What you need to know about measles

Measles is a highly contagious disease caused by a virus. It spreads easily when an infected person breathes, coughs or sneezes. It can cause severe disease, complications, and even death.

Measles can affect anyone who is not immune but is most common in children.

The virus is so contagious that 90% of people who are not immune (through measles vaccination or from having had the disease) and who come into contact with an infected person will become infected and develop the disease.

Measles is normally spread through direct contact and through the air. The virus infects the respiratory tract and then spreads throughout the body.

The measles virus can live for up to 2 hours on a surface or in the air. If other people breathe in the contaminated air or touch the infected surface and then their eyes, nose or mouth, they can become infected. An infected person can spread the virus even before they have typical symptoms (e.g. rash).

Measles infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body. Measles is a highly contagious and potentially serious disease.

Most deaths from measles are from complications related to the disease. Complications are most common in children under 5 years and adults over age 30.

One in 5 children infected with the measles virus may develop severe complications.

Complications can include:

• blindness
• encephalitis (an infection causing brain swelling and potentially brain damage)
• severe diarrhoea and related dehydration
• ear infections that can lead to permanent deafness
• severe breathing problems including pneumonia.

Measles infection has also been shown to weaken a person’s immune system, making it more difficult for them to fight off other diseases for months to even years after being sick with measles.

If a woman catches measles during pregnancy, this can be dangerous for the mother and can result in her baby being born prematurely with a low birth weight.

The only way to stop measles is to prevent it through vaccination. Measles vaccine is safe and effective. 2 doses of measles-containing vaccine provide 99% protection from infection and the potentially serious consequences of the disease. For most people this protection is lifelong.

There is no specific treatment for measles. Drinking enough water and treatments for dehydration can replace fluids lost to diarrhoea or vomiting. Eating a healthy diet is also important.

Doctors may use antibiotics to treat secondary bacterial pneumonia and ear and eye infections. Giving the vaccine or immunoglobulin in the early stage after infection may sometimes prevent severe disease. All children and adults with measles should receive 2 doses of vitamin A supplements given 24 hours apart. This restores low vitamin A levels that occur even in well-nourished children. It can help prevent eye damage and blindness. Vitamin A supplements may also reduce the number of deaths due to measles.

If you suspect that you or your child has measles, you need to contact your health-care provider as soon as possible and let them know about your symptoms or concerns. Your health-care provider may decide to make special arrangements to evaluate you, if needed, without putting others at risk.

Core strategies for achieving measles elimination in the WHO European Region include:

• achieving and sustaining high vaccination coverage (≥ 95%), with 2 doses of measles-containing vaccine;
• providing measles immunization opportunities, including supplementary immunization activities, for all populations susceptible to measles;
• strengthening surveillance systems through rigorous case investigation and laboratory confirmation of suspected sporadic cases and outbreaks;
• building up methodologies and capacities to respond adequately and in a timely manner to outbreaks; and
• improving the availability and use of high-quality, evidence-based information for health professionals and the public on the benefits and risks associated with immunization against measles to build confidence and demand for immunization.

The measles-mumps-rubella (MMR) vaccine is a so-called live virus vaccine that contains measles, mumps and rubella viruses that have been weakened, so they can produce an immune response but cannot cause the diseases themselves.

A single dose of MMR vaccine is approximately:

• 95% effective against measles
• 78% effective against mumps
• 99% effective against rubella.

After a second MMR dose, protection increases to 99% against measles and 88% against mumps.

It is extremely unlikely to develop measles once vaccinated, and in those few cases, symptoms are generally milder.

No. Vaccination protects a child from suffering the consequences of the disease.

While a person, generally, will not become infected again after recovering from measles, natural infection with the measles virus comes with serious risks.

A child with measles can suffer great discomfort and may develop severe and potentially life-threatening complications. Measles infection has also been shown to weaken a person’s immune system, making it more difficult for them to fight off other diseases for months to even years. Rarely, a person can develop subacute sclerosing panencephalitis (SSPE), a devastating complication of the measles virus infection.

Most children don’t develop any side effects from the measles-containing vaccine. Side effects that may occur are usually mild and may include soreness, redness, or mild swelling at the injection site. Fever lasting 2–3 days, mild flu-like symptoms, and a mild rash can occur 7–10 days after vaccination but are not cause for concern.

More serious adverse reactions following immunization are extremely rare. The risk of serious outcomes from measles is far higher than the risk of side effects from the vaccine.

Allergic reactions to the vaccine are possible but extremely rare. Measles vaccines should not be given to a child or adult with a history of anaphylactic reactions or severe allergic reactions to any component of the vaccine (e.g. neomycin or gelatin).

Measles vaccination occasionally induces febrile seizures. Most children recover quickly from febrile seizures and have no lasting effects.

Talk to your health-care provider to find out when your child is eligible for the vaccine.

If your child has missed any scheduled doses, they could be vulnerable to very serious diseases. Make an appointment to catch up as soon as possible.

Most countries in the WHO European Region use an immunization schedule that recommends the first dose of measles-containing vaccine in the second year of life and the second dose from just one month after the first dose to usually up to 6 years of age. Countries decide this schedule based on considerations, including the disease epidemiology, health system development and availability of services, antigens included in the immunization programme, population and social attitudes in regard to immunization, and other relevant factors. In the event of increased transmission of measles and outbreaks, a child can be immunized from 6 months of age (this dose should be considered as the “zero” dose). Globally, the first dose is usually given at 9 months of age in countries where measles is common and 12–15 months in other countries. A second dose should be given later in childhood, usually at 15–18 months.

If you do not have written documentation of measles immunity, consult your health-care provider about getting vaccinated. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella).

The following factors can contribute to measles outbreaks:

• accumulation of susceptible individuals, including older children and young adults who were not targeted by immunization schedules or who missed routine vaccination in their childhood, and did not get the disease;
• low vaccination coverage generally or in some population groups (due to various reasons, such as vaccine supply issues, lack of access to health services, or resistance to vaccination based on religious or philosophical beliefs);
• lack of strong provider recommendations to vaccinate when seeing patients;
• ongoing reforms in the health systems of countries in transition, affecting funding, organization and availability of immunization services and surveillance activities;
• poor surveillance and diagnostics; and
• inadequate capacity for or regulation of outbreak response.