What you need to know about measles
Symptoms, treatment and prevention

What is measles?
SCHOOL-BASED VACCINATION CAMPAIGN
The HPV school-based vaccination programme takes place at the same time as the national measles campaign – which is also administered in schools.
It is safe for a girl to get the HPV vaccine and the measles vaccine at the same time.
Measles is a childhood infection caused by a virus. It spreads easily and can be fatal for small children. Due to a decrease in children vaccinated for measles, there have been measles outbreaks reported recently in some provinces in South Africa, with several cases identified.
We’ve put together all you need to know about measles and how to protect your child from infection.
Causes and symptoms of measles
Measles is a highly contagious disease. About one in every four people who get measles will be hospitalized. Measles typically starts with an elevated fever, cough, runny nose and watery eyes, and then a rash appears three to five days later. Coughing and sneezing allow the virus to spread through the air and onto surfaces, infecting others if they breathe the contaminated air or touch the infected surface. In fact, the measles virus can live for up to two hours on a surface or in respiratory droplets in the air in a closed space.
Measles spreads through the air by respiratory droplets from infected persons when coughing or sneezing. Children can get measles just by being in a room where a person with measles has been, even up to two hours afterwards.
Measles symptoms only appear 10 to 14 days after exposure and include:
- fever, dry cough, sneezing and a runny nose
- inflamed & watery eyes and a sore throat
- tiny white spots on the inner lining of the cheek
- a red, blotchy skin rash
The infection occurs in these stages over 2 to 3 weeks
- Infection and incubation: For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
- Nonspecific signs and symptoms: Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat. This relatively mild illness may last 2 to 3 days.
- Acute illness and rash: The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.
Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 40 to 41 degrees Celsius. - Recovery: The measles rash may last about seven days. The rash gradually fades first from the face and last from the thighs and feet. As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.
When can a person spread the measles virus?
A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.
Measles spreads in various ways:
- By airborne respiratory droplets (coughs or sneezes).
- By saliva (kissing or shared drinks).
- By touching a contaminated surface.
- By skin-to-skin contact (handshakes or hugs).
- By mother to baby contact during pregnancy, labour or nursing.
What happens when a child gets measles?
- Most children who have measles are sick for less than a week, and should start to feel better about two days after the rash appears. The cough may persist for two weeks.
- Sometimes, children may get ear infections, pneumonia or diarrhoea and vomiting when they have measles.
- In some cases, measles can cause severe complications and secondary infections which include pneumonia, severe diarrhoea, ear infections, blindness, encephalitis (brain swelling) and death.
- It can also weaken the immune system of a child and make them more vulnerable to other infections long after recovering from measles.
What to do if a child has measles?
Measles requires a medical diagnosis by a doctor or clinic staff.
Call your health care provider to get tested if you think you or your child may have been exposed to measles, or if you or your child has a rash that looks like measles.
There's no treatment to get rid of an established measles infection, but medication may be provided to reduce the symptoms.
Keep your child isolated from others if they have measles. Apply hygiene practices such as covering mouth and nose when coughing or sneezing, washing hands regularly, and disinfecting frequently touched surfaces such as toys and doorknobs.
How can measles be prevented?
The MeasBio vaccine is a routine Measles vaccination that children in South Africa receive. It is given in 2 doses, with the first dose administered at 6 months and the second (booster) dose administered at 12 months. This is part of the routine immunization available free at public health facilities. Private clinics also offer the measles-mumps-rubella (MMR) vaccine at cost.
Getting vaccinated is the best way to protect against measles. Review your child’s vaccination records with your doctor or nurse, especially before your child is in day care or school.
DON'T send a child with measles to school for about 10 days. They can give measles to others from 5 days before the first spots appear until at least 5 days after the rash develops.
The Covid-19 pandemic has interrupted vaccination campaigns around the world, including for measles. Let us make sure that every child gets the immunizations that they need to be healthy.
If your child has missed any of these doses, please go to your nearest health facility for vaccination.
Limiting the spread of measles
Having the right cleaning and hygiene products and procedures in place can help reduce the risk of a measles outbreak in your home or facility.
Whether you oversee a school, retail store, restaurant, office building or another type of facility, consider these strategies for keeping measles in check:
- Disinfection and cleaning essentials. Supplies like disinfectants, soap and paper towels are used more frequently during outbreaks. Never be caught without these items – order extra stock so that your employees always have the solutions they need to clean and everyone in your facility has access to the necessary products for maintaining health.
- Increase the frequency of cleaning. When germs are left unattended on surfaces, they can easily transfer to people’s hands and then to other people. If these individuals touch their eyes, nose or mouth, they can become ill. When the number of cases of a virus like measles spike, increase the frequency of cleaning to ensure your environment doesn’t contribute to its spread. Be sure to clean from top to bottom and to address high-touch surfaces like desks, counters and shopping carts, as well as overlooked areas like sink handles and revolving doors.
- Encourage hand hygiene. Regular hand hygiene can keep those who are ill from further spreading the measles virus and can help healthy people remove potentially infectious germs from their hands. Encourage hand washing by stocking up on soap and sanitizer, and by making sure that taps are functioning in restrooms, classrooms and kitchen areas.
- Promote healthy habits. A major aspect of infection prevention is educating the people who work and frequent your facility about healthy behaviours that curb the spread of illness. Use signage to promote the use of hand sanitizer and hand washing in key areas, distribute communication around the warning signs of measles and encourage individuals to stay home if they feel ill.
Useful links for more information
Childhood routine immunization schedule
HPV school-based vaccination programme
The National Institute for Communicable Diseases (NICD)
Centre for Disease Control (CDC)