Measles factsheet

What is measles?
Measles is a highly contagious disease caused by a virus. Patients mostly have fever with a rash, comprising small, red, flat spots over the body. Other signs include cough, conjunctivitis (red eyes) and coryza (running nose).  Complications of measles can include diarrhea, dehydration, brain infection (encephalitis), blindness and death. Complications are more serious in those who catch measles as young infants (under 2 years of age).

Who can get measles?
 Any person who is not immune to measles can catch measles from an infected person. Once a person has had measles once, they are immune to the virus and do not get sick from measles again. Vaccination is another way to become immune to measles. Vaccinated individuals are protected from severe symptoms of measles.

Where does measles occur in South Africa?
Measles virus can occur anywhere in South Africa, and cases can be found in communities or in institutions like crèches or day care centres. When many measles cases occur in a specified area over a short period of time (five or more cases in a health district within four weeks), this is called an outbreak and public health interventions are required to control the spread of the disease.

How is measles transmitted?
Transmission is by contact with saliva or mucus droplets from the mouth or nose of an infected person when s/he breathes, coughs, or sneezes. The virus becomes airborne and is capable of infecting individuals for up to two hours in the same area. Measles is one of the most infectious viruses known. Infected people can spread measles from four days before to four days after the start of the rash.

What are the signs and symptoms of measles?
The first sign of measles is usually a high fever, accompanied by rash, cough, running nose, and conjunctivitis (red eyes).  The rash starts at the head and spreads to the rest of the body. People with a weak immune system due to HIV, cancer or other diseases do not always develop a rash. Measles can lead to complications like pneumonia (infection of the lungs), blindness, diarrhoea, dehydration, brain infection (encephalitis) or death.

How is measles diagnosed?
Measles should be considered in any person presenting with a fever and rash. Koplik spots (white spots) in the mouth can also be an indication of measles. The measles rash is very similar to that of certain other viral infections (like German measles) and the diagnosis should always be confirmed by a blood test. A throat swab can also be sent to the laboratory. Measles is a notifiable disease, meaning that the blood sample should be sent to the laboratory with a case investigation form, allowing public health officials to respond to any positive case to prevent outbreaks. The measles case investigation form is available here…..(insert link – currently CIF is on CVI page)

How is measles treated?
Treatment is directed at improving symptoms and preventing complications.  Vitamin A should be given to all children with measles to prevent eye damage

How is measles prevented?
Vaccination is an effective was to prevent measles. Measles vaccine is included in the expanded program on immunizations (EPI) schedule in South Africa. Measles vaccine is administered at 6 months and 12 months of age. Measles vaccine is also available as a combination called   measles, mumps, and rubella (MMR) vaccine in the private sector and in military health care facilities. MMR is usually administered at 12 months and 18 months. If a measles vaccine dose has been missed, it is never too late to catch up measles vaccination. 

Where can I find out more information
For the Public:
For Healthcare Workers:
Contact the NICD hotline after hours and in emergency situation: 0828839920