What is measles?

Measles is a very contagious viral illness, best known for its characteristic red blotchy rash. Measles can be very serious. The complications that can come with measles can lead to hospitalisation and even death.

Measles was very common in Australia before measles vaccination was added to the childhood immunisation schedule in 1971. Thanks to widespread vaccination, measles is now rare in Australia, but sometimes outbreaks still occur when infected people enter from overseas.

This page focuses on advice for adults and children above 5 years of age. You can find information about measles during pregnancy and in babies and younger children on the Pregnancy, Birth and Baby website.

What are the symptoms of measles?

The symptoms of measles usually appear about 10 days after exposure to an infected person.

The most characteristic symptom of measles is a blotchy red rash, but this is not usually the first symptom.

Measles usually starts as a flu-like illness lasting for between 2 and 4 days with symptoms that include:

• fever
• tiredness
• severe cough
• red eyes (conjunctivitis)
• runny nose
• white spots in the mouth (known as Koplik spots)

On days 3 to 7 of the illness, the rash appears. It is usually red and blotchy, but not itchy.

A measles rash generally starts at the head and then spreads down to the rest of the body. It usually lasts 4 – 7 days.

Other symptoms may develop if the infection leads to complications, so if you have measles and new symptoms appear or the current symptoms worsen, speak to your doctor.

What causes measles and how is it spread?

Measles is caused by a virus.

Measles is spread through contact with an infected person — for example, when they cough or sneeze nearby. It can also be spread if you come into contact with virus particles that remain in the air or on surfaces, even if the infected person has already left the area. Virus particles can stay in a room and infect others for up to 2 hours after an infected person leaves it.

Measles is very contagious, and people are usually contagious from around 5 days before the rash appears to around 4 days after it has appeared.

Up to 9 in every 10 people who are not immune to measles — including people who have never been sick with or vaccinated against measles — will catch it if they come into contact with an infected person.

If you think you have measles, it is important to stay home from childcare, school or work to stop you from spreading the infection. Your doctor will review your symptoms to determine if you have measles, and to recommend when you can go back to school or work.

Measles is a notifiable disease. This means that the doctor who diagnoses measles needs to report the case to the local health authorities, who can take steps to prevent or control an outbreak. Since measles is very contagious, this usually involves a process called contact tracing. After speaking to the person with measles, contact tracers attempt to identify anyone who has had close contact with them recently.

People who are not immune to measles but who had close contact with an infected person can then be offered treatments — known as post-exposure prophylaxis. In this way, they reduce their chance of getting sick with measles and continuing to spread the virus.

Post-exposure prophylaxis for measles usually involves vaccination, or for those unable to be vaccinated, a medicine containing antibodies against measles.

Who is at risk of measles?

Anyone of any age can catch measles if they are not immune. You are considered immune to measles if you have been sick with it in the past or if you have had a course of measles vaccinations.

In Australia, people born before 1966 are generally considered to be immune since it is very likely that they caught measles in childhood.

People with weakened immune systems (for example, those who are receiving chemotherapy) are more likely to catch measles if exposed, and to suffer from complications.

Measles and pregnancy

Catching measles during pregnancy increases the risk of miscarriage or preterm labour.

Measles vaccinations are not recommended during pregnancy. If you are planning a pregnancy, see your doctor for a pre-conception health check. This usually includes making sure that you are immune to infections like measles.

When should I see my doctor?

You should speak to your doctor if you think that you or your child has measles, to make sure you get an accurate diagnosis. Your doctor will also advise you on how to best protect people in your household. It is important for the local health authorities to know about cases of measles in the community so they can act quickly and control the spread.

Measles is very contagious, so it’s important to call your doctor before you plan a visit to the clinic. Otherwise, you may infect others. Ask your doctor about the possibility of a home visit or telehealth appointment, such as a phone or video call.

See your doctor urgently if you are concerned, or if you have severe symptoms that include:

• trouble breathing
• high fever
• neck stiffness
• severe drowsiness
• earache
• diarrhoea

These can be signs that you are developing complications from measles and may need urgent medical treatment.

How is measles diagnosed?

Your doctor can diagnose measles by asking you about your symptoms and looking at your rash. They may also ask if you’ve been in recent contact with anyone infected with measles, and about your vaccination history.

If your doctor thinks you have measles, they may refer you for a blood test, urine test or a swab of your nose or throat. These tests can confirm the diagnosis.

How is measles treated?

There is no specific medicine or treatment available to treat measles. Antibiotics will not help you recover from measles because the illness is caused by a virus, not bacteria.

Strategies to try to relieve your symptoms at home include:

• getting plenty of rest
• drinking enough fluids
• taking paracetamol to relieve fever

If your symptoms are severe or you experience complications, you many need to be treated in hospital.

How can I prevent measles?

Vaccination is the best way to prevent measles.

A two-dose course of a measles vaccine is 99% effective at preventing infection by the virus that causes measles.

The measles vaccine is given as part of a combination vaccination for measles, mumps and rubella (known as MMR) or measles, mumps, rubella and varicella (known as MMR-V). Both are very effective and have similar side effects. Your doctor can advise which vaccine is right for you.

Children are offered 2 doses of measles vaccine for free, based on the National Immunisation Program Schedule at 12 and 18 months of age.

If you were born in or after 1966 and you haven’t received vaccination against measles, speak to your doctor about getting vaccinated.

Vaccination against measles is strongly recommended for non-immune people who work in childcare, aged care or healthcare, as well as for travellers.

Measles vaccination is not recommended for pregnant women or people who have a weakened immune system.

What complications can come with measles?

1 in 10 people who catch measles will experience complications that can cause life-long effects or, occasionally, death.

Complications include:

• ear infection
• lung infection (pneumonia)
• inflammation of the brain or the lining of the brain (meningitis or encephalitis)

Resources and support

For more information about immunisation in Australia, visit the Department of Health Immunisation website.