Measles - Leaflet for patients
Introduction
Measles is a highly infectious viral illness. It causes a range of symptoms including fever,
coughing and distinctive red-brown spots on the skin.
The measles virus is contained in the millions of tiny droplets that come out of the nose and
mouth when an infected person coughs or sneezes.
You can catch measles by breathing in these droplets or, if the droplets have settled on a
surface, by touching the surface and then placing your hands near your nose or mouth.
The most effective way of preventing measles is the measles, mumps and rubella (MMR)
vaccine.
How common is measles?
The success of the MMR vaccine means that in the UK, cases of measles are rare. However, in
recent years the number of cases has been increasing. For example, in 2009 there were 1,143
cases of measles in England and Wales compared with 70 cases in 2001.
It is thought that the rise in the number of cases of measles is due to parents not getting
their child vaccinated with the MMR vaccine. This is probably due to speculation linking MMR
to autism.
Publicity in 1998 highlighted a report claiming a link between the MMR jab and autism.
However, numerous studies that were undertaken to investigate this claim found no link
between the MMR vaccine and autism.
Who is affected?
Measles is most common among children aged 1-4 years old, although anyone who has not
been vaccinated against measles can catch it.
Outlook
Specific treatment for measles is normally not necessary as the body's immune system can
usually fight off infection in a couple of weeks. Typically, once you have fought off the
measles infection, you develop immunity (resistance) to it.
Symptoms
Around 9 to 11 days after you get the measles infection, the following symptoms begin to
appear:

cold-like symptoms, such as runny nose, watery eyes, swollen eyelids and sneezing,

red eyes and sensitivity to light,

a mild to severe temperature, which may peak at over 40.6°C (105°F) for several days,
then fall but go up again when the rash appears,
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
tiny greyish-white spots (called Koplik's spots) in the mouth and throat,

tiredness, irritability and general lack of energy,

aches and pains,

poor appetite,

dry cough, and

red-brown spotty rash (see below).
The above symptoms generally last for up to 14 days.
Rash
The measles rash appears three 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 measles, but measles has a range of symptoms, not just a rash.
Most childhood rashes are not measles, but see your GP without delay if:

you suspect it is measles,

symptoms worsen,

temperature increases to above 38°C (100.4°F),

temperature stays high after other symptoms have gone, or

there are signs of other related illnesses (see ‘Complications’ below).
Causes
Measles is caused by infection with the rubeola virus. This virus is contained in the millions of
tiny droplets that come out of the nose and mouth when someone with measles coughs or
sneezes.
You can catch measles by breathing in these droplets or, if the droplets have settled on a
surface, by touching the surface and then placing your hands near your nose or mouth. The
measles virus can survive on surfaces for a few hours.
Once inside your body, the virus multiplies in the back of your throat and lungs before
spreading throughout your body, including your respiratory system and the skin.
Someone with measles is infectious for two to four days before the rash appears and for
about five days after it appears.
Immunity
Anyone who has not had measles before can be infected. However, cases of reinfection, after
you have had the virus, are extremely rare because the body builds up immunity (resistance)
to the virus.
Most people who are not immune from measles and are sharing a house with somebody who
is infected will develop the condition.
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Diagnosis
Your GP will usually be able to diagnose measles from the combination of symptoms, such as
the characteristic rash and the small spots inside the mouth.
A simple blood or saliva test can confirm the diagnosis and identify the rubeola virus.
Doctors have a duty to notify the local Health Protection Unit of all reported and suspected
cases of measles. They will also notify the child's school if necessary.
Your child should not return to school until at least five days after the appearance of the rash.
Treatment
There is no specific treatment for measles. Once the rash starts, you will need to rest and
treat the symptoms until your immune system fights off the virus. If there are no
complications, symptoms will usually disappear within 7-10 days.
If your child has measles, you may find the following advice useful:

Use liquid baby paracetamol or ibuprofen to relieve fever, aches and pains. Do not give
aspirin to children under the age of 16.

Closing curtains or dimming lights can help reduce light sensitivity.

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.

Cough medicines are of little help and should not be given to children under the age of
six. Children over 12 months old may benefit from a teaspoon of lemon juice and two
teaspoons of honey in a glass of warm water. Honey should not be given to babies under
the age of 12 months.

Placing a bowl of water in the room will make the atmosphere more humid, which can
help relieve a cough.

Feverish small children rapidly lose water, which makes a cough worse. Children should
drink as much as possible to prevent dehydration.
Complications
Complications resulting from measles are more likely to develop in certain children, for
example:

children with a weakened immune system, such as those with leukaemia or HIV,

children with a poor diet, and

children under the age of five.
Complications are also more likely to develop in adults who are over the age of 20.
Common complications
Some of the common complications of measles are:

diarrhoea,

vomiting,

eye infection (conjunctivitis), and

inflammation of the voice box (laryngitis).
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Inner ear infection and inflammation (otitis media), which often causes earache, may also be
a complication of measles.
Fits that are caused by a fever (febrile convulsions) are also possible complications of
measles. However, the fits, although alarming, are not usually dangerous.
Less common complications
Less common complications of measles are:

meningitis,

pneumonia (lung infection), signs of which are fast, difficult breathing, chest pain and
deteriorating condition,

hepatitis (liver infection),

encephalitis (inflammation of the brain), which can be fatal, so watch for drowsiness,
headache and vomiting,

low platelet (white blood cell) count, known medically as thrombocytopenia, which affects
the blood's ability to clot,

bronchitis and croup (infection of the airways), characterised by a hacking or barking
cough, and

squint, if the virus affects the nerves and muscles of the eye.
Rare complications
In rare cases, measles can lead to the following conditions:

serious eye disorders, such as an infection of the optic nerve (the nerve that transmits
information from the eye to the brain), known as optic neuritis, which can lead to
blindness,

heart and nervous system problems,

a serious brain complication known as subacute sclerosing panencephalitis (SSPE), which
can sometimes occur several years after measles. Although the condition is fatal, it is very
rare, occurring in only 1 in every 100,000 cases of measles.
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