Measles

Measles is a serious illness caused by the measles virus that lives in the nose and throat mucus of an infected person. It can easily spread to others through coughing and sneezing. Measles can cause serious complications in children and adults. These include ear infections, pneumonia, encephalitis (swelling of the brain) and death. About 1 in 10 people with measles will need hospital treatment.

The measles virus spreads easily through the air by sneezing or coughing. It can also be spread by contact with surfaces contaminated with an infected person’s nose and throat secretions (snot and saliva). If you are not immune, and you’ve been in the same room as someone with measles, you are very likely to catch it. It can stay in the air for 2 hours and properly fitted and worn N-95 masks are better at protecting you than surgical masks (the commonly available blue ones).

Vaccination is a very effective way of protecting against measles

• Very few people who are fully vaccinated still get measles. 
• The vaccine is called the measles, mumps and rubella (MMR) vaccine. No measles-only vaccine is available in New Zealand.
• Having only 1 dose of the MMR vaccine is not enough protection against measles – you need to have 2 to complete the course. A single dose of MMR gives you a 95% chance of being protected against measles, 2 doses increases this to 99%.
• The vaccine is part of the childhood immunisation schedule(external link) for children at 12 months and 15 months of age. 
• The vaccine is free.
• Some people may not be able to have the vaccine. Read more about the MMR vaccine.
• If you're not sure you have been vaccinated against measles, it’s best to get immunised. It’s safe to have an extra dose of the MMR vaccine.
• It can take around 2 weeks for a person to be fully immune after a vaccination.
• Very few people who are fully vaccinated still get measles, but they are more likely to have a milder illness and are less likely to spread the disease to other people.

By getting vaccinated, you can help people at risk

Measles can cause serious complications in children and adults, especially in: 

• anyone with a chronic illness or a weakened immune system
• children younger than five years who are not immunised
• babies younger than 12 months who are too young to receive the first dose of the MMR vaccine
• pregnant women.

When enough people in the community are vaccinated (about 95% of the population), the spread of a disease slows down or stops completely. This is called herd immunity and it most especially protects pregnant people and children younger than 12 months cannot get vaccinated. Read more about the MMR vaccine and reasons to vaccinate.

Video: How to protect tamariki from measles

Watch this video about measles and vaccination. This video may take a few moments to load.

Symptoms usually take around 7 to 10 days to appear after you have caught the virus.

If you catch measles, you’re infectious (can spread the virus) from 4 days before the rash appears and for 4 days after the rash appears.

Image: Auckland Regional Public Health Service – Te Whatu Ora

Most people will recover from measles after a week or two, but sometimes it can lead to serious complications, even death. Common complications that affect about 1 in every 15 cases include:

• ear infections
• diarrhoea, which can also lead to dehydration
• fits caused by fevers (febrile seizures)
• pneumonia – this is the main cause of deaths from measles.

Inflammation of the brain (encephalitis) occurs in about 1 in 1000 measles cases, with some of these people dying and 1 in 3 being left with permanent brain damage. 

Other complications include sclerosing panencephalitis a degenerative brain disease (which can occur in 1 in 100,000 measles cases), problems with blood clotting, and inflammation of the small airways in the lungs, the heart, kidneys or liver. 

Pregnant women who become ill with measles during pregnancy are at risk of miscarriage, going into labour early (premature labour) and having babies with low birthweight.

If you are pregnant and think you may have measles, or if you have come into contact with someone with measles, call your doctor or lead maternity carer as soon as possible.

Pregnant women should not be given the measles vaccine during pregnancy but close contacts of pregnant women should be vaccinated to help protect both the mother and unborn baby from exposure. Read more about measles and pregnancy.(external link)

You are considered to be at risk of getting measles if you were born after 1 January 1969 AND:

• have not had measles before
• have not had 2 doses of the MMR vaccine at or after 12 months of age
• aren’t sure if you’ve had the MMR vaccine.

If you are at risk of getting measles and come into contact with someone who has measles, you are regarded as a close contact – see I am a close contact of somebody with measles. What do I do?

People with measles need to get plenty of rest. If you have medicine you take normally, continue to have this. To ease your symptoms you can:

• use pain relief, such as paracetamol or ibuprofen, to reduce pain and discomfort
• drink plenty of water or other fluids to avoid dehydration 
• treat sore eyes by wiping the crustiness from the eyelids and lashes using cotton wool and water (use a separate piece of cotton wool for each eye) and avoiding bright light.

About 15% (15 in every 100) of people with measles will need hospital treatment so if you feel unwell do not hesitate to seek help. Call Healthline free on 0800 611 116 any time of the day for advice.

• Stay home from work, school or day care for 4 days after the rash appears. Check this with the measles quarantine calculator.(external link)
• Don't invite other children or visitors to the house.
• Your public health service will tell you when your child can return to school or childcare. 
• Wash your hands regularly. Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds then dry well. Remind others in your home to do the same.
• You will be regularly contacted by a health professional who will provide advice and check on your wellbeing.
• Read more about information for people with measles. (external link) 

Read more about measles information for contacts(external link) and check the measles quarantine calculator.(external link)

Video: Quiet Hero – Protect your whānau against measles

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(Manatū Hauora, NZ 2022)

Video: Keep your whānau safe from measles - get immunised!

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(Ministry of Health, NZ, 2021)

Video: Awhikiritia tō tinana! Protect yourself and your whānau from measles (Te Reo Māori)

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(Ministry of Health, NZ, 2021)

Video: Protecting our whānau - a kōrero about measles and immunisation

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(Ministry of Health, NZ, 2020)

Video: Did you miss out on your measles immunisation?

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(Ministry of Health, NZ, 2021)

Video: Don't be a Bots, Get your shots!

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(Ministry of Health, NZ, 2021)

Video: ARPHS Measles information in NZ Sign Language

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(ARPHS, NZ, 2019)

You can find more NZSL video's about measles here.(external link) 

Video: Protecting children with cancer from measles - Leroy Beckett

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(Ministry of Health, NZ, 2012)

Resources

• Measles(external link) Immunisation Handbook, Ministry of Health, NZ, 2020
• Measles(external link) IMAC, NZ 2022
• Quick answers to frequent MMR questions(external link) IMAC, NZ 2020
• MMR Immunisation - Guardians of the Future resources(external link) Te Hiringa Hauora, NZ
• Auckland Regional Public Health
  • Clinical pathway (external link)
  • Measles factsheet for cases (external link)
  • Measles factsheet for close contacts (external link)
  • Calculate your quarantine period(external link)
  • Email Notification Form (external link)

Continuing professional development

Podcast

Measles in NZ(external link) Goodfellow Podcast, NZ, 2019

Nikki Turner discusses the management of measles in New Zealand. Nikki is an academic general practitioner and an associate professor in the Department of General Practice and Primary Care, University of Auckland. She works part time as a GP in Wellington and is director of the Immunisation Advisory Centre (IMAC).

Video

Ben Harris, a medical microbiology scientist talks about the following topics:

• Can you be fully vaccinated and still catch measles?
• When was measles vaccination introduced to NZ?
• Why do people born before this date in NZ not have to get vaccinated?\
• What are Koplik spots?
• What is the measles incubation time?
• When is someone with measles infectious?

Video: Ben Harris Webinar - Measles

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(Mobile Health, NZ, 2019)