Measles vaccine, rash and symptoms: All you need to know as experts suggest MMR vaccine should be made compulsory for children

Experts have warned that measles vaccinations should be made compulsory for children starting primary school in a bid to control it.

Italian researchers found that current vaccination policies are not enough to keep the disease at elimination status and said more action is need to tackle it.

In the UK, falling vaccination rates have been blamed on misleading campaigns claiming vaccinations are dangerous. Just last month, Unicef announced that more than 500,000 children in the UK were unvaccinated against measles between 2010 and 2017.

And earlier this year, the World Health Organisation (WHO) revealed that the number of cases identified worldwide had surged 50% this year compared to 2017.

So what are measles and what are the symptoms to watch out for? Here’s everything you need to know.

What is measles?

According to the WHO measles is a highly contagious, and sometimes fatal disease which remains an “important cause of death among young children”.

It is a viral illness of the respiratory system which, if left untreated, can have serious health complications including infection of the lungs and brain.

The disease can spread through contact with infected mucus and saliva. 

Katherine O’Brien, WHO’s director of immunisation and vaccines, said: “Our data are showing that there is a substantial increase in measles cases. We’re seeing this in all regions.

“We’re having outbreaks that are protracted, that are sizeable and that are growing. This is not an isolated problem.”

What are the symptoms of measles?

According to the NHS, the initial symptoms of measles typically develop around ten days after you’ve been infected.

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 which may reach around 40 C
• small, greyish-white spots on the inside of cheeks

A few days later, a red-brown blotchy rash will appear, usually starting on the head of the upper neck before spreading to the rest of the body.

How do you spot a measles rash? 

A rash will usually appear after the first few days of feeling ill. 

The NHS identifies four key characteristics of a measles rash: 

• made up of small red-brown, flat or slightly raised spots that may join together into larger blotchy patches.
• usually first appears on the head or neck before spreading outwards to the rest of the body.
• slightly itchy for some 
• can look similar to other childhood conditions, such as slapped cheek syndrome, roseola or rubella.

When was the latest measles outbreak?

Philippines was in the midst of an outbreak earlier this year, which led to the death of at least 70 people, mostly children.

Thousands of cases have also been reported in the East African country of Madagascar. The WHO said: “from October 2018 through 12 February 2019 a total of 66,278 cases and 922 deaths have been reported.”

The WHO says that in poorer countries, lack of access to vaccination services is one of the main reasons behind the spike of confirmed cases.

Meanwhile, in August 2018 measles cases in Europe hit a record high, with more than 41,000 people being infected in the first six months of the year.

Figures out in April from Unicef showed that over half a million children in the UK were unvaccinated against measles between 2010 and 2017.

In the UK in 2017, there were 259 measles cases in England, rising to 966 in 2018.

In 2016 and 2017, uptake of the first dose of the MMR vaccine in five-year-olds in the UK exceeded 95%.

But uptake of the second dose of MMR in five-year-old children is 88% – well below the 95% WHO target.

Experts say cases in Europe and other wealthy areas are the result of misinformation about the MMR vaccine.

Is measles deadly?

Measles will usually pass in around 7 to 10 days, but in some cases, it can lead to potentially life-threatening complications.

These include meningitis, febrile convulsions, liver infection (hepatitis), pneumonia and encephalitis (infection of the brain).

Can you get measles more than once?

Once you’ve developed immunity after a vaccination or suffered from measles once, your body builds up a tolerance, so it’s unlikely you’ll get measles again.

Who is most at risk of developing measles?

Unvaccinated children are most at risk of developing measles and contracting its subsequent complications.

Pregnant women are also at risk.

Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected by the virus.

How can you prevent measles?

Routine measles vaccinations for children have been in use for the past 50 years.

According to the WHO, in 2016 about 85% of the world’s children received 1 dose of measles vaccine by their first birthday through routine health services.

In the UK, measles is prevented by giving the measles, mumps and rubella (MMR) vaccine, which is given in two doses as part of the NHS childhood vaccination programme.

Alternatively, a treatment called human normal immunoglobulin (HNIG) is used if you’re at immediate risk of catching measles.

How do you treat measles?

There is no specific antiviral treatment that exists for measles, but there are several measures you can take to help relieve your symptoms.

These include:

• taking paracetamol or ibuprofen to soothe fever, aches and pains
• staying hydrated by drinking plenty of water
• keeping the curtains closed to reduce light sensitivity
• using damp cotton wool to clean the eyes
• taking time off work or school for at least 4 days when the rash first appears.

The WHO also recommends that children diagnosed with measles should receive two doses of vitamin A supplements to prevent the risk of eye damage.

Who should have the MMR vaccine? 

The first dose of MMR vaccine is offered to all children at one year old.

Children are given a second dose of MMR before they start school, usually at three years and four months.

There are certain circumstances where children should not have the MMR vaccination, which goes into detail on the NHS website.

Adults who missed out on the MMR vaccine as a baby and are therefore not immune can have the MMR vaccine on the NHS.

Is the MMR vaccine safe?

In the 1980s, there was some controversy about whether the MMR vaccine might cause autism following a 1998 study by Dr Andrew Wakefield.

This caused a dramatic drop in the number of children being vaccinated.

There was later found to be no evidence to link the MMR vaccine and autism.

Whilst the MMR vaccine may not work for everyone and cause side effects in some children, the vaccine is generally recognised as safe.

However, deciding whether or not to get your child vaccinated is a personal choice, so make sure you speak to your GP who can best advise you.

In 2016 the WHO announced the UK had eliminated it because of the effectiveness of the vaccine.