Measles
Measles is a highly infectious disease caused by a virus. It is most common in children and is spread by coughing, sneezing or sometimes kissing.
After the person has been infected by the virus it usually takes 4-12 days (but sometimes up to 21 days) for the illness to develop – the ‘incubation period’.
A person with measles is infectious from two days before any symptoms show to at least five days after the onset of the rash. Children should be kept away from school or childcare facilities throughout this infectious period.
If there are no complications, the illness usually clears up after about 10 days. An acute infection of measles almost always gives lifelong immunity. Measles is very common in many overseas countries and is responsible for more than a million childhood deaths each year.
Symptoms of measles
First symptoms include:
Fever
Weakness
Loss of appetite
Red, sore, watery eyes and an inability to tolerate light
Blocked or runny nose
Dry cough
Sore throat
Swollen neck glands.
Day 3 symptoms: By the third day, tiny white-blue spots may be seen inside the mouth, which may have a fine red circle around them. These are called Koplik’s spots. They do not last very long and are not seen in every case of measles.
Days 3 to 5: After 3 to 5 days a blotchy, flat red rash appears. It usually starts behind the ears then spreads to the face, body and then the arms and legs. The rash may or may not be itchy. The child is usually most unwell for the first day or two after the rash starts.
Complications from measles
Measles is often a serious disease that can lead to complications in up to a third of people affected. Complications include ear infections, pneumonia and swelling of the brain. Sometimes measles can be fatal or lead to permanent brain damage.
Measles during pregnancy can cause miscarriage, premature labour and low birth weight in babies. There is also a risk of the mother dying.
Vaccination
There is no specific treatment available for measles (other than relieving the symptoms) so preventing it by immunisation is very important. The National Immunisation Schedule includes the free measles vaccine in its MMR (measles-mumps-rubella) vaccine.
Children who are immunised according to the schedule receive the MMR vaccine at ages 15 months and 4 years. Measles vaccine induces long-term (probably life-long) immunity in most individuals. The chances of complications from a MMR vaccine have been shown to be much lower than the chances of developing complications from measles itself.
See Your Pharmacist or Medical Professional
You should always contact your doctor if you think your child has measles, but phone first: Due to the highly infectious nature of measles, it is best to phone the surgery for advice before taking your child there. You can also phone Healthline for advice on Freephone 0800 611 116.
See your doctor again if your child:
Has ear pain
Is having trouble breathing
Is complaining of having a stiff neck
Is very drowsy or cannot be woken
Is coughing up green or yellow mucus
Has a fit
Has not passed urine for 10 hours
Has a green or dark yellow discharge from the eyes
Remains unwell after the rash subsides.
Meningitis
Meningitis is a medical emergency that can cause permanent disability and death. Meningitis is a different infection from measles, but as there can be some similar symptoms, it is important for parents to be aware of the signs. Meningitis can affect infants, children and adults.
Meningitis can occur very suddenly and requires immediate medical treatment – see a doctor urgently or call 111 for ambulance.
For more information on signs of meningitis, click here
Treatment Tips
Treatment tips for measles
Wash hands frequently, especially after tending to a sick child
Observe children frequently and seek urgent medical advice if they appear to be getting worse
Dress the child in light, loose fitting clothing or pyjamas. Overheating and friction from clothing can worsen itching
Encourage the child to drink plenty of fluids
Offer soft foods and cool drinks regularly as many illnesses affect the mouth and throat
Avoid salty foods and citrus fruits
Encourage the child to get plenty of rest
Lie the child down in a darkened room if light hurts their eyes
Keep the child at home to avoid spreading the infection
Give paracetamol or ibuprofen occasionally to relieve a child's discomfort if necessary (see Treatment options below)
Do not give aspirin to children under 16 years old because it may cause Reye’s syndrome – a serious condition
Avoid scratching skin – cut nails extra short
Try using an anti-itch product if itching is a problem (the rash may or may not be itchy)
If eyes are sticky or crusty they can be washed gently with a teaspoon of salt dissolved in 500ml of warm, previously boiled water. Use clean cotton wool or a very clean flannel and use a separate piece/part for each eye to avoid spreading infection
Steam in the bedroom or sitting the child on your knee in a steamy bathroom may give some relief if a dry cough is a problem. A mist vapouriser can also be used to make the air more humid and soothe dry, irritated airways
cough medicines may be soothing and give some relief (however, most cough medicines have ingredients that are not recommended for children under age 6 years; ask your pharmacist for product advice for young children)
If your child has not been immunised and comes into contact with someone with measles, having your child vaccinated with the measles vaccine within 72 hours may stop them from getting the disease.
Treatment Options
Always discuss treatment options with your pharmacist to ensure the best outcome.
Medications to reduce fever and relieve pain
[PHARMACY ONLY]
e.g., paracetamol liquid preparations (Children’s Panadol Colour-free Suspension, Pamol Infant Drops, Pamol All Ages, Paracare for Babies & Young Children 3 months to 6 yrs, Paracare for Children 6+ yrs & Adults), ibuprofen liquid preparations (Fenpaed, Nurofen for Children)
Paracetamol is suitable for most people but it is important only to give it occasionally and not to give more than the recommended dose – check labels for dosage instructions appropriate to the age of the child
Paracetamol is a common ingredient in other medicines, e.g., cold and flu preparations, (which may be used by adults and adolescents) so be careful not to double dose
Vaccinations: paracetamol is not recommended for routine use before or after vaccination (i.e., it is not recommended to give it 'just in case' of discomfort) as it may reduce the ability of some vaccinations to stimulate long-lasting immunity
Paracetamol and ibuprofen are also available in other forms (e.g., tablets), which are often [GENERAL SALE] medicine – these may be preferred by older children and adults (check labels for dose appropriate to age – you can also ask your pharmacist for individualised advice)
Ibuprofen is not suitable for everyone.
Check with your pharmacist before giving ibuprofen if the child/person:
Is dehydrated
Has a history of stomach problems, such as ulcers or indigestion
Has asthma – some people with asthma find their condition is made worse by these types of medicines
Has kidney problems or a heart condition
Takes other medications.
Topical anti-itch products (if itch present)
[GENERAL SALE]
e.g., Pinetarsol, Eurax, Calamine lotion
Pinetarsol can be added to bathwater or diluted and dabbed onto skin to relieve itching
Eurax cream can be used as long as the skin is unbroken
Calamine lotion is a traditional remedy for itchy skin but may be quite drying
Baking soda (sodium bicarbonate) may also relieve itching – add half a cup to a warm bath.
Oral anti-itch products (if itch present)
[PHARMACIST ONLY]
e.g., Phenergan
Phenergan contains promethazine which is an antihistamine that can reduce itching. Promethazine can cause drowsiness and can assist with sleep, which may be helpful if the child is scratching at night.
Promethazine is available as [PRESCRIPTION ONLY] medicine if the child is under two years old.
Natural/herbal products/supplements
e.g., honey, echinacea, vitamin A cream, calendula ointment, zinc cream
One to two teaspoonfuls of honey at night can help relieve a dry cough associated with measles
Children's echinacea may help boost immunity
Vitamin A cream, calendula ointment and zinc cream may help relieve irritated skin.
More Information
Phone helplines
If you are concerned about your child and need advice there are two phone helplines available:
Plunketline on 0800 933 922 – for information and advice on parenting and health issues for children under five years
Healthline on 0800 611 116 – for advice about health concerns for people of all ages
Both numbers are staffed 24 hours a day by registered nurses or other health professionals. Calls to either line (within New Zealand) are free and confidential.
For more detailed information about immunisation, see the topics Child immunisation and Measles on www.everybody.co.nz
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
