Measles

Measles is an extremely contagious viral disease caused by the measles virus (MV), which is spread by aerosolised droplets through coughing or sneezing. Measles is common in many countries where childhood vaccination rates are low or absent. In recent years, there have been significant outbreaks in countries such as Australia and New Zealand. The majority of these outbreaks are associated with travellers who are not immune to the disease and bring measles into the country. Travellers should note that measles remains common in many areas of the world, such as Europe, the Middle East, Asia, the Pacific, and Africa.

Measles is frequently contracted in crowded places and is a potentially serious disease. Severe cases are rare but can be especially severe in infants, people who are malnourished, and those who are immunocompromised.

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Symptoms

The incubation period is seven to 10 days, with the initial symptoms resembling a cold with fever, a runny nose, red eyes that are sensitive to light, and a dry, hacking cough. A red rash may appear, spreading from the ears and face to the rest of the body. White spots (Koplik spots) may appear at the back of the mouth or inside of the cheeks two to three days after the initial onset of symptoms. Infected individuals are contagious for several days prior to these symptoms occurring. Complications, including swelling of the brain, pneumonia, meningitis or encephalitis, can be extremely severe and death can occur. Many years after an infection, individuals can rarely develop a widespread brain infection with an extremely high death rate.

Prevention

Travel inevitably involves increased exposure to airborne diseases in crowded airports, buses, trains and while sightseeing. It is advisable to seek medical advice if you suspect you may have measles; however, due to the infectious nature of the disease, you must call the clinic or hospital before arriving.

Most cases in Australia have occurred in people born after the mid-1960s, particularly in those who have not been immunised. 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 1992 may have only had a single dose and are advised to have a booster if they are uncertain about their vaccine history. Children travelling to risk areas can receive the vaccination from six months of age. They still need to proceed with the scheduled vaccine doses following this.

Immunisation can be provided through the MMR vaccine, which includes immunisation against mumps and rubella as well as measles. This vaccination is provided as part of the standard childhood immunisation schedule for Australian children. Once fully vaccinated, individuals will have a lifelong immunity to measles, with the level of protection effectiveness reaching over 95% after two doses of MMR.

Children usually receive their first dose of the MMR vaccination at 12 months of age, but under special circumstances, such as travel to regions where measles outbreaks are occurring, vaccination can be provided to infants from six months of age.

Adults who don’t have immunity to measles can receive two doses of the MMR vaccine at least four weeks apart. If you have had a dose of the vaccine previously, as many adults born between 1966 and 1992 have, you should only need one further dose to provide full immunity to measles.

Individuals who have had a serious reaction to the vaccine previously should not receive another dose.

Treatment

There is no specific treatment for measles once it has progressed to an infection. If you know you have been exposed through close contact with an infected person, you may receive a treatment known as post-exposure prophylaxis, which usually involves a vaccination or medicine containing antibodies against measles. This will help reduce your chances of getting sick with measles and prevent the spread of the virus.

Antibiotics will not help you recover from measles, but paracetamol can help relieve a fever. Prioritising rest and drinking enough fluids will help relieve your symptoms. If your symptoms are severe, you may need to seek treatment at a hospital.