Measles is a contagious virus, which causes a rash, fever and occasionally serious complications. It has been considered an eliminated disease in the UK by the World Health Organisation since 2016 due to the effective MMR vaccine. This means that it has been reduced to a low enough level to be confined for 3 years. There were still 966 confirmed cases of measles in England in 2018 - which had nearly quadrupled from the previous year. It has been suggested that this is due to lower-than-needed take up levels of the vaccine. People can also catch the disease by travelling to an area where there is an outbreak.
The virus that causes measles is a member of the paramyxovirus family, which is transmitted through the air as water droplets, or via direct contact. The virus infects the respiratory system first, but then spreads through the body. Animals do not get measles.
The symptoms of measles include symptoms similar to a cold, like a runny nose, a cough and sneezing, however the disease can also include eyes that are sore and red and sensitive to light, a high temperature (up to 40C) and small white spots on the inside of the cheeks. After a few days, the rash will appear. It is red-brown in colour, starting on the head or neck, before spreading to the rest of the body. Symptoms of measles can take up to 10 days to appear after first contact with the disease.
The illness lasts about 7-10 days.
Complications of measles could include pneumonia, bronchitis or croup, febrile seizures or fits caused by fever, or encephalitis which is an infection of the membranes of the brain. The the eyes can also be affected, through infection of the optic nerve, which could lead to sight loss. The disease can also infect the hearing apparatus and cause deafness or the heart and nervous system. Patients could also suffer dehydration through diarrhoea and vomiting. The liver can also become infected.
People most at risk from contracting measles include babies who are younger than 1 year old, children who do not have a good diet, or have a weakened immune system, teenagers and adults. Healthy children, over a year old, have the lowest risk of developing complications from the disease. Women who contract measles while pregnant, are at risk of miscarriage or still birth, having a premature baby or the baby being born at a low birth weight. A pregnant woman who has come into contact with someone who has measles, should see her GP as soon as possible to reduce the risk of developing the condition.
Immediate medical advice should be sought if someone has measles and develops a sharp chest pain that gets worse when breathing, shortness of breath, is coughing up blood, feeling drowsy, is feeling confused or having fits or convulsions. These symptoms could be the sign of a serious bacterial infection, which could need the patient to be admitted to hospital for treatment with antibiotics. People who have measles and these symptoms, should call an ambulance.
People who have measles should try not to be with people who may be at risk of infection, such as young children or women who are pregnant. Other people at risk include people who have weak immune systems, such as cancer treatment or people with HIV. People who develop measles should also not be at work or school for at least 4 days, from when they first develop the rash.
The measles vaccine was first introduced as a mass vaccination programme in 1968. Before its introduction, the World Health Organisation has estimated that major epidemics of the disease would occur every 2-3 years, and that the disease could cause around 2.6 million deaths every year. Global deaths from the disease have decreased from approximately 545,000 in the year 2000, to 110,000 in 2017.
In the UK, babies are offered the MMR (measles, mumps and rubella) vaccine at around 1 year and 3 years old. Two doses are recommended to ensure immunity. The vaccine can also be offered to anyone, over 6 months of age, who are at risk of being infected with measles.
Epidemics of measles are more likely in developing countries, or those countries recovering after a natural disaster or the effects of war, which could interrupt immunisation programmes.
Children who have been diagnosed with measles, should be given two supplements of Vitamin A, 24 hours apart. This helps to prevent eye damage and blindness. The best treatment for measles is to keep the patient hydrated, while treating any infections with antibiotics.
People who suspect that they may have come into contact with measles and may have no immunity, should see their GP. If there should be an outbreak of measles in your area, or you are in an at risk group, it is possible to have a vaccination which offers short-term immunity. Talk to your GP if you think this is something you require.