Measles 101: A family guide to measles

Measles title graphic

As immunisation rates fall, measles is rearing its ugly head again, here’s what you need to know about this serious, wildly infectious virus.

Measles 101

Measles is a highly contagious, airborne viral illness. In fact, measles is one of the most easily spread of all viruses. Being in the same room as someone with measles is enough to expose you to the infection.
 
Measles is usually spread via mucus or saliva droplet infection from an infected person. The virus can also be spread via contaminated surfaces or objects – from hand to mouth. 

MMR and MMRV vaccinations 

The Measles, Mumps and Rubella (MMR) Vaccine and the Measles, Mumps, Rubella and Varicella (MMRV) Vaccines protect against measles.
 
If your child has had the two scheduled vaccinations – MMR and MMRV – the odds of them contracting measles is very low.
 
“MMR vaccine should be given to children at age 12 months and a second dose as MMRV (measles, mumps, rubella and varicella) should be given at 18 months of age,” NSW Government Health advises.
 
Australian Immunisation Schedule

Measles symptoms

Measles symptoms usually occur about 10 to 12 days after infection. Symptoms of measles may include:
  • fever
  • loss of appetite
  • general discomfort or feeling unwell
  • runny nose
  • diarrhoea
  • dry cough
  • sore, red eyes
  • sore ears
  • red and bluish spots inside the mouth (known as Koplik’s spots)
  • red and blotchy skin rash that appears first on the face and hairline, and then spreads to the body.  The rash is not itchy.

Measles diagnosis and reporting

If a patient is showing symptoms of measles, a blood test and samples from the nose, throat and urine are collected to properly confirm the diagnosis.

In Australia, measles is a notifiable condition due to public health concerns. Doctors, hospitals and laboratories, schools and childcare centres must notify cases of measles to their local public health unit.

Measles exclusion

The incubation period for measles is approximately 10 days, but may range from 7 to 18 days from exposure to the onset of fever. It is usually 14 days until the rash appears.

Patients with measles should be isolated for at least 4 days after the rash begins.

Non-immunised people who have been in contact with someone with measles should be excluded until 14 days after the first day of appearance of rash in the last case.

If unimmunised contacts are vaccinated within 72 hours of their first contact with the first case, or if they receive immunoglobulin within 144 hours of the contact, they may return to school.

Measles complications

Sometimes considered a routine childhood illness, measles can have serious, potentially fatal, complications and is definitely not to be taken lightly.
 
Complications include:
  • inflammation of the middle ear
  • diarrhoea and/or vomiting
  • dehydration
  • respiratory infections like bronchitis, croup or laryngitis
  • pneumonia
  • encephalitis
  • subacute sclerosing panencephalitis (SSPE)
Approximately one in three people who contract measles develop complications. Around one in every 1000 people with measles develop encephalitis (swelling of the brain). 
 
Approximately 60 percent of measles deaths are caused by pneumonia
 
Ear infections occur in about one out of every 10 children with measles and can result in permanent hearing loss.
 
While there has been talk of the risks of immunisation from the anti-vaccination movement, the risk of complications from measles is much higher than the risks of complications from immunisation. 
 
Measles is also potentially extremely dangerous for pregnant women and can cause miscarriage, low birthweight babies or premature labour.

What to do if you think your child has measles

“If you develop the symptoms of measles, seek medical advice,” Dr Vicky Sheppeard, Director, Communicable Diseases at NSW Health says, urging people to inform their GP or other health practitioner of their suspicions, before attending.
 
“Please call ahead to your doctor or emergency department so that arrangements can be made to keep you away from others to minimise the risk of infection.”
 
If you think you’ve been in contact with someone who has measles, the Royal Children’s Hospital says it’s best to “remain at home in an isolated environment to avoid infecting others” – and again call your GP to discuss your concerns.

Protecting your baby from measles if they’re too young to be vaccinated

Check your own immunisation status is up to date, as well as the status of those in contact with the baby.

The optimal way to protect young babies from measles is to ensure that those in close contact with the baby are immunised. 

If you are fully immunised for measles your baby will have received some immunity from you during pregnancy. If you are unsure, you can have a blood test to check if you are immune to measles. Have a chat to your GP about your concerns.

2017: Measles in Australia

Measles outbreaks are on the rise as adult and child vaccination rates fall, leaving many unprotected.
 
By April 2017, there had been a spate of measles cases confirmed in NSW, with more expected. This followed a case of measles on the Sunshine Coast, an outbreak in Perth in February 2017 and several cases in Melbourne in January 2017.

Measles deaths worldwide

The World Health Organisation reports that:

  • Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.
  • In 2015, there were 134 200 measles deaths globally – about 367 deaths every day or 15 deaths every hour.
  • Measles vaccination resulted in a 79 per cent drop in measles deaths between 2000 and 2015 worldwide.
  • In 2015, about 85 per cent of the world’s children received one dose of measles vaccine by their first birthday through routine health services – up from 73 per cent in 2000.
  • During 2000-2015, measles vaccination prevented an estimated 20.3 million deaths making measles vaccine one of the best buys in public health.

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