Measles Vaccination, Prevention and Treatment

Measles in Australia is fortunately quite uncommon, but it remains widespread in other parts of the world. It is a highly contagious and deadly virus that still infects approximately 10 million per year despite the availability of a cost-effective vaccine. It kills over 100,000 people per year, with most of the victims being under the age of 5.

Australia was declared measles-free in 2014, which means that there has been no local ongoing transmission of the illness. However, Australians can still be exposed while traveling overseas. Cases of measles in Australia can almost always be traced back to an overseas exposure.

Adults can get measles if they are not vaccinated. It most commonly affects infants who are too young to be vaccinated and young adults who are unvaccinated. Measles is still prevalent in other parts of the world, including parts of the Middle East, the Americas, Africa, Asia, and some parts of Europe.

Measles can have permanent or fatal complications. Approximately 1 in 20 people develop pneumonia, and 1 in 1,000 develop encephalitis. Common symptoms of measles include fatigue, fever, rash, dry cough, runny nose, a general feeling of unwellness, and red and sore eyes.


What is Measles?

Measles is an extremely contagious viral illnesses caused by measles virus (MV), which is spread through aerosolised droplets spread via coughing or sneezing.

The symptoms of measles include a general feeling of unwellness (malaise), fatigue, fever, dry cough, runny nose, sore and red eyes, white marks (Koplik’s spots) on the back of the mouth or inside of the cheeks, and a rash with red spots that are slightly raised (occurring around the third or fourth day).

The rash often starts behind the ears and spreads to the neck and face and then the remainder of the body. These symptoms usually last for around 10 days, but for some people symptoms may last longer.

At least 1 in 5 measles cases result in hospitalisation. Measles frequently has serious complications such as encephalitis (0.1% of cases), middle ear inflammation (9% of cases), severe diarrhoea (8% of cases), and pneumonia (5% of cases). Some affected individuals can recover fully and 7-10 years later develop a form of encephalitis which always causes death.


Measles Transmission & Diagnosis

The highest risk group for measles infection and complication are young, unvaccinated children under the age of 5. Other high-risk groups include unvaccinated young adults, unvaccinated pregnant women, and immunocompromised adults.

Measles spreads from one person to another through coughing or sneezing droplets and aerosolised particles into the air. The virus can survive up to 2 hours in the air and is only inactivated light, heat or extremes of pH. The incubation period for measles is approximately 10-14 days. This is the time it takes for symptoms to appear after exposure.

Measles is extremely contagious. Each person with measles can infect 12-18 other people if they are not immune and are exposed. Someone with influenza would infect 1 to 1.5 others in the same situation. The virus is thought to be the most contagious from approximately 4 days before the rash first appears to up to 4 days after the rash disappears.

Measles is most common in developing countries in Africa and Asia. Outbreaks of measles have occurred recently in countries such as Japan, Israel, Thailand, Vietnam, the Philippines, and Ukraine. An outbreak even occurred in New Zealand as recently as 2019. Europe has also had seen high levels of measles cases in some countries.

Measles can be accurately diagnosed with a throat swab early in the disease. If you suspect that you have measles, you should stay at home and call your doctor to receive instructions and monitor the progress of the disease.

There is no specific treatment for measles once it has progressed to an infection. If you know you have been exposed, post exposure vaccines and antibody treatments are available for a brief window of time to reduce the severity of the illness.

Fever and pain medications can provide symptom relief. Rest, hydration, and limited exposure to light are all recommended home therapies. Your medical provider will create a custom treatment plan for you.


Measles Vaccinations and Prevention

The MMR vaccine provides lifelong immunity to measles, with approximately 99% prevention effectiveness at two doses and 90% effectiveness for one dose. Vaccination is the surest way to prevent a measles infection for most adults.

The MMR vaccine is a combination vaccine delivered via injection, meaning that the vaccine combines three separates vaccines (measles, mumps and rubella) into one. Side effects of the MMR vaccine may include a mild rash, fever, soreness at the injection site, and temporary joint pain or stiffness. It is a live attenuated vaccines so some people will not be able to be vaccinated. Your doctor will discuss this if there are any concerns.

You typically do not need to get vaccinated again if you have been vaccinated twice. A booster will be recommended for those who have been vaccinated only once.


Measles FAQs

Can you get measles twice?

Once you get measles your body builds up an immunity, making it highly unlikely to get it again. But you may have serious complications from the first infection.

Can adults get measles?

Adults who are unvaccinated can most certainly get measles. If you do not know your current measles vaccination status, it is a good idea to meet with a medical provider to determine if you need a vaccination.

Do I need a measles vaccine?

If you do not have presumptive evidence of immunity, such as laboratory evidence or written documentation of a vaccination, you may need one or two doses of the MMR vaccine as an adult. All children are recommended to receive the MMR vaccine at 12 months of age and the MMVR vaccine at 18 months of age. If you are unsure discuss this with your doctor.

How long does the measles vaccine last?

Measles is caused by the measles virus (MV). It is easily spread through coughing or sneezing which releases a highly contagious aerosol containing the virus.

What causes measles?

The MMR vaccine provides lifelong immunity to measles with a 90% effectiveness rate for one dose and 99% for two doses.

What are the symptoms of measles?

Typical symptoms include fever, rash, sore and red eyes, malaise, dry cough and fatigue. Serious complications can include pneumonia, vision loss, brain swelling, diarrhoea and ear inflammation.

How long does measles last?

The infection often lasts for approximately 10 days but for some people, symptoms can last for weeks, especially if there are complications.

Symptoms

The incubation period is seven to ten days with the initial symptoms resembling a ‘cold’ with fever, runny nose, dry, hacking cough and red eyes that are sensitive to the light. A red rash will appear spreading from the ears and face to the rest of the body. Infected persons are contagious for several days prior to these symptoms occurring. Complications including pneumonia and meningitis or encephalitis can be extremely severe.

Prevention

Vaccination is strongly recommended if you have not had the disease and cannot be sure if you were immunised properly as a child. Those born between 1966 and 1981 may have only had a single dose and are advised to have a booster.

Treatment

It is advisable to seek medical advice if you suspect you have measles. Travel inevitably involves increased exposure to airborne diseases in crowded airports, buses, trains and sightseeing. Most cases in Australia have occurred in people born after the mid-1960s, particularly in those who have not been immunised.