Measles: what you need to know

When was the last time you heard of someone sick with diphtheria? Or polio? Mumps?

Chances are, if you’ve grown up in a part of the world where vaccination is commonplace, you’ve probably forgotten or never known what it’s like to have these diseases. It’s easy to feel complacent when they almost disappear from our collective public consciousness … until one of those preventable diseases starts making its way into news headlines, with outbreaks occurring across the globe. Like measles.

Australia has already seen more cases of measles within the first four months of 2019 than it did for the entirety of 2018. It’s one of the most contagious diseases affecting humans, but it’s also preventable, with an effective vaccine that’s widely available.

So, what’s it like to have measles—and just how bad can it get, anyway?

What is measles?

Measles is a serious, highly infectious viral illness. It’s spread through the air when an infected person coughs or sneezes. Sometimes even just breathing may be enough to spread the virus.

It’s highly contagious: if you’re not immune to the virus and you come into contact with someone infected with measles, you have a 90 per cent chance of getting sick. A single infected person can typically make between 14–18 other people sick. If someone with measles enters a room and coughs, the virus can stay in the air for some time after that person leaves the room—sometimes for up to two hours.

An infected person is contagious from the first day of symptoms. These typically don’t appear until about 10 days after exposure. At first, measles symptoms may be very similar to other viral infections, with people experiencing a fever, cough, runny nose, sore red eyes, and generally feeling sick and tired. A few days later, a nasty, spotty rash develops, starting from the face and progressing down the rest of the body. The rash lasts for 4–7 days.

There is no specific treatment for measles. Instead, the aim is to manage the symptoms and reduce risk of complications. Medication such as paracetamol may be used to help reduce discomfort and lower a fever, but otherwise it’s a case of bed rest, drinking plenty of fluids and staying away from other people to prevent the disease’s spread.

More than just a ‘mild’ disease

At first glance, measles might seem like just another illness: a nasty rash, fever and cough that’s pretty unpleasant for a few days, but something you’ll eventually fight off as life goes back to normal … right?

Aside from being a miserable sickness to experience, roughly 10 per cent of measles cases involve complications. Some may be comparatively mild, such as diarrhoea or ear infections. Others, however, can be fatal: 1 in 20 people will develop pneumonia, one of the most common causes of death for young children affected by measles, while approximately 1 in 1000 people will develop encephalitis (inflammation of the brain) that can lead to permanent brain damage or death.

In fact, it was encephalitis that claimed the life of children’s author Roald Dahl’s seven-year-old daughter after she contracted measles. In later years, when a vaccine became available, Dahl penned an open letter to parents unaware of the dangers should they decide against vaccinating their children.

Even after surviving the initial illness, in rare cases, measles can lead to a devastating and fatal complication called subacute sclerosing panencephalitis (SSPE), a progressive inflammatory condition of the brain. The condition typically only develops several years after the initial measles infection, beginning with milder symptoms such as personality changes and mood swings, before progressing to seizures, muscle spasms, and eventually leading to coma and death.

Complications tend to be more common and more severe in people who are chronically ill (including those with compromised immune systems), very young children, and pregnant women, where it can lead to loss of the pregnancy.

Staying protected

The most effective way to keep yourself and your community safe from measles is through vaccination. In Australia, the MMR vaccine is typically given during childhood as two separate doses and provides protection against measles, mumps and rubella.

It’s safe and highly effective: if you’ve had two doses of the vaccine, it is 99 per cent effective at preventing measles infection. Not sure if you’ve had two doses? It’s safe to have another MMR vaccine if you don’t have evidence of a second dose to ensure you’ve got the best possible protection.

Preventing measles means preventing its nasty complications, too. The incidence of SSPE has declined by at least 90 per cent in countries where widespread immunisation against measles has taken place.

Those most at risk of developing complications tend to be the same people who are unable to be vaccinated against the disease—so it’s crucial that others in the community are fully immunised to prevent spread of disease to the most vulnerable in our society. Check your vaccination records and, if in doubt, speak with your GP today to keep yourself protected.

This is part of a series of articles produced by The Australian Academy of Science, funded by the Australian Government.

This article was first published on Australia’s Science Channel, the original news platform of The Royal Institution of Australia.

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