7 things every parent needs to know about measles

Measles cases are rising once again in the UK and experts are urging people to check if they need to be jabbed against this highly contagious disease.

In 2023 there were 1,603 suspected cases of measles in England and Wales, up from 735 in 2022 and 360 in 2021, according to the UK Health Security Agency (UKHSA).

Large cities including London and Birmingham are becoming measles hotspots and primary school children and young adults who have not had the MMR vaccine are particularly at risk of falling ill. 

Keep scrolling to see the symptoms to look out for, who is most at risk and what you can do to keep safe.

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1. What is measles?

Measles is an extremely infectious viral disease that's spread through water droplets dispersed by coughing or sneezing.

Vaccination, which became available in 1963, significantly reduced deaths from measles globally. By 2017 it was declared that the UK had eliminated measles, but now it's on the rise again.

There are various reasons for this, but it's partly because of an immunity gap that's been created by low childhood vaccine uptake rates during the Covid-19 pandemic, and a cohort of young people missing out on vaccination in the late nineties and early noughties.

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2. A rash is just one symptom of measles

You may associate measles with a red, blotchy rash but this usually appears up to four days after other symptoms have emerged, including:

• Cold-like symptoms such as runny or blocked nose, sneezing and a cough.
• Sore red eyes or swollen eyes that might become crusty, plus sensitivity to light.
• Aches and pains caused by your body fighting the infection.
• A high temperature which may reach around 40°C.
• Small white spots in the mouth inside the cheeks. 

A measles rash tends to start from the face (typically behind the ears and at the hairline) before spreading to the rest of the body, but unlike other childhood illnesses such as chicken pox or German measles, it isn't itchy.

It may be harder to see on darker skin types, where it can look brown or red and may be slightly raised, too.

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3. Measles is highly contagious

The World Health Organization has identified measles as one of the most contagious infections in the world.

To give you an idea of just how contagious it is, when someone has Covid they will, on average, spread it to around three people. Someone with measles will spread it to 15 others.

Spending just 15 minutes with an infected person is enough to get infected yourself, which is why those who have measles should isolate until they're no longer able to pass it on.

If you suspect you or your child are infectious, don't socialise and don't let your child go to school or play with other kids for at least four days from when the rash first appears. 

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4. Teens and young adults are getting measles, too

Vaccine coverage is the lowest it's been in a decade: about one in 10 children are not protected from measles by the time they start school. But increasing numbers of teens and young adults are catching measles, too.

Although the current hotspots are the West Midlands and London, students going to university or college elsewhere may be exposed to the virus as they mix with students who've come from affected areas from both the UK and overseas.

The UK Health Security Agency (UKHSA) is urging university students to speak to their GP to get up-to-date with their measles vaccine (the MMR), along with those for meningitis and septicaemia (the MenACWY jab) and the human papilloma virus (the HPV vaccine, for female students).

Even though they have youth on their side, teens and young adults can still become poorly with measles. In fact, along with babies under one, statistics show that it's adults over the age of 25 who have the highest rates of hospital admission as a result of contracting it.

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5. Measles can be dangerous

Newborn babies, unvaccinated pregnant women, older people and people with weakened immune systems (such as those having chemotherapy) are vulnerable to being seriously unwell if they catch measles.

It can be a mild infection for some children, but one child in five will need to go to hospital while one in 15 will experience complications, such as meningitis or sepsis.

Complications can include pneumonia, meningitis or encephalitis (inflammation of the brain), blindness and seizures, and it can also result in miscarriage, stillbirth or premature birth in pregnancy.

In some rare cases it can cause devastation years later with sclerosing panencephalitis (SSPE), which leads to the progressive destruction of the central nervous system, dementia, loss of motor control, epilepsy and eventually death.

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6. You can have the MMR vaccine at any age

Although the MMR vaccine is conventionally given at 12-13 months for the first dose and between 3-4 years for the second, it's never too late to have it if you or your child has missed out on either the second or both doses.

You may especially want to check if the following applies:

• You were born between 1998 and 2004. Vaccine uptake levels dropped considerably during these years. If you're between the ages of around 19 to 26 you may want to check, as you might have missed being jabbed.
• You live in London or the West Midlands. These areas are currently experiencing higher than expected levels of measles so unvaccinated people are particularly at risk of catching it right now. In some areas of London, as many as 40% of children are unvaccinated.
• Your child is primary school age. Many young children either missed their second jab because of lockdown or missed both doses altogether. This means that more than 102,000 children aged four and five starting in reception are not currently protected against catching measles, mumps and rubella. 
• You were born or brought up abroad. The NHS says that different countries offer different immunisations and not all use the combined MMR vaccine, so if you don't have a record of what vaccines you received or you are unsure, speak to your GP.

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7. How to treat measles

There is no specific treatment for most measles cases because it's viral so all you can really do is ease the symptoms. Here's how:

1. Get plenty of rest This helps your body fight the viral infection.
2. Drink lots of water This is to avoid getting dehydration, which can be caused by fever.
3. Take painkillers Paracetamol and ibuprofen can be used to reduce a high temperature, including Calpol and other childhood pain relief for little ones.
4. Gently remove eye crusts Use cotton wool soaked in warm water to do this, plus keep lighting low if eyes are sensitive.

Symptoms usually improve in about a week, but if they worsen and you experience shortness of breath, a high temperature that isn't brought down by paracetamol or ibuprofen, confusion or seizures (fits), call 999 or go to A&E.