Measles is a highly infectious disease (about 90% of people who have not been immunised or had a past infection develop measles if they live in the same house as someone with measles). Caused by the rubeola virus, and transmitted by droplets through coughing and sneezing, It is most common in children aged 1-4 years old.

The incubation period, from exposure to the first symptoms is between 9 and 11 days. The time from exposure to the appearance of the rash is about 14 days. First symptoms are feeling tired and exhausted, irritability, a high fever, runny eyes with swollen eyelids, dislike of the light, a hacking cough and runny nose. There can also be diarrhoea, vomiting and abdominal pain.

A bright red or brown blotchy rash usually starts on the forehead, face, then neck and trunk, working down to the feet over three days. The rash tends to last about four to seven days.

There is no specific treatment for measles. The patient should drink lots of clear fluid to replace body water lost through the fever. Paracetamol can be used to reduce the fever. Aspirin should NOT be given to children as its use is associated with Reye’s Syndrome (a severe neurological disorder). Children with measles should be closely monitored for complications and the doctor consulted on what symptoms to watch out for.

  • Severe cough
  • Difficulty in breathing
  • Signs of an ear infection (pulling at ears may indicate pain)
  • Discharge from the eyes
  • Excessive sleepiness and difficulty in rousing from sleep
Death from measles in the UK is rare but it should not be forgotten that about one million children die from measles world-wide each year. However, even in the UK, it is not uncommon for complications to occur as a result of measles. These include a severe cough and breathing difficulties (croup), ear infections, viral and bacterial lung infections (pneumonia), and eye infections (conjunctivitis).

Measles infection during pregnancy can result in the loss or early birth of the baby.

The most serious problems involve the nervous system. Inflammation of the brain (acute encephalitis) occurs 2-6 days after the rash has appeared. This happens in less than 1 in 1000 measles cases , but 25% of those affected in this way are left with brain damage.

Subacute sclerosing pan-encephalomyelitis is the most severe complication of measles. It usually occurs years after the initial illness and is a slowly progressive brain infection. SSPE starts with intellectual impairment and deteriorates to seizures and eventually death. It is, however, very rare occurring in less than 1 in 100,000 cases of measles.

Measles can be prevented by a highly effective vaccine. This is part of the measles-mumps-rubella (MMR) immunisation See MMR The Facts. MMR vaccine can also be used in the control of measles outbreaks and should be offered to children within 3 days of exposure to infection.

Measles is most infectious from the fourth day before the appearance of the rash until 4 days afterwards. The DoH guidelines on infection control in schools and nurseries recommend that a child should be kept off school for 5 days after the onset of the rash.

Further information

MMR The Facts

This article published on
08 February 2006

Next review date 2/1/2013


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