Measles: signs, symptoms and the MMR vaccination
Juliet Blank
Associate EditorLast updated by: Jennifer Howze
Cases of measles in the UK have been growing – whether due to misinformation online and anti-vaxxer movements or families falling behind with immunisations – and the number of children being protected are falling. Here's how to spot it and protect against it
Measles is a serious disease and one that is on the rise. Find out the facts about the measles vaccination, the signs of it, how to spot the signs of a measles rash and how it's treated.
In May 2023, the World Health Organisation announced that 17 countries in their European Region reported more than 900 cases of measles since the start of the year. The news prompted an urgent warning to British families spending holidays in one of the countries. Parents have been urged to check that their child's MMR jab in up to date, as it is an easily preventable disease.
In 2016 and 2017, measles was considered to be eliminated in the UK. However, by 2018 it was spreading again. In 2019 880 cases were confirmed.
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What is measles?
The NHS describes measles as:
'A highly infectious viral illness that can be very unpleasant and sometimes lead to serious complications.'
These include pneumonia, meningitis, and on rare occasions, long-term disability or even death. They add that it is 'particularly easy to catch in environments when in close contact with others'.
Early symptoms include:
- Cold-like symptoms, such as a runny nose, sneezing, and a cough
- Sore, red eyes that may be sensitive to light
- A high temperature (fever), which may reach around 40C (104F)
- Small greyish-white spots on the inside of the cheeks
- A red-brown blotchy rash – this usually appears a few days later
The rash usually starts on the head or upper neck, before spreading outwards to the rest of the body.
What does the measles rash look like?
The rash is made up of small red-brown, flat or slightly raised spots that may join together into larger blotchy patches. It usually first appears on the head or neck, before spreading outwards to the rest of the body, and can be itchy.
The measles rash can look similar to other childhood conditions, such as slapped cheek syndrome, roseola or rubella. If your child has been fully vaccinated (had two doses of the MMR vaccine) or had measles before then it is unlikely they have measles.
Is measles serious?
Although most people will recover from measles after around 7 to 10 days, it can sometimes lead to serious complications.
The NHS estimates that around one in every 5,000 people with measles will die as a result of the infection.
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)
- pneumonia, bronchitis and croup – infections of the airways and lungs
- fits caused by a fever (febrile seizures)
The NHS estimates that one in every 15 children with measles will develop complications like these.
If you think your child may have measles, call your GP as soon as possible. As it's contagious, it's best to phone before you visit so that your GP surgery can make arrangements to reduce the risk of spreading the infection to others.
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How can I prevent measles?
This is simple. By making sure your child is up to date with her immunisation schedule. Here in the UK, the MMR (measles, mumps and rubella) vaccine is available on the NHS for babies and pre-school children.
Babies receive the MMR jab at the age of one to protect against measles, mumps and rubella. They then have a second dose as part of the pre-school booster, which is given at the age of three years and four months.
Measles outbreak: what's the latest?
The UK Health Security Agency (UKHSA) recently reported an increase in measles outbreaks in the UK. Between 1 January and 20 April in 2023, there have been 49 cases of measles. That compares with 54 cases in all of 2022.
Cases of measles have hit a record high in Europe, according to the World Health Organisation (WHO).
More than 41,000 people have been infected by the disease within the first six months of the year, in comparison to 23,927 in 2017 and 5,273 cases in 2016.
Most of the measles cases have been found in countries where immunisation coverage has dropped. This includes France, Germany, Poland, Switzerland and Ukraine. The largest outbreaks are being seen in Italy and Romania.
However, measles is also on the rise here in the UK, with cases quadrupling in the last year, not helped by the number of people getting themselves or their children steadily falling.
England saw 913 confirmed cases of the disease in 2018, compared to 259 cases reported in 2017.
Health experts are recommending parents to make sure that their child is up to date with his or her vaccinations.
A previous measles warning in the UK
Previously, in 2020, Prime Minister Boris Johnson ordered urgent action after cases of measles in the UK quadrupled in 1 year. Vaccination rates at the time had fallen to just 87.2%. Rates need to be 95% to eradicate the disease.
Johnson called for:
- GPs to promote catch-up vaccinations for children who may have missed out on both doses.
- Social media companies to quash misleading anti-vaccine messages (see Netmums' own content that addresses all vaccine concerns here) and attend a summit to explore how they can better promote accurate vaccination information.
- The government to use the NHS website to address misleading claims about the safety of vaccines.
At the time, Dr Mary Ramsay, head of immunisation at PHE, said:
'It's a real concern that so many young children – as many as a quarter of a reception class in some areas – could be starting school without the full protection that the NHS childhood immunisation programme offers for free.
'We know that parents want the best protection for their children and so many may be unaware that their child is not up-to-date.'
As a result, just 3 years after the virus was eliminated, Britain has now lost its World Health Organization 'measles-free' status.
As parents, we can do our bit, too.
The MMR vaccination is available through the NHS in 2 doses. Normally administered at the age of 1 and as part of the pre-school booster, it's also never too late to have it.
Check your child’s Red Book to ensure they're up-to-date with scheduled immunisations.
Contact your GP if your child still needs it.
Is the MMR vaccine safe?
This outbreak of measles in the UK may be due to the now-discredited doctor, Andrew Wakefield, whose research led to concern about a link between the MMR (measles, mumps and rubella) vaccine and autism.
But hundreds of studies based on millions of cases have since found no link between the MMR vaccine and autism.
The National Autistic Society says the following:
'The National Autistic Society is clear that there is no link between autism and the MMR vaccine.
'We believe that no further attention or research funding should be unnecessarily directed towards examining a link that has already been comprehensively discredited. Instead, we should be focusing our efforts on improving the lives of the 700,000 autistic people in the UK, and their families.
'Much research has been devoted to this issue and the results have repeatedly shown there is no link. This includes a comprehensive review of all available studies on links between autism and vaccines in 2014, using data from more than 1.25 million children.
'In addition, the original research linking the MMR vaccine and autism has been comprehensively discredited and the person who wrote it has been struck off the medical register.'
Unjustified fears lowered uptake of the MMR to about 60 per cent in the capital in 2003 to 2004.
The children who missed their vaccinations then – given as a single injection to babies around 13 months old, and a second injection before starting school between 3 and 5 years old – are teenagers and young adults now.
However, this outbreak may put younger children who have not had their MMR jabs at risk now. Public Health England has informed schools of the situation.
What about MMR as a single jab?
The NHS does not recommend single measles, mumps or rubella vaccines, as there is no evidence to support their use or to suggest that they are safer than MMR.
Having single vaccines could also put your child at risk of catching measles, mumps or rubella in the time between the doses of each of the vaccines.
Some private clinics in the UK offer single vaccines against measles, mumps and rubella, but the NHS does not keep a list of them because clinics that offer these privately are unlicensed, which means there are no checks on their safety and effectiveness.
Why is vaccination so important?
By vaccinating your child, you are not only protecting your child from unpleasant and potentially dangerous diseases, you're also helping to get rid of them altogether.
Research has shown that effective immunisation programmes can help to get rid of diseases: smallpox was eliminated worldwide by 1979 which meant vaccinations against it could finally be stopped.
If immunisation levels fall, diseases have a tendency to rear their ugly head again, which is what's happened with measles.
Last updated: 24 May 2023
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