Measles starts with cold-like symptoms that develop about 10 days after becoming infected. This is followed a few days later by the measles rash.

For most people, the illness lasts around 7 to 10 days.

Initial symptoms

The initial symptoms of measles can include:

• a runny or blocked nose
• sneezing
• watery eyes
• swollen eyelids
• sore, red eyes that may be sensitive to light
• a high temperature (fever), which may reach around 40C (104F)
• small greyish-white spots in the mouth
• aches and pains
• a cough
• loss of appetite
• tiredness, irritability and a general lack of energy

Spots in the mouth

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DR P. MARAZZI/SCIENCE PHOTO LIBRARY

A day or two before the rash appears, many people with measles develop small greyish-white spots in their mouth.

Not everyone with measles has these spots, but if someone has them in addition to the other symptoms listed above or a rash, it's highly likely they have the condition.

The spots will usually last for a few days.

The measles rash

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DR P. MARAZZI/SCIENCE PHOTO LIBRARY

Credit:

Mediscan / Alamy Stock Photo

The measles rash appears around 2 to 4 days after the initial symptoms and normally fades after about a week.

You'll usually feel most ill on the first or second day after the rash develops.

The rash:

• is made up of small red-brown, flat or slightly raised spots that may join together into larger blotchy patches
• usually first appears on the head or neck before spreading outwards to the rest of the body
• is slightly itchy for some people
• can look similar to other childhood conditions, such as slapped cheek syndrome, roseola or rubella
• is unlikely to be caused by measles if the person has been fully vaccinated (had 2 doses of the MMR vaccine) or had measles before

When to seek medical advice

Contact a GP as soon as possible if you suspect that you or your child has measles, even if you're not completely sure.

It's best to phone before your visit, as the GP surgery may need to make arrangements to reduce the risk of spreading the infection to others.

You should also see a GP if you have been in close contact with someone who has measles and have not been fully vaccinated or haven't had the infection before, even if you do not have any symptoms yet.

There's no specific treatment for measles, but the condition usually improves within 7 to 10 days. A GP will probably suggest taking things easy at home until you're feeling better.

Stay away from work or school for at least 4 days from when the measles rash first appears to reduce the risk of spreading the infection.

You should also try to avoid contact with people who are more vulnerable to the infection, such as young children and pregnant women.

Relieving symptoms

If the symptoms of measles are causing discomfort for you or your child, there are some things you can do to treat these while you wait for your body to fight off the virus.

Controlling fever and relieving pain

Paracetamol or ibuprofen can be used to reduce a high temperature (fever) and relieve any aches or pains if your child's uncomfortable.

Liquid infant paracetamol can be used for young children. Aspirin should not be given to children under 16 years old.

Speak to a pharmacist if you're not sure which medicines are suitable for your child.

Drink plenty of fluids

If your child has a high temperature, make sure they drink plenty of fluids as they may be at risk of dehydration.

Keeping hydrated may also help reduce throat discomfort caused by coughing.

Treating sore eyes

You can gently clean away any crustiness from your child's eyelids and lashes using cotton wool soaked in water.

Closing curtains or dimming lights can help if bright light is hurting their eyes.

Treating cold-like symptoms

If your child has cold-like symptoms, such as a runny nose or a cough, there are a number of things you can do to help them feel more comfortable.

For example, it might help your child if they sit in a hot, steamy bathroom. Or you could put a wet towel on a warm radiator to moisten the air, which may help ease your child's cough.

Drinking warm drinks, particularly ones containing lemon or honey, may also help to relax the airways, loosen mucus, and soothe a cough.

Honey should not be given to babies under 12 months.

Spotting signs of serious illness

If you or your child has measles, you should keep an eye out for any signs of the serious complications that can sometimes develop.

Signs of a more serious problem include:

• shortness of breath
• a sharp chest pain that feels worse with breathing
• coughing up blood
• drowsiness
• confusion
• fits (convulsions)

Go to your nearest accident and emergency (A&E) department or call 999 for an ambulance if you or your child develop any of these symptoms.

Read more about the complications of measles

Most people will recover from measles after around 7 to 10 days, but sometimes it can lead to serious complications.

Who's most at risk?

Complications of measles are more likely to develop in certain groups of people.

These include:

• babies younger than 1 year old
• children with a poor diet
• children with a weakened immune system (such as those with leukaemia)
• teenagers and adults

Children who are older than 1 year and otherwise healthy have the lowest risk of developing complications.

Common complications

More common complications of measles include:

• diarrhoea and vomiting, which can lead to dehydration
• middle ear infection (otitis media), which can cause earache
• eye infection (conjunctivitis)
• inflammation of the voice box (laryngitis)
• infections of the airways and lungs (such as pneumonia, bronchitis and croup)
• fits caused by a fever (febrile seizures)

Uncommon complications

Less common complications of measles include:

• liver infection (hepatitis)
• misalignment of the eyes (squint) if the virus affects the nerves and muscles of the eye
• infection of the membranes surrounding the brain and spinal cord (meningitis) or infection of the brain itself (encephalitis)

Rare complications

In rare cases, measles can lead to:

• serious eye disorders, such as an infection of the optic nerve, the nerve that transmits information from the eye to the brain (this is known as optic neuritis and can lead to vision loss)
• heart and nervous system problems
• a fatal brain complication known as subacute sclerosing panencephalitis (SSPE), which can occur several years after measles (this is very rare, occurring in only 1 in every 25,000 cases)

Measles in pregnancy

If you're not immune to measles and become infected while you're pregnant, there's a risk of:

• miscarriage or stillbirth
• your baby being born prematurely (before the 37th week of pregnancy)
• your baby having a low birthweight

If you're pregnant and think you have come into contact with someone with measles and you know you're not immune, you should see a GP as soon as possible.

They can advise you about treatment to reduce your risk of developing the condition.

Read more about preventing measles

When to seek immediate medical advice

Go to your nearest accident and emergency (A&E) department or call 999 for an ambulance if you or your child have measles and develop:

• shortness of breath
• a sharp chest pain that feels worse with breathing
• coughing up blood
• drowsiness
• confusion
• fits (convulsions)

These symptoms may be a sign of a serious bacterial infection, requiring admission to hospital and treatment with antibiotics.

You can avoid catching measles by having the measles, mumps and rubella (MMR) vaccine.

If the MMR vaccine is not suitable for you, a treatment called human normal immunoglobulin (HNIG) can be used if you're at immediate risk of catching measles.

MMR vaccine

Routine vaccination

The MMR vaccine is given as part of the routine NHS childhood vaccination programme.

One dose is usually given to a child when they're 12 to 13 months old. A second dose is given at 3 years and 4 months.

Contact a GP if you're uncertain about whether your child's vaccinations are up-to-date.

You or your child can be vaccinated at any point if you have not been fully vaccinated before.

If you're not sure whether you were vaccinated in the past, having the vaccine again will not cause any harm.

Special circumstances

A dose of the MMR vaccine can also be given to anyone over 6 months of age if they're at immediate risk of catching measles.

For example, this could be if:

• there's an outbreak of measles in your local area
• you have been in close contact with someone who has measles
• you're planning on travelling to an area where the infection is widespread

Children who have the vaccine before their first birthday should still have the 2 routine doses at around 13 months of age and 3 years and 4 months.

Human normal immunoglobulin

Human normal immunoglobulin (HNIG) is a special concentration of antibodies that can give short-term but immediate protection against measles.

It may be recommended for people in the following groups if they have been exposed to someone with measles:

• babies under 6 months of age
• pregnant women who have not been fully vaccinated or have not had measles before
• people with weak immune systems (for example, those with HIV or people receiving treatment that weakens their immune system, such as treatment for leukaemia)

HNIG should ideally be given within 6 days of exposure.

Stopping measles spreading to others

If you already have measles, it's important to reduce the risk of spreading the infection to other people.

You should:

• avoid work or school for at least 4 days from when you first developed the measles rash
• try to avoid contact with people who are more vulnerable to the infection, such as young children and pregnant women, while you're ill