Measles in children: symptoms, complications, isolation and vaccination

The NHS says measles usually starts with cold-like symptoms, followed by a rash a few days later, and that some people also get small spots in the mouth. The first symptoms include a high temperature, runny or blocked nose, sneezing, a cough and red, sore, watery eyes.

NHS inform says the first symptoms develop around 10 days after infection, that a fever can reach around 40C, and that small greyish-white spots may appear in the mouth. The rash appears around 2 to 4 days after the first symptoms and normally fades after about a week. It is made up of small red-brown, flat or slightly raised spots that may join into larger blotchy patches, usually starts on the head or neck before spreading outwards and is not usually itchy. It may be harder to see on brown and black skin.

NHS inform lists people under 12 months old, people with a weakened immune system even if immunised, and pregnant women as at greater risk of measles or of complications. The NHS says that if you get measles when you are pregnant it could harm your baby, causing miscarriage or stillbirth, premature birth or low birthweight.

The NHS says measles can lead to serious problems if it spreads to the lungs or brain: pneumonia, meningitis, blindness and seizures. These are rare, but some people are more at risk. NHS inform names pneumonia and encephalitis as potentially life-threatening complications, and says in severe cases a child may need admission to hospital.

The NHS says to ask for an urgent GP appointment or call 111 if you think a child has measles, if a child under 1 has been in contact with measles, if a pregnant woman or someone with a weakened immune system has been in close contact, if someone unvaccinated has been in close contact, or if there is a high temperature that has not come down after paracetamol or ibuprofen, difficulty breathing, poor feeding, less peeing or a very unwell child. Because measles spreads easily, call the surgery before going in.

The NHS says to call 999 or go to A&E if a child with measles:

• has a seizure (fit)

• has severe difficulty breathing, such as gasping, choking, grunting or the stomach sucking under the ribcage

• cannot stay awake or suddenly becomes confused

• is limp, floppy or not responding normally

• has a rash that does not fade under a glass, or a stiff neck or light that hurts the eyes

After a GP has seen the child, the NHS suggests rest, plenty of fluids, paracetamol or ibuprofen for children if distressed or uncomfortable (checking the leaflet) and gently removing eye crusts with cotton wool soaked in water that has been boiled and cooled. NHS inform adds that aspirin should not be given to children under 16. The NHS also advises opening windows and doors to reduce spread, taking care with safety catches where there are young children.

UKHSA lists measles as requiring people to stay away from the setting until 4 days after the rash started, and asks settings to contact their local health protection team. The NHS says to stay off nursery, school or work for at least 4 days from when the rash first appears and to avoid close contact with babies and anyone who is pregnant or has a weakened immune system.

The NHS says the MMRV vaccine is offered to all young children in the UK and the MMR vaccine is recommended for adults and older children who were not vaccinated when younger, free on the NHS from the GP. NHS inform says the MMR vaccine is given in 2 doses and that anyone can be vaccinated at any age if not fully vaccinated, and that human normal immunoglobulin can be used for people at immediate risk when the vaccine is not suitable.