Measles
Everything you need to know about Measles - symptoms, causes, treatment options available in Australia, and when to see a doctor. Evidence-based medical information.
Overview
Measles is a highly contagious viral infection caused by the measles virus, a member of the Paramyxoviridae family.
How it works in your body (pathophysiology):
Measles affects your body through specific biological processes:
- Rapid transmission: Measles spreads quickly, especially in young children and people with weak immune systems.
- Respiratory system impact: The virus mainly targets the respiratory system (lungs and airways).
- Immune system suppression: Measles can weaken your immune system temporarily. This makes you more likely to get other infections.
- Virus entry and spread: The virus enters through your respiratory tract (nose and throat). It first infects the epithelial cells (cells lining the surfaces).
- Lymphatic system involvement: After initial infection, the virus moves to the lymphatic system (part of the immune system).
- Viraemic phase: The virus then spreads throughout your body in the bloodstream.
Statistics and Prevalence in Australia
In 2024, Australia reported 57 cases of measles, reflecting a low prevalence but indicating the presence of the disease primarily linked to international travel. Despite these cases, Australia maintains its "measles elimination" status, a testament to the effectiveness of its vaccination programmes and public health measures [1]. However, early 2025 saw an increase in cases, particularly among children under four and adults aged 25–29, underscoring the need for continued vigilance and vaccination efforts [1].
Symptoms and Clinical Presentation
Measles typically presents with an initial prodromal phase characterised by fever, malaise, cough, coryza (runny nose), and conjunctivitis. These symptoms are often followed by the appearance of Koplik's spots—small white lesions on the buccal mucosa, which are pathognomonic for measles [3]. The most recognisable feature of measles is the maculopapular rash, which usually begins on the face and spreads cephalocaudally to the trunk and extremities.
Red flag symptoms requiring immediate medical attention include high fever, difficulty breathing, persistent cough, and signs of dehydration. Complications such as pneumonia, encephalitis, and subacute sclerosing panencephalitis (SSPE) can occur, particularly in those with weakened immune systems [4].
Causes and Risk Factors
Measles is caused by the measles virus, which is transmitted via respiratory droplets from coughs and sneezes of infected individuals. Risk factors for contracting measles include being unvaccinated, travelling to areas with high measles prevalence, and having a weakened immune system [2]. The virus's ability to suppress the host's immune response further exacerbates the risk of complications and secondary infections [3].
Diagnosis
Diagnosis of measles in Australia is guided by clinical suspicion based on symptomatology and confirmed through laboratory testing. The Royal Australian College of General Practitioners (RACGP) and the National Health and Medical Research Council (NHMRC) recommend serological testing for measles-specific IgM antibodies and nucleic acid amplification tests (NAAT) such as PCR from respiratory specimens and urine [2][4]. The Public Health Laboratory Network (PHLN) provides detailed protocols for specimen collection and testing, ensuring accurate diagnosis and public health management [3].
Treatment Options in Australia
There is no specific antiviral treatment for measles; management is primarily supportive. This includes maintaining hydration, managing fever with antipyretics, and addressing any secondary bacterial infections with appropriate antibiotics [2]. Vitamin A supplementation is recommended for children with measles, as it has been shown to reduce morbidity and mortality [4].
In Australia, treatment protocols are aligned with national guidelines, and the Pharmaceutical Benefits Scheme (PBS) provides coverage for necessary medications. The Medicare Benefits Schedule (MBS) supports diagnostic testing and follow-up care, ensuring accessible healthcare services for all Australians [3].
Living with Measles
Management of measles involves not only addressing the acute symptoms but also monitoring for potential complications. Patients should be advised to rest, maintain adequate fluid intake, and avoid contact with others to prevent transmission. Follow-up care is crucial for monitoring recovery and managing any long-term effects, particularly in cases with complications [4].
Patient education is a key component of measles management, emphasising the importance of vaccination and understanding the signs of complications. Psychosocial support may be necessary for families dealing with severe cases, and healthcare providers should ensure coordinated care, especially in rural and remote areas where access to services may be limited [3].
Prevention
Vaccination remains the cornerstone of measles prevention. The measles-mumps-rubella (MMR) vaccine is highly effective and is part of the National Immunisation Programme in Australia. It is recommended that children receive two doses of the MMR vaccine, with the first dose at 12 months and the second at 18 months [2].
Public health strategies also focus on maintaining high vaccination coverage, rapid identification, and isolation of cases, and providing post-exposure prophylaxis to susceptible contacts. These measures are essential to prevent outbreaks and maintain Australia's measles elimination status [1].