Measles

One of the most contagious infections there is. It starts like a bad cold with sore red eyes, then a blotchy rash spreads from the face down. Two doses of MMR vaccine protect about 99 in 100 people.

Quick answer: Measles is a highly contagious virus. It starts with fever, cough, runny nose and red eyes, then a blotchy rash spreads from the face down 2 to 4 days later. It can cause pneumonia and brain swelling. Two MMR doses protect about 99%. If you think you have it, phone before visiting a clinic to protect others.

How it spreads. Through the air when an infected person breathes, coughs or sneezes. The virus can hang in the air of a room for up to 2 hours after they leave. About 9 in 10 people who aren’t immune catch it after close contact. People are infectious from about 4 days before the rash appears until 4 days after.

The measles timeline

• Exposure to first symptoms: usually 10 to 14 days (range about 7 to 21 days).
• The first 2 to 4 days: fever (often high), cough, runny nose, red watery eyes and feeling very unwell. Tiny white spots inside the cheeks (Koplik spots) can appear.
• Rash: red-brown blotches start on the face and behind the ears, then spread down the body to the arms and legs over about 3 days. The fever often peaks as the rash appears.
• Recovery: the rash fades in the same order after about 5 to 6 days. The cough can last up to 2 weeks.

Complications

Complications are most common in children under 5, adults, pregnant women, people with a weakened immune system and children who are malnourished. Per the Australian Immunisation Handbook:

• Ear infection in about 9 in 100 people, and diarrhoea in about 8 in 100
• Pneumonia in about 6 in 100; it causes most measles deaths in children
• Brain inflammation (encephalitis) in about 1 in 1,000, which can cause permanent brain damage
• Subacute sclerosing panencephalitis (SSPE): rare, always fatal, appearing on average 7 years later
• In pregnancy: miscarriage, stillbirth and preterm birth
• Measles also weakens the immune system for weeks to months afterwards, raising the risk of other infections

In high-income countries, about 1 to 3 in 1,000 children with measles die. Worldwide, WHO estimates there were about 10.3 million cases and 107,500 deaths in 2023, mostly in unvaccinated children under 5.

Think it might be measles? Phone first. Call your GP, clinic or emergency department before you go, so they can see you away from the waiting room, and wear a mask if you can. In Australia you can also call healthdirect on 1800 022 222. Call 000 (Australia) or your local emergency number for trouble breathing, a seizure, unusual drowsiness or confusion, or a severe headache with a stiff neck.

Treatment

There’s no specific antiviral. Care is rest, fluids, and paracetamol or ibuprofen for fever. WHO recommends vitamin A for children with measles, as it lowers the risk of complications and death, especially where vitamin A deficiency is common; your doctor will advise. Antibiotics are only for bacterial complications such as ear infections or pneumonia. Stay home, away from others, until at least 4 days after the rash appeared.

The MMR vaccine

Measles-mumps-rubella vaccine is a live vaccine that gives long-lasting protection.

• How well it works: about 95 in 100 are protected after 1 dose and about 99 in 100 after 2.
• In Australia: MMR at 12 months and MMRV (which adds chickenpox) at 18 months, free under the National Immunisation Program. Babies from 6 months can have an early dose before travel to areas with measles; it doesn’t count, so they still have their 12- and 18-month doses.
• Adults: anyone born in or after 1966 (Australia) should have 2 documented doses. If you’re not sure, a catch-up dose is safe; ask your GP or pharmacist. Most people born before 1966 are immune from childhood infection.
• Not in pregnancy: MMR is a live vaccine, so avoid pregnancy for 28 days after it. Check immunity before pregnancy if you can.
• After exposure: MMR within 72 hours can prevent measles. For babies, pregnant women and people with weak immune systems, public health teams may arrange immunoglobulin within 6 days.
• Autism myth: large studies, including a Danish study of over 650,000 children, show MMR doesn’t cause autism.

Measles parties are a terrible idea. Catching it for immunity means risking pneumonia and brain swelling for something two jabs give you safely.

Outbreaks

Measles cases have risen worldwide since vaccination rates fell during the COVID-19 pandemic. About 95% of people need 2 doses to stop it spreading. Canada lost its measles elimination status in November 2025 after more than 5,000 cases, and large outbreaks have occurred in the US and Europe. In Australia, measles was declared eliminated in 2014, but travellers bring it in and cause local outbreaks; health departments publish lists of exposure sites. Check you’re up to date before overseas travel.

See your GP (phone first) if

• You or your child has a fever and rash, especially after travel or a known exposure
• You’ve been near someone with measles and aren’t sure you’re immune: the 72-hour window matters
• You’re pregnant, have a baby under 12 months, or have a weakened immune system and may have been exposed
• You’re not sure you’ve had 2 doses of a measles vaccine

Health days. World Immunization Week is in the last week of April: see our health days calendar.

Evidence and more information

• WHO: Measles fact sheet
• Australian Immunisation Handbook: Measles
• CDC: Measles clinical overview
• Hviid et al, Ann Intern Med 2019: Measles, mumps, rubella vaccination and autism
• CIDRAP 2025: Canada loses measles elimination status
• healthdirect: Measles
• NHS: Measles

Updated 8 November 2026. General education, not personal medical advice. Talk to your GP or pharmacist about your situation.

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