What are the signs of measles?

Measles is spreading quickly and dangerously in East Asia and the Pacific.

Measles can cause serious illness and death — and children, especially young ones, are most at risk.

It’s a scary reality. But thankfully, you’re not powerless. There are ways to keep children safe.

Here’s what UNICEF experts want parents to know.

“What is measles?”

Measles is one of the most contagious diseases in the world.

It’s caused by a virus that infects the nose, throat and lungs (respiratory tract) and then spreads throughout the body.

Symptoms include a high fever, cough, runny nose and a spotty rash all over the body.

Measles also weakens the immune system, making it vulnerable to other infections. It can lead to severe disease like pneumonia, breathing and neurological complications, diarrhoea, deafness, blindness, and brain swelling (encephalitis), which can be fatal.

Measles can affect anyone but is most common in children under 5 years old.

“How is measles spread?”

Measles spreads easily when an infected person breathes, coughs or sneezes. The measles virus can be spread through their mucus or saliva and can live for up to two hours in the air and on surfaces.

Other people can become infected if they breathe the contaminated air or touch a contaminated surface — and then touch their eyes, nose or mouth.

Measles spreads incredibly quickly — twice as fast as COVID-19 and chickenpox.

The virus is so contagious that if a child with measles walks into a classroom, every unvaccinated child will most certainly get it too.

Measles can be passed to others before the distinctive rash develops. This is one of the reasons that it spreads so quickly among children — it’s passed on before parents even realise that their child has it.

“What are the symptoms of measles in children?”

The early symptoms of measles are vague and can easily be mistaken for other illnesses.

These early symptoms appear 7 to 14 days after encountering the virus and include:

• High fever
• Cough
• Runny nose
• Red and watery eyes
• Small white spots inside the cheeks (Koplik spots)

The measles rash appears 3 to 5 days after these symptoms. It’s a red spotty rash that usually starts on the face and neck before spreading to the rest of the body. It takes around 3 days to spread and usually lasts 5 to 6 days before fading.

The measles rash can appear as small, raised spots that may merge into larger, blotchy areas. It usually doesn’t itch.

On lighter skin, the rash often looks red or brown. On darker skin, the rash might be harder to see.

>> Learn more about measles symptoms from the World Health Organization

“How dangerous is measles for children?”

If your child gets measles, they can become seriously ill — it's more dangerous than many people realize.

The virus attacks the body and can cause deadly complications, especially in young children.

Severe complications of measles can include:

• Blindness
• Deafness
• Severe diarrhoea and dehydration
• Severe breathing problems including pneumonia
• A brain infection (encephalitis) that can occur years later and cause brain damage

Measles can also weaken a child’s immune system of a child and make the body “forget” how to protect itself against infections, leaving children extremely vulnerable to other infections after they’re recovered from measles. This is known as immunity amnesia.

In 2024, 110,000 children died from measles across the world.

Measles and the complications they can cause for children are really scary. But it’s completely preventable if your child is vaccinated.

The best way to protect children is to get them vaccinated against measles.

“How dangerous is measles for babies?”

Measles is especially dangerous for babies under 12 months.

Young babies are more likely to get very sick from measles and die from complications.

This is because in most countries babies aren’t usually vaccinated until they’re over the age of one, so they have no protection against the virus. On top of that, babies' immune systems are still developing, making it harder for their bodies to fight off infections.  

One of the best ways to protect babies is to make sure everyone around them is vaccinated.

“Which children is measles most dangerous for?”

Measles is especially dangerous for:

• Babies
• Children under five years old who have not been vaccinated
• Children who are malnourished, especially those without enough vitamin A
• Children with weak immune systems
• Children with other health conditions, like HIV

“How can I protect my child from measles?”

Getting a measles vaccine is the best way to protect your child from getting measles and spreading it to others.

The measles vaccine can be given alone or combined with vaccines for mumps and rubella. It’s given through a short needle, usually in your child’s arm.

The vaccine is safe and very effective. Children need two doses to make sure they’re fully protected. For most people, this protection lasts for life.

The age that your child should receive their measles vaccines depends on your country.

The first vaccine dose:

• In countries where measles is common, children are usually given the first vaccine dose at 9 months old, as they’re more at risk.
• In countries where measles isn’t common, your child will normally get their first vaccine dose between 12 and 15 months old.

The second vaccine dose:

• Your child should get their second vaccine dose after they are 18 months old.

To find out when your child should be getting their measles vaccines you can ask your doctor for the national immunization schedule or check the Ministry of Health’s website.

“Why are measles cases rising in East Asia and the Pacific?”

Measles is spreading more in recent years because not enough children are getting vaccinated.

During the COVID-19 pandemic, many children missed routine vaccinations, and health systems were overwhelmed, making it harder to track vaccinations and monitor disease outbreaks. Even now, many countries are still working to catch up.

At the same time, misinformation about vaccines has made some parents more hesitant, which has caused vaccination rates to drop.

In East Asia and the Pacific, the number of children vaccinated against measles dropped from 92% in 2022 to 88% in 2023 — leaving 2.4 million children without any protection against measles.

It’s a trend that’s happening globally too. In 2023, more than 22 million children across the world missed their first dose of measles vaccine.

This drop in vaccination has left a big gap in immunity, making it easier for measles to spread. In fact, measles cases rose by 20% in 2023 compared to 2022.

There were an estimated 10.3 million measles cases worldwide in 2023, a sharp reminder of how quickly the virus can resurge and spread across countries and borders when protection levels fall.

To stop measles from spreading and protect all children, at least 95% of children need to be vaccinated with two doses of the measles vaccine in every country. This is what is known as herd immunity.

“My baby is too young to be vaccinated against measles. How can I keep him safe?”

Until babies can get the measles vaccine, they depend on you and others to keep them safe.

If your baby is too young to be vaccinated against measles, you can help better protect them by:

• Keeping your baby away from children and adults who are sick and have symptoms of measles (cough, fever, runny nose, red eyes, rash)
• Regularly washing your hands with soap when caring for your baby
• Making sure your home, especially the bathroom and toilet are kept clean and the windows open, so fresh air can get in
• Keeping your baby's body, nose, throat, eyes and mouth clean
• Continuing to breastfeed
• Feeding your baby healthy first foods when they’re over six months old. More advice on healthy first foods.

• If your baby is at daycare, ask if they clean toys often, and how classrooms are cleaned and ventilated. It’s okay to ask — it helps protect your child and others.

   

“What should I do if my child has signs of measles?”

If your child has symptoms of measles like a fever or a rash, take them to the doctor right away.

Getting medical help quickly is important to treat the illness and avoid serious problems. It also helps stop the infection from spreading to others.

Keep your child at home and away from other people until a doctor has checked them. Then follow the doctor’s advice for care and treatment.

The World Health Organization recommends that all children with measles get two doses of vitamin A, 24 hours apart. This will be given to your child by the doctor.

Vitamin A helps reduce the risk of eye damage, blindness and death — and boosts your child’s immunity. Vitamin A is especially important for children under 2 years old and in areas where malnutrition is common.

“How do I look after a child with measles?”

Measles can’t be treated with medicine. The body has to fight it off naturally.

If your child has measles and the doctor has advised they recover at home, you can help feel them better and avoid serious problems by:

• Helping them rest and relax: Make sure your child gets lots of sleep and takes it easy.
• Keeping them comfortable: Make sure the room is quiet, close the curtains and dim the lights.
• Keeping them hydrated: Encourage your child to drink plenty of water —especially if they have diarrhoea, or are vomiting, to stop them getting dehydrated. Treatments for dehydration, such as oral rehydration salts (ORS), can replace lost fluids.
• Continuing to breastfeed, if you already are.
• Feeding them a healthy diet: Eating healthy food also helps the body recover.

>> Tips on healthy foods for children aged 6 months to 3 years.

If your child is malnourished, they should receive treatment by health professionals.

If your child’s symptoms start getting worse, go to the hospital immediately. 

“My child is over age 5. But I can’t remember if they were vaccinated against measles. What should I do?”

If you can’t remember if your child has been vaccinated against measles and there are no vaccination records, speak to your local health facility about getting your child vaccinated.

There is no harm in your child getting vaccinated with more doses of the measles vaccine if they have been vaccinated before.

“How dangerous is measles for pregnant women ?”

It’s important to know that measles can be serious during pregnancy, both for pregnant women and their babies.

The most common issue for pregnant women who get measles is pneumonia, which affects about 1 in 5. Frighteningly, in rare cases it can lead to death. Measles can also increase the chance of premature birth — about 13 out of 100 pregnant women who get measles may deliver early.

If you’re not pregnant yet, get the measles vaccine before trying to conceive — as it’s not recommended during pregnancy.

If you’re pregnant and not vaccinated against measles:

• Stay away from people with fever, rash, or flu-like symptoms — especially during measles outbreaks.
• Make sure people close to you (partner, children, family) are fully vaccinated to reduce your risk.

• If you think you’ve been exposed to measles, contact your doctor immediately.

   

“Will measles outbreaks get worse?”

Worryingly, it’s likely that measles outbreaks will get worse.

To stop outbreaks, we rely on something called herd immunity. This happens when enough people in a community are protected from a disease — usually through vaccination — so the disease can’t spread easily. That way, even people who can’t be vaccinated, like young babies, are kept safe because the virus has fewer chances to spread.

For measles, we need at least 95% of the population vaccinated to create strong herd immunity. But right now, we’re falling short.

In East Asia and the Pacific in 2023, just 88% of children had been vaccinated against measles. Worldwide, the number was even lower — just 74%. That leaves millions of children unprotected and allows the virus to keep spreading.

Until more children are vaccinated, babies and other vulnerable people will stay at risk.

That’s why it’s so important to make sure your child gets both doses of the measles vaccine. It not only protects them but also helps stop the spread in your community. And if there’s an outbreak where you live, keep unvaccinated babies away from anyone who might be sick.

“How dangerous is measles for adults?”

Measles mostly affects children, but adults can catch and spread it too — especially if they haven’t been vaccinated or their protection has worn off.

During measles outbreaks, adults can make up 10 to 20% of all cases.

This is worrying because adults can pass measles to young children, who are more likely to get seriously ill.

Unvaccinated young children and pregnant persons are at highest risk of severe measles complications.

“How long can someone with measles spread it to others?”

People with measles can spread the virus even before they know they have it.

They’re contagious for about 8 days — starting 4 days before the rash shows up and lasting until about 4 days after.

That means even if your child just has a fever, cough, runny nose, or red eyes, they could already be spreading measles to others.

Symptoms usually appear 7 to 18 days after being exposed, so it’s important to be careful if you think your child might have been around someone with measles.

We know that rising measles cases can be scary. But remember, by staying informed and making sure your children are vaccinated, you’re taking powerful steps to protect your loved ones from harm.