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%.
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
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.
Watch this video about measles and vaccination
(Kids Health, NZ, 2023)
Symptoms usually take around 7 to 10 days to appear after you have caught the virus.
Symptoms of measles
Usual symptoms in the first few days of being unwell
3 to 7 days after the first symptoms people start to develop a rash
The rash starts on your head or face, often at your hairline or behind your ears, and then spreads to your body and then to your arms and legs.
You usually feel most unwell a day or two after the appearance of the rash.
The rash will fade after about a week, leaving a slight mark on the skin, but this will not be permanent. You are no longer at risk of passing on measles to others 4 days after you developed your rash.
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:
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.
Contact your doctor or get urgent medical advice if you or someone you know has measles and develops any of these symptoms.
If you or your child:
have trouble breathing
have a stiff neck
feel drowsy or cannot be woken up
are coughing up green or yellow thick mucous
have sore ears
have a fit (seizure)
do not pee for 10 hours.
For your child if:
they become floppy, very drowsy or are difficult to wake
their breathing becomes very fast or noisy
they become very pale or have blue lips or gums.
Always call first if you need to visit a medical practice or hospital.
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
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).
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?\