pneumonia
  • other diseases of the airways (like bronchiolitis and croup)
  • ulcers of the eye (corneal ulcers)
  • idiopathic thrombocytopenic purpura (low platelets)

Measles in pregnancy increases risk of premature labour, miscarriage and stillbirth.

1 in 1000 people with measles develop inflammation of the brain (encephalitis). About 15% of these people die and about 30% are left with permanent brain damage.

1 in 100,000 people who have had measles will, years later, develop a serious brain inflammation called subacute sclerosing panencephalitis (SSPE). This serious complication always results in death.

Who is most at risk of complications from measles

  • those who are unimmunised
  • tamariki under 5
  • adults over 20
  • those with long-lasting (chronic) diseases
  • those with a weakened immune system
  • those who are undernourished

How measles spreads

Measles is very easy to catch. It spreads through the air by infectious droplets through coughing, sneezing and talking, or by touching a surface with infected saliva or mucus.

Who is most at risk of catching measles?

Unvaccinated children

All tamariki who have not received at least 1 dose of the MMR (measles, mumps and rubella) vaccine are at increased risk of catching measles.

About 90% to 95% of people who receive 1 dose of the MMR vaccine are protected. Those who do not develop immunity after the first MMR dose, almost always do so after the second dose. 

2 doses of the MMR vaccine offers the best protection.

Children with certain conditions

These tamariki often can't have the MMR vaccine and rely on protection from those around them.

Pregnant women

Measles during pregnancy increases the risk of premature labour, miscarriage, and low birth weight pēpi (babies).

How to prevent your child from catching measles

Vaccination given on time is the only way to prevent measles. 2 doses of the MMR vaccine is 99% effective in preventing measles.

Measles Vaccination

What to do if you think your child has measles

Contact Healthline on 0800 611 116 or your health professional as soon as possible for advice. 

How to prevent measles from spreading

If your child has measles, keep them away from other people. That means staying away from:

  • daycare, early childhood services or school
  • group and social activities
  • sports and recreation events
  • public places like cinemas and shopping malls
  • work and community gatherings

Your child will need to stay in isolation until they are no longer infectious. The infectious period usually ends 5 days after the rash appears. Your local Public Health Service or other health professional can give you advice about this. 

Managing measles

Because measles is caused by a virus, there is no specific treatment.

Antibiotics are not helpful for measles and a health professional won't give them to your child unless your child also 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 needed.

Caring for your child with measles at home

Paracetamol

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.

Never give your child or young person aspirin as this may increase the risk of Reye syndrome, which is a rare and serious illness.

Other things you can do

Give your child fluids often, to prevent dehydration.

Use saltwater drops (saline) to treat a stuffy nose.  Ask your pharmacist or health professional for instructions.

Use damp cotton wool to clean away any crustiness around the eyes. Use one piece of cotton wool for every wipe for each eye. Gently clean the eye from the inner to outer lid.

Keep your child at home and resting until they are well. Your local Public Health Service can advise you about when your child can return to school or daycare.

When to get medical help for your child with measles

When to see a health professional urgently

You need to see a health professional urgently if your child:

  • is under 3 months old
  • has trouble feeding or drinking fluids
  • is weeing less than normal
  • has difficulty breathing
  • is very irritable and is not wanting to be held
  • is becoming less responsive
  • develops a worsening headache
  • has an unusual high-pitched cry
  • looks unwell 
  • doesn't seem to be improving
  • you are worried for any reason

When to call 111

Call 111 within New Zealand for urgent medical help (use the appropriate emergency number in other countries) if your child is:

  • blue around the mouth
  • struggling to breathe
  • hard to wake
  • floppy
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Healthline logo with phonenumber on it
Healthline

Healthline is available 24 hours a day, 7 days a week on 0800 611 116. Call Healthline if you need advice about a child of any age who is unwell, hurt, or has any symptoms of sickness. It's free to callers throughout New Zealand, including from a mobile phone.

Call Healthline 0800 611 116

Acknowledgements

Images
The photo of a young child with a measles rash on face, chest and arms is reproduced courtesy of Waikato District Health Board.

The 2 photos of a boy with a measles rash on his face and body are reproduced courtesy of DermNet NZ.

Illustration showing symptoms of measles by Dr Greta File. Property of KidsHealth.

References
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