Measles is an infection caused by a highly contagious virus. When someone with the virus coughs or sneezes, contaminated respiratory particles spread through the air and land on nearby surfaces. Your child can catch the virus by inhaling these particles or by touching them and then touching their face, mouth or eyes.
Your child is more likely to develop measles if they do not have the measles vaccination, and if they travel to other countries, where measles is more common, without being vaccinated. Vaccination can be considered for children as young as 6 months of age if they are travelling to an at-risk area—talk to your health-care provider. Your child is also more likely to be exposed to measles if overall measles vaccination rates drop in your community. It is important to catch up on all delayed or missed vaccinations.
Signs and symptoms of measles
Common symptoms of measles include:
- a fever that lasts for a couple of days
- a cough, runny nose, and red and watery eyes (conjunctivitis)
- a rash that starts on the face, upper neck and behind the ears, and then spreads down the body before spreading to the arms, hands, legs and feet
After about five days, the rash fades in the same order it appeared.
How measles spreads
Measles is a very contagious disease. It spreads very easily from one person to another and can also spread in the air.
The measles virus lives in the nose and throat of infected people. When an infected person sneezes or coughs, respiratory particles spray into the air. The virus can stay in the air or land on surfaces nearby, where the virus can spread for up to two hours. Sharing the same room or area with someone who has measles, even for a brief period of time, can be enough to transmit the infection to someone who is not immune. This is why parents need to call ahead before going to their doctor, a clinic or the emergency department when they suspect their child has measles so that precautions can be put in place to prevent further spread.
People with measles are usually contagious from four days before, until four days after the rash appears. Children with immune system problems may stay contagious much longer.
How measles is diagnosed
Measles is diagnosed by a physical examination of your child. The health-care provider may also order blood and urine tests and viral swabs from the nose or throat. If you think your child has measles, call your child’s health-care provider, the clinic or emergency department before going to see them so the infection is not passed on to other patients.
How to prevent measles
The only way to prevent measles and its complications is to receive measles vaccinations. The measles vaccine is available free of charge in many countries. Children receive two doses of the measles vaccine.
- The first dose is usually given soon after your child's first birthday.
- The second dose is usually given when your child starts kindergarten.
Measles is included in the measles, mumps and rubella (MMR) and measles, mumps, rubella and varicella (MMRV) vaccines. Ask your child's health-care provider if your child's measles vaccination is up to date.
Reactions to the vaccine
When given the measles vaccine, some children develop mild symptoms. Often, a pink rash appears about seven to 10 days after the vaccination. This rash lasts for about three days. The child may also develop a mild fever and minor joint pain at the same time as the rash. If you are concerned in any way, call your child’s health-care provider.
Importance of measles vaccination
Since the introduction of the measles vaccine in Canada, the number of measles infections fell from an estimated 400,000 cases a year in 1963 to only 29 cases in 2018.
In countries where the vaccine is free and readily available, vaccination has helped to reduce measles to very low levels. However, measles is still common in many parts of the world and because not all children are being vaccinated, measles is becoming more common in many countries that previously had low levels of infection. You, your child and your family should be vaccinated against measles to protect yourself from the disease and its complications, especially if you are travelling to other countries. In some cases, vaccination may be recommended as early as six months of age. If a dose of measles vaccine is given early, an additional second and third dose would still be needed according to the routine schedule. Talk with your child’s health-care provider before travelling.
Complications of measles
Complications are dangerous and rates are highest in young children. About a quarter of children under five years of age with measles will require admission to hospital. Some children with a measles infection will also get an ear infection, diarrhea or even pneumonia.
Rarely, some children who have measles also get a swelling or infection of the brain (encephalitis). Severe cases of encephalitis can lead to seizures, hearing loss, brain damage or death.
Children with vitamin A deficiency who get measles can become blind.
Caring for your child at home
There is no specific treatment for measles. You can support your child by trying to make them comfortable.
Monitor the fever
You can use acetaminophen or ibuprofen to treat the fever. Do not give ASA (acetylsalicylic acid, Aspirin) to children.
Isolate your child and allow them bed rest
Your child should isolate at home (e.g., cannot go to school or daycare) until at least five days after the rash first appears. In Canada, cases of measles are reported to the Public Health Department. They will follow up with you about when it is safe for your child to return to their daily routine.
Give your child fluids
Offer your child water and other fluids often.
When to see a doctor
Call your child's regular health-care provider if:
- your child's fever does not lessen four days after the rash starts
- your child's coughing gets worse
- your child develops ear pain
Take your child to the nearest Emergency Department or call 911 if your child:
- becomes short of breath or develops persistently noisy breathing
- shows a change in behaviour or movement problems
- has a seizure
- develops a severe headache or persistent vomiting
Let the clinic or emergency department know your child may have measles before you arrive so that precautions can be made to prevent the spread of the infection to others.
Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to spot these signs in order to seek help from a health-care provider.
References
Government of Canada. (2019, April 1). Measles in Canada. Retrieved from https://www.canada.ca/en/public-health/services/diseases/measles/measles-in-canada.html