11 Measles

Key information

Mode of transmission By direct contact with infectious droplets or, less commonly, by airborne spread. Measles is one of the most highly communicable of all infectious diseases.
Incubation period About 10 days, but may be 7–18 days from exposure to onset of fever. The incubation period may be longer in those given immunoglobulin after exposure.
Period of communicability From 5 days before to 5 days after rash onset, counting the day of rash onset as day 1.
Herd immunity threshold To prevent recurrent outbreaks of measles, 95 percent of the population must be immune.
Funded vaccine Measles-mumps-rubella vaccine (MMR II) is a live attenuated vaccine.
Funded vaccine indications and schedule Children at ages 15 months and 4 years.

Adults who are susceptible to one or more of measles, mumps and rubella. Susceptible adults are:
  • individuals born after 1968 with no documented history of 2 doses of measles-containing vaccine after age 12 months
  • ​individuals with no documented measles IgG antibody.
For (re-)vaccination following immunosuppression (seek specialist advice).
Vaccine efficacy/effectiveness Measles vaccines are highly efficacious, and immunisation programmes have controlled measles to the point of elimination in many populations.
Egg allergy Egg allergy, including anaphylaxis, is not a contraindication for MMR vaccine.
Adverse events to vaccine MMR vaccine is generally well tolerated. The risk of adverse reactions to MMR vaccine is low compared to the risk of complications from measles disease.
Public health measures Notify the local medical officer of health immediately on suspicion.

Prevent measles transmission through exclusion and use of personal protective equipment.

Promote immunisation to susceptible individuals.

Management of contacts of measles cases should be discussed with the medical officer of health.