Measles is a contagious viral illness that causes a skin rash and fever. Serious and sometimes fatal complications include pneumonia and encephalitis (brain inflammation). Measles is also known as rubeola, not to be confused with rubella (German measles). Worldwide, measles is the fifth highest cause of illness and death in children.Measles is rare in Australia because of the widespread use of the measles vaccine. It is important to continue immunising children in Australia, because there is a risk that the infection can be brought in by people arriving or returning from overseas.
Symptoms of measles
The signs and symptoms of measles may include:
- general discomfort, illness or lack of wellbeing (malaise)
- runny nose
- dry cough
- sore and red eyes (conjunctivitis)
- red and bluish spots inside the mouth (Koplik’s spots)
- red and blotchy skin rash that appears first on the face and hairline, and then spreads to the body.
Complications of measles
Possible complications of measles include:
- otitis – inflammation of the middle ear
- diarrhoea and vomiting – may cause further complications such as dehydration
- respiratory infections – such as bronchitis, croup or laryngitis
- pneumonia – a type of lung inflammation that causes about 60 per cent of measles deaths
- pregnancy problems – if a pregnant woman contracts measles, she risks miscarriage or premature labour
- encephalitis – or brain inflammation, affects about one person with measles in every 1000. About 10 to 15 per cent of people with encephalitis die and 15 to 40 per cent of survivors have permanent brain damage to varying degrees
- subacute sclerosing panencephalitis (SSPE) – occurs in about one in every 100,000 cases of measles. SSPE is an extremely rare progressive inflammation of the brain that causes brain degeneration and is always fatal. SSPE usually begins about seven years after the measles infection.
Measles is most commonly spread when someone swallows or inhales the cough or sneeze droplets from an infected person. The measles virus is carried inside mucus or saliva droplets and remains alive for several hours.
Infection can also occur if someone touches contaminated surfaces or objects and then touches their own mouth or nose or eats before washing their hands. Symptoms usually occur about 10 to 12 days after infection.
Measles is very contagious. Estimates suggest that a person with measles will infect about nine in every 10 people they have contact with who have not been immunised or previously infected with measles.
Measles is rare in Australia because of the immunisation program, but cases still occur. Anyone who hasn’t been immunised, particularly children and healthcare workers, are at high risk of infection.
People who are at increased risk of potentially fatal measles complications include:
- anyone with a chronic illness
- children younger than five years
Diagnosis of measles
Tests used to diagnose measles may include:
- medical history, including immunisation status and travel history
- physical examination
- blood test.
Treatment for measles
A case of measles without complications usually lasts about 14 days and most people make a full recovery. Antibiotics don’t work because the illness is viral. Treatment aims to ease symptoms and reduce the risk of complications. Options may include:
- bed rest
- plenty of fluids
- paracetamol to reduce pain and fever
- isolation to reduce the risk of transmission.
Occasionally, measles develops into a serious disease that requires urgent treatment and can even be life threatening. Sometimes, people can die from complications even if they receive prompt medical attention.
Treatment depends on the complication but may include:
- supportive care – for example, to maintain hydration, and to check for fever and infection
- antibiotics – to treat bacterial infection.