Measles

About measles

Measles is a highly contagious viral illness. It causes flu-like symptoms, a skin rash and fever, and can lead to serious complications including pneumonia and encephalitis (brain swelling), which can be life-threatening.

In the past, it was a common illness in Australia. Most people born before 1966 were likely to have been infected with measles during childhood and are likely to be immune. Thanks to vaccination, measles is now rare in Australia.

Measles is still common in many parts of the world. People arriving from overseas can potentially spread measles in Australia to those who are not immune. Worldwide, measles is still a leading cause of illness and death in children.

Understanding measles

You can watch additional videos on measles testing, vaccinations and travel:

• Measles symptoms and testing (video) – view transcript
• Measles catch up vaccination (video) – view transcript
• Measles and travel (video) – view transcript.

Symptoms of measles

The first symptoms of measles usually appear 7 to 18 days after exposure and can include:

• fever
• feeling generally unwell (malaise) or tiredness
• cough
• runny nose
• sore and red eyes (conjunctivitis)
• diarrhoea (especially in infants)
• white spots in the mouth (known as Koplik spots).

A few days later, a red, blotchy, non-itchy rash appears. It usually starts on the face and neck, spreads down the body and lasts for 4 to 7 days.

If you have measles symptoms, get medical care urgently. Call the doctor or clinic before you go in and wear a mask to avoid spreading infection.

Figure: Example of a typical measles rash

Complications of measles

Some groups are at increased risk of severe illness and complications from measles, such as:

• people with a weakened immune system
• children younger than 5 years
• pregnant women.

Up to a third of people with measles develop complications and may need to go to hospital. Complications can include ear infections, diarrhoea, pneumonia and encephalitis (brain swelling) which occurs in about 1 in every 1,000 people with measles.

Measles increases the risk of complications during pregnancy such as miscarriage, premature labour and low birth weight infants.

How measles spreads

Measles is mainly spread when a person breathes in the virus that has been coughed or sneezed into the air by an infectious person. It can also spread through nose or throat secretions and by touching contaminated surfaces or objects.

The measles virus can survive in the air or on surfaces for up to 2 hours. Just being in the same room as someone with measles can result in infection.

People with measles are infectious from 24 hours before symptoms appear until 4 days after the rash appears.

Diagnosis of measles

Measles is diagnosed by your doctor based on symptoms, physical examination and medical history, including vaccination and travel history. The diagnosis is confirmed by testing, such as:

• nose and throat swab
• urine sample
• blood test.

Confirming the diagnosis is important as it allows public health follow-up of people who may have been exposed to the virus and are at risk of infection.

If measles is suspected, stay home until advised otherwise. Do not go to work, school or public places such as supermarkets.

Treatment of measles

There is no specific treatment for measles. It can take a few weeks to fully recover from measles. Antibiotics don’t work because the illness is viral.

People with measles should:

• stay at home
• rest
• drink plenty of fluids
• take paracetamol to treat the fever.

People with severe illness may need to go to hospital.

Measles vaccination

Getting vaccinated against measles is the best way to protect against measles. Two doses of a measles vaccine provides long-term protection in 99% of people.

The measles vaccine is free and available at GPs, community pharmacies, Aboriginal Health Services and local council immunisation services.

Victorian funded measles vaccine

In Victoria, you can get a free measles vaccine if you were born during or after 1966 and:

• have not had two documented doses of a valid measles vaccine, or
• do not have blood test results showing immunity.

Free measles vaccine is also available for infants aged 6 months to under 12 months who are travelling overseas. If vaccinated before 11 months, they will still need two additional doses at 12 and 18 months as per the National Immunisation Program Schedule.

You do not need a Medicare card to receive a state-funded measles vaccine.

National Immunisation Program

Measles vaccine is free under the National Immunisation Program Schedule for

• children at 12 months of age (measles-mumps-rubella vaccine)
• children at 18 months of age (measles-mumps-rubella-varicella vaccine).

Free catch up measles vaccine is available for:

• people aged up to 20 years who have not been fully vaccinated
• refugees and humanitarian entrants aged 20 and over.

Combination measles vaccines are safe, and provide protection against several diseases at once, which helps reduce the number of separate vaccinations needed. Separate vaccines for measles, mumps, and rubella are not available in Australia.

Check if you have been vaccinated

To check if you have been vaccinated against measles:

• Find your immunisation records on the Australian Immunisation Register (AIR) – a national register that records vaccines given to people of all ages in Australia.
• Contact your doctor or immunisation provider for your immunisation records (if you were vaccinated by them).

Read more information on how to find your immunisation records.

It is safe to receive the measles vaccine more than twice. Visit your GP or pharmacy for a catch-up measles vaccine if you are unsure if you are immune.

Travellers

International travel is the main source of measles cases in Australia. All travellers should check their vaccination status before travelling overseas.

Infants travelling overseas can receive the measles vaccine from 6 months of age. If vaccinated before 11 months, they still need two additional doses at 12 and 18 months as per the National Immunisation Program Schedule.

If you have measles or have been exposed

If you have measles

Stay home until you are no longer infectious, this is until the end of day 4 after the rash appears and once you are feeling well. Do not go to work, school or public places while you are infectious.

Avoid contact with people outside your home, especially those at higher risk of serious illness. This includes people with a weakened immune system, young children and pregnant women.

Children with measles must not attend primary school and early childhood education and care until at least 4 days after the rash appears.

If you have been exposed to measles

Check the Measles public exposure sites in Victoria page to see if you have been at a location visited by a person with measles.

If you have had contact with someone with measles, monitor for symptoms for up to 18 days after contact.

If you are not fully immune to measles, or you are unsure, you may be able to receive preventive treatment — either a measles vaccine (within 3 days of exposure) or an immunoglobulin injection (within 6 days, for some people). Call the doctor or clinic before you go in and wear a mask to avoid spreading infection.

Children who were exposed to measles may be required to not attend primary school, early childhood education or care if they are not vaccinated and have not received preventive treatment.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Virtual Emergency Care
• Urgent Care Clinics – when immediate healthcare is needed but it's not life-threatening
• Your GP (doctor)
• Nurse-on-Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Local government immunisation service
• Maternal and Child Health Line Tel. 13 22 29 (24 hours, 7 days)
• Immunisation Program, Victorian Department of Health
• National Immunisation Information Line Tel. 1800 671 811
• Pharmacist
• SAEFVIC Tel. 1300 882 924 – to report an unexpected or serious reactions to vaccination