Measles fact sheet

What is measles?
Measles is an acute, highly contagious viral disease capable of producing epidemics. Measles is not thought of as being a serious disease, but it can be very serious if complications arise.

Who gets measles?
Measles occurs only in human beings and although it is usually considered a childhood disease, it can be contracted at any age.

Where does measles occur?
Measles remains the leading cause of vaccine preventable deaths in children worldwide. More than one million children die from measles each year especially in malnourished children whose immune systems are not strong enough to fight off the infection. Approximately 98% of these deaths occur in developing countries, mostly on the African continent. In many European countries measles is still a cause of great public health concern. The disease continues to spread primarily because the degree of vaccination coverage required to interrupt transmission has not been achieved. Several European countries are still reporting measles outbreaks.

How is measles spread?
The measles virus spreads very easily from person to person through fluid droplets of coughs, sneezes and runny noses. A measles case is infectious from four days before the appearance of the rash to four days after its appearance.

What are the symptoms of measles?
Symptoms usually appear after 10-12 days of infection, initially resembling a cold with a runny nose, cough and a slight fever. The eyes may become reddened and sensitive to light. As the illness progresses, and usually on the third to seventh day, the temperature may reach up to 39-41 o C, and a red blotchy rash lasting four to seven days appears. The rash usually begins on the face and then spreads over the entire body. Little white spots (Koplik spots) may also appear on the gums and inside of the cheeks. There is no specific treatment for measles. Life-long immunity to the virus is attained following infection.

What are the complications associated with measles?
Measles can be complicated by secondary ear infections, diarrhea, croup, and mild pneumonia. In some cases (about 1 out of 1,000) patients with measles develop inflammation of the brain tissue (encephalitis). Very rarely, a persistent measles virus infection can produce subacute sclerosing panencephalitis (SSPE), a disease in which nerves and brain tissue degenerate. In 2005, in EUVAC.NET countries, four cases were reported with encephalitis and, 13 deaths attributed to measles.

How can measles be prevented?
Thanks to measles vaccine, the number of measles cases has gone down drastically but not sufficiently enough to interrupt transmission in many countries. The vaccine is usually given together with mumps and rubella in a vaccine shot called MMR. Two doses of vaccine are needed for maximum protection. They normally provide life-long immunity. The first dose is usually given at 12-15 months of age. In most European countries the second dose is usually given between four and seven years of age. However, vaccination schedules differ considerably in different countries.

Is the MMR vaccine safe?
The MMR vaccine is safe and effective and generally has very few side effects. Mild reactions such as fever, redness or swelling at the injection site have been reported. As with any medicine, there are very small risks that serious problems could occur after getting a vaccine. However, the potential risks associated with measles disease are much greater than the potential risks associated with the measles vaccine.
Following media publicity surrounding a report published in 1998 claiming a link between MMR vaccination and autism, public confidence in some countries has been undermined. Findings of subsequent studies have shown no link between vaccination and autism. Indeed no health regulatory body in the world has changed its policy on measles vaccination as a result of this hypothesized link.

Are there any plans to eliminate measles?
Following the successful interruption of wild poliovirus transmission in the European Region, many countries are eager to move towards targeting measles elimination. This means that endemic measles transmission does not occur in a large geographical area. Many European countries are strengthening measles surveillance and have already started the implementation of elimination strategies, or set elimination goals. The World Health Organization Regional Office for Europe has developed a strategy plan to eliminate measles in the European region by 2010. This includes the achievement and maintenance of very high routine immunisation coverage with two doses of measles vaccine and strengthening surveillance and laboratory confirmation of measles.

Note: The information presented by this fact sheet is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals.