What is measles? Rash, symptoms and complications

What is measles? Rash, symptoms and complications

Parents and medical professionals need to be on “high alert” for measles after the vaccine rate among young children dropped to a 10-year low.

It is the first time in decades the Royal College of Paediatrics and Child Health (RCPCH) has issued national guidance to be wary as experts warn the unvaccinated are more at risk of developing serious side effects from the highly contagious disease.

At least 95% of children should be double vaccinated by the age of five but the UK is well below that target.

The latest figures from the NHS showed only 84.5 per cent had received a second shot of the protective measles, mumps and rubella (MMR) jab – the lowest level since 2010-11.

Measles can make children very sick. The main symptoms are a fever and a rash but it can cause serious complications including meningitis. For some, it can even be fatal.

The RCPCH is now worried the UK is now seeing a "devastating resurgence" of virtually eliminated life-threatening diseases such as measles because of low vaccine uptake.

RCPCH president Dr Camilla Kingdon said: "Having to consider measles in our national guidance for the first time in decades is a disappointing but necessary move.

"Many paediatricians I know live in fear of potential measles outbreaks this winter."

The RCPCH is urging doctors to use "every opportunity" to check a child's vaccination status and offer the MMR jab to those who have not had two doses.

Jane Clegg, regional chief nurse for the NHS in London, said: “Measles can easily spread between unvaccinated people and can be serious but it is preventable, which is why we continue to encourage Londoners to take up the vaccine, with GPs calling over 10,000 parents of unvaccinated children, and hundreds booking appointments to get vaccinated as a result.

“Cases of measles in the capital remain low but it’s really important that people check that they, and their children, are up to date with their jabs and protected against MMR – and, if you have any questions or concerns, please get in touch with your GP practice or local pharmacist for advice. Now’s the time to act to protect yourself and loved ones from measles.”

UKHSA has also urged parents to check that their children are up to date with their MMR vaccinations amid an increase in cases of measles.

So what is measles and what are the symptoms to watch out for?

What is measles?

According to the WHO, measles is a highly contagious, and sometimes fatal disease, which remains an “important cause of death among young children”.

It is a viral illness of the respiratory system which, if left untreated, can have serious health complications including infection of the lungs and brain.

The disease can spread through contact with infected mucus and saliva.

What are the symptoms of measles?

According to the NHS, the initial symptoms of measles typically develop around 10 days after the person is infected.

Symptoms include:

  • cold-like symptoms, such as a runny nose, sneezing and a cough

  • sore, red eyes that may be sensitive to light

  • a high temperature, which may reach around 40°C

  • small, greyish-white spots on the inside of cheeks.

A few days later, a red-brown blotchy rash will appear, usually starting on the head or the upper neck before spreading to the rest of the body.

How do you spot a measles rash?

A rash will usually appear after the first few days of feeling ill.

The NHS identifies four key characteristics of a measles rash:

  • made up of small red-brown, flat, or slightly raised spots that may join together into larger blotchy patches

  • usually first appears on the head or neck before spreading downwards to the rest of the body

  • slightly itchy for some

  • can look similar to other childhood conditions, such as slapped-cheek syndrome, roseola, or rubella.

Why has there been a rise in measles cases?

The UKSHA has warned that measles is now circulating in many countries around the world.

The World Health Organization (WHO) has warned that Europe is likely to see a resurgence in cases unless parents get their children vaccinated.

During the Covid pandemic, the number of children who were vaccinated against measles fell, which has left “many children unprotected from serious infections and countries at increased risk of outbreaks", according to UKSHA.

The NHS director of vaccinations and screening, Steve Russell, said: “The MMR vaccine has helped prevent the development of potentially life-threatening illness among millions and it is clear that, when uptake falls, infections rise, so I strongly urge parents to review the status of their child’s vaccinations so they can keep them and others protected from measles, mumps and rubella.”

Is measles deadly?

Measles will usually pass in around seven to 10 days but, in some cases, it can lead to potentially life-threatening complications.

These include meningitis, febrile convulsions, liver infection (hepatitis), pneumonia and encephalitis (infection of the brain).

Can you get measles more than once?

Once you've developed immunity after vaccination or suffered from measles once, your body builds up a tolerance, so it's unlikely you'll get measles again.

Who is most at risk of developing measles?

Unvaccinated children are most at risk of developing measles and contracting its subsequent complications.

Pregnant women are also at risk.

Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected by the virus.

How can you prevent measles?

Routine measles vaccinations for children have been in use for the past 50 years.

In the UK, measles is prevented by giving the measles, mumps, and rubella (MMR) vaccine, which is given in two doses as part of the NHS childhood vaccination programme.

How do you treat measles?

There is no specific antiviral treatment that exists for measles, but there are several measures you can take to help relieve your symptoms.

These include:

  • taking paracetamol or ibuprofen to soothe fever, aches, and pains

  • staying hydrated by drinking plenty of water

  • keeping the curtains closed to reduce light sensitivity

  • using damp cotton wool to clean the eyes

  • taking time off work or school for at least four days when the rash first appears.

WHO also recommends that children diagnosed with measles should receive two doses of vitamin A supplements to prevent the risk of eye damage.

Who should have the MMR vaccine?

The first dose of MMR vaccine is offered to all children at one year old.

Children are given a second dose of MMR before they start school, usually at three years and four months.

There are certain circumstances where children should not have the MMR vaccination. There are more details on the NHS website.

Adults who missed out on the MMR vaccine as a baby and are therefore not immune can have the MMR vaccine on the NHS.

Is the MMR vaccine safe?

In the 1990s and 2000s, there was some controversy about whether the MMR vaccine might cause autism following a 1998 study by Dr Andrew Wakefield. This caused a dramatic drop in the number of children being vaccinated.

There was later found to be no evidence to link the MMR vaccine and autism.

While the MMR vaccine may not work for everyone and cause side effects in some children, the vaccine is generally recognised as safe. However, deciding whether or not to get your child vaccinated is a personal choice, so make sure you speak to your GP who can best advise you.

In 2016, WHO announced the UK had eliminated the disease because of the effectiveness of the vaccine.