Measles

Measles is an infection that spreads very easily and can cause serious problems in some people. Measles usually starts with cold-like symptoms, followed by a typical rash a few days later.

There has been a recent rise in measles cases in the UK (Dec 2023). Measles is spread when an infected person coughs or sneezes. It can spread very easily. Having the MMR vaccine is the best way to prevent it.

Anyone who has not had measles infection before or who has not had 2 doses of a measles containing vaccine will be susceptible to measles. Vulnerable groups include immunosuppressed individuals, infants under 1 year of age and pregnant women.

You can protect your child by making sure they get 2 doses of the MMR vaccine. The first dose of MMR should be given between 12 and 13 months of age (i.e. within a month of the first birthday), and the second dose around 3 years 4months of age. Even if you or your children have missed these vaccines, it’s not too late to get them. Contact your GP practice today.

If your child has had both doses of their MMR vaccine, there is almost no chance of them getting unwell with measles (unless they have a severely weakened immune system).

Click on the links for further information about the MMR vaccine and other childhood vaccinations.

Why is measles on the rise?

Low levels of immunisation uptake over the last decade have led to a significant increase in the number of children and young people not protected against measles. The more people that are not protected, the more rapidly measles will spread.

To prevent this, children need to be immunised with MMR vaccine. Children under the age of 18 years who have missed their MMR vaccination should have the vaccine.

Is measles serious?

Measles is caused by a very infectious virus giving a rash and high fever. It can cause serious complications or rarely death.

What should I do, then?

The safest and most effective way to prevent measles is to ensure your child is fully vaccinated with MMR vaccine.

Your child should receive MMR vaccinations at around 12-13 months of age, and again at three years and four months or soon after – best before starting school. If your child has missed one of their routine MMR vaccinations, your local health service such as your GP surgery may send you an appointment to bring your child for an MMR vaccination. This catch-up is being offered to all children and young people under 18 years of age. It is never too late to have your child vaccinated.

Symptoms

The initial symptoms of measles appear around 10 days after contact with a case The measles rash usually appears a few days afterwards. The illness lasts for up to 10 days.

Measles starts with:

  • fever
  • red, sore, watery eyes (conjunctivitis)
  • runny nose
  • cough

After a few days:

  • Small white spots may appear inside their mouth and on the back of their lips.
  • A rash. The rash starts on the face and behind the ears. It then spreads all over the body. The spots of the measles rash are sometimes raised and often join together to form blotchy patches. They are not usually itchy. The rash looks brown or red on white skin. It may be more difficult to see on brown or black skin.
Measles Rash

The measles rash appears two to four days after initial symptoms and lasts for up to eight days. The spots usually start behind the ears, spread around the head and neck, then spread to the legs and the rest of the body.

The spots are initially small but quickly get bigger and often join together. Similar-looking rashes may be mistaken for other infections, but measles has a range of other symptoms too, not just a rash.

Further information can be found at:

https://www.nhs.uk/conditions/measles/

https://www.gov.uk/government/publications/measles-symptoms-diagnosis-complications-treatment/measles-symptoms-diagnosis-complications-and-treatment-factsheet#symptoms-and-signs

Cause

Is my child at risk?

Measles is one of the most infectious diseases known. A cough or a sneeze can spread the measles virus over a wide area. The risk is greatest in children who have received no MMR vaccine. Children who have only received one dose of MMR vaccine need a second dose of the vaccine to provide the best protection.

Over 90% of individuals will produce antibodies to measles, mumps and rubella antibodies after the first dose of the MMR vaccine. A single dose of measles-containing vaccine is at least 95% effective in preventing measles. After a second dose of measles-containing vaccine, protection increases to well above 95%.

Some children cannot have MMR because they have illnesses such as leukaemia or other conditions that affect their immune system. They can only be protected if enough healthy children are vaccinated so measles is eliminated.

Diagnosis

It’s always concerning when a child is unwell. As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.

Contact NHS 111 if or your GP if:

  • you think you or your child may have measles.
  • you’ve been in close contact with someone who has measles and you’ve not had measles before or you’ve not had 2 doses of the MMR vaccine.
  • you’ve been in close contact with someone who has measles and you’re pregnant – measles can be serious in pregnancy.
  • you have a weakened immune system and think you have measles or have been in close contact with someone with measles.

Measles can spread to others easily. Call your GP surgery before you go in. They may suggest talking over the phone, or arranging for you to come in at the end of a clinic. You may be directed to wait in a separate room to minimise the risk to others. Please be aware that healthcare staff are advised to wear personal protective equipment (PPE) when assessing or managing patients with confirmed or suspected measles.

Call 999 or go to A&E if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs.
  • there are long pauses (more than 10 seconds) when your child breathes.
  • your child’s skin, tongue or lips are blue.
  • your child is floppy and will not wake up or stay awake.
  • your child feels very cold or clammy to touch.
  • your child has severe pains in their arms, legs neck or back.
  • your child has a painful, red area of skin, especially if it is getting bigger quickly.

High Temperature guidance:

  • Parents can see guidance on when to seek advice if your child has a high temperature, by using the free HANDi Paediatric app (developed by the NHS in Devon). Answer the quick questions in ‘High Temperature’ section for clear simple guidance.
  • The app is also very useful for other common childhood conditions.

If you’re not sure it’s measles

It’s very unlikely to be measles if you’ve had both doses of the MMR vaccine or you’ve had measles before.

Treatment – What should I do?

  • If you think your child has measles, let your GP practice know. You should inform them urgently if your child is under 12 months of age or has a severely weakened immune system.
  • Measles usually starts to get better in about a week.
  • To make your child more comfortable, you may want to lower their temperature using paracetamol (Calpol) or ibuprofen.
  • However, remember that fever is a normal response that may help the body to fight infection. Paracetamol and ibuprofen will not get rid of it entirely. Paracetamol and Ibuprofen bring down the temperature but do not treat the infection. Whilst your child is unwell, they will continue to get temperatures once the effects of the medicine has worn off.
  • Encourage your child to drink lots of fluids.
  • If there are any crusts on your child’s eyes, gently clean them using cotton wool soaked in warm water.
  • Your child can spread the infection to others from the time their symptoms start until about 4 days after the rash appears.
  • Children cannot go back to school or nursery until 4 days after the rash has started. They should also avoid contact with babies, pregnant women, people who have not had 2 doses of the MMR vaccine and people with weak immune systems.
  • If your child with measles has been in contact with someone who has a very weak immune system, let that person know about your child’s measles. Ask them to contact their GP practice or NHS 111 urgently.
  • Finally, make sure that you and your partner are up to date with your MMR vaccines before getting pregnant. Measles can be extremely severe during pregnancy and can harm your unborn baby.

When to contact your GP

If you think your child has measles, let your GP practice know. You should inform them urgently if your child is under 12 months of age or has a severely weakened immune system.

If you are pregnant and haven’t received 2 doses of the MMR vaccine, or if there are any children in your family who have a severely weakened immune system or are under 12 months old, please inform your GP practice urgently. They might need immediate treatment to protect them from getting measles.

Selfcare and more information

Useful information

Measles:

MMR and Childhood Vaccinations:

Children’s Health Resources

Published: April 2024