Measles Rash & Immunization Information

This page gives information on measles rash and general symptoms as well as information on the MMR immunization. Although children are usually a little unwell before they get the rash, it is the rash which is so characteristic that leads to a diagnosis of measles.

There have been increasing outbreaks of measles in developed countries which is related to falling immunization rates. Measles immunization is available in most countries and can prevent this childhood illness.

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What causes measles?

Measles is caused by a virus called a paramyxovirus. It is spread by droplets, so as an infected person coughs or sneezes, they spread the virus to others. You can also get infected by coming into contact with secretions from the nose or throat of a person with measles.

So if you have measles or your child has measles, remember to cover your nose and mouth when coughing or sneezing (preferably with a paper tissue) and always dispose of paper tissues after use. Wash your hands frequently.

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Is measles a serious disease?

Yes. In underdeveloped countries, particularly if there is malnutrition, measles causes serious disease and is often fatal (often due to measles pneumonia).

In the developed world where we have had immunizations for some time, we don't see measles so much and many people have forgotten what a serious disease it can be. But even in the developed world, there are still serious complications and even deaths from measles. That is why is so important to have your child immunized if it is available to you.

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What are the symptoms of measles?

When measles starts, there is no rash, but your child will have a fever and be irritable. She may have conjunctivitis (so the whites of the eyes will be red) and a runny nose. There will also be cough - if your child doesn't have cough, then it probably isn't measles. If your doctor examines your child at this time, a clue to the diagnosis of measles will be the appearance of white spots on the inside of the cheeks (called Koplik's spots).

After about 3 days, your child will develop the characteristic measles rash. Your child will be miserable with the fever and rash.

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What does the measles rash look like?

The characteristic rash starts as pink spots behind the ears, then it spreads to the rest of the face and then the chest, arms, abdomen and legs. The rash (spots) becomes red and what start as small patches spread and join up so there can be large areas of red rash. The rash will eventually fade and the skin can peel off the fingers and toes.

The measles rash usually lasts from 4 days up to a week.

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How long is my child infectious?

Measles is a very infectious disease so it is important to keep her away from other children (other than your family) - so daycare or school - until 7 days after the rash first appeared. 

If your child has been in contact with a child with measles, and is not immunized, then she should not got to school or daycare for 14 days after the first appearance of the rash in the child she had contact with. This is because measles takes 14 days to incubate before it causes illness.

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What is the treatment of measles?

There is no specific treatment if your child is usually well and just has the usual measles rash and symptoms. You can give Paracetamol or Acetominophen to keep her comfortable when she has a fever. It is also important to keep her drinking so she doesn't get dehydrated. To read more on the signs of dehydration, click here

If your child gets complications, treatment will be required for those.

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What are the complications of measles?

  • Pneumonia – 1:25 patients. The pneumonia can be severe enough to cause death.
  • Otitis Media – 1:40 patients. Otitis media can cause transient hearing loss
  • Children may die of measles – 1:1000
  • Encephalitis – 1:1000-1:5000 patients. Measles can also cause brain infection – encephalitis (inflammation of the brain) and this can cause death or permanent brain damage. Children with encephalitis have reduced conscious levels and may have seizures. Encephalitis usually occurs 4 -7 days after the measles rash appears
  • Subacute Sclerosing Panencephalitis (SSPE) – 1:25000 patients. Measles can also cause an even more severe brain infection called SSPE which is always associated with brain damage, intellectual deterioration and death. This can occur years after the measles rash.

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How can I protect my child from measles?

You can protect your child by giving her the measles immunization which is one part of the MMR vaccine. MMR stands for Measles, Mumps, Rubella and is one vaccine providing immunity to 3 diseases.

Measles immunizations saves lives - there is no doubt about that and there is good research evidence to support this statement.

Usually the measles vaccine is given at a year of age, as most babies will get passive immunity from their mothers (so they will have maternal antibodies against measles which last to about 9 - 12 months). In some communities where there is severe measles, including Aboriginal children in Australia and in children in developing countries, the vaccine is given at 9 months of age.

In the 1990's the measles vaccine was added to a vaccine for rubella (German measles) and mumps - the so-called MMR vaccine which combines vaccines to measles, mumps and rubella in one.

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What are the side effects of the MMR vaccine?

Most children will have no side effects after MMR.It is not uncommon, however, for children to get a rash and a fever 6-12 days after the MMR immunization. Don’t worry, this just means the vaccine is working.

Some children will get a febrile convulsion with the fever – to read more on febrile convulsions, click here.

There is no increase in the risk of your child developing epilepsy or any other complications if he has a febrile convulsion after MMR.

Some children (about 1:30,000) get easy bruising because they have temporarily low platelets. This resolves by itself.

In rare cases, there may be encephalitis (brain infection) after the MMR vaccine, but this occurs in less than one child in a million. If children are not immunized, one in a thousand may get encephalitis, so it is afer to immunize.

MMR does not cause autism – to read more, click here.

What is clear from the studies is that the complications from having measles or mumps or rubella disease are far more serious than having complications or side effects as a result of the MMR immunization.

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What if my child has had a measles rash already?

The MMR vaccine should be given regardless of your child already having had measles, mumps or rubella.

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What if my child is allergic to eggs?

Children with egg allergy can be given MMR.

If your child has had an anaphylactic reaction to eggs, she can still have the MMR but it is wise to wait at least 30 -60 minutes minutes after the injection before leaving the surgery.

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References

  • Issacs D, Gilbert G. Infectious Diseases of Childhood in Practical Paediatrics, ed by Robinson, Roberton. Churchill Livingston 4th ed.
  • Vaccination Training Manual. IMAC. 8th edition. www.immune.org.nz
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To go to the top of the Measles Rash page, click here

To read about MMR immunization and autism, click here

To go to the Infant Immunization Schedule page, click here

To go to the main Immunization page, click here

To go to the Infections page, click here

To go to the Skin Rash page, click here

To return Home, click here


Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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