Measles is a highly contagious airborne disease caused by a virus, which can lead to severe complications and even death. Between 2000 and 2024, measles vaccination prevented nearly 59 million deaths worldwide. Yet, in 2024 alone, about 95,000 deaths were reported globally—mostly among unvaccinated or under-vaccinated children under five years of age. This is despite the availability of an effective vaccine.

In 2024, only 84% of children received the first dose of the measles vaccine, slightly below the 2019 coverage level of 86%.

Measles spreads when an infected person breathes, coughs, or sneezes. It is more common in children, but anyone can be infected.

Signs and symptoms
Symptoms usually appear 10–14 days after exposure. The most recognizable sign is a widespread skin rash. Early symptoms last 4–7 days and include:

• High fever
• Runny nose
• Cough
• Red, watery eyes
• Small white spots inside the cheeks

The rash typically begins 7–18 days after exposure, starting on the face and neck and spreading to the arms, body, and legs within 3 days. It usually lasts 5–6 days before fading.

Complications

Measles-related deaths are usually due to complications, which can include:

• Blindness
• Encephalitis (brain inflammation)
• Severe diarrhea and dehydration
• Ear infections
• Pneumonia and other severe respiratory illnesses

Measles during pregnancy can lead to premature birth and low birth weight. Complications are most common in children under five, adults over 30, malnourished children, and those with vitamin A deficiency or weakened immunity (e.g., HIV).

Who is at risk?

• Unvaccinated individuals and those without immunity
• Pregnant women
• People living in areas with poor healthcare infrastructure and low vaccination coverage

Measles is widespread in parts of Africa, the Middle East, and Asia, largely due to limited access to vaccines.

Transmission
Measles is one of the most contagious diseases in the world. It spreads through direct contact with nasal or throat secretions, or by inhaling air that an infected person has breathed.
The virus can survive in the air or on surfaces for up to two hours, and one infected person can transmit the disease to up to 18 others. Transmission occurs from four days before the rash appears to four days after.

Treatment
There is no specific antiviral treatment for measles. Care focuses on symptom relief and preventing complications:

• Adequate hydration and nutrition
• Antibiotics for secondary infections (pneumonia, ear, or eye infections)
• Vitamin A supplementation (two doses 24 hours apart), which reduces complications and risk of blindness

Prevention

Vaccination is the safest and most effective way to prevent measles and its spread.
Two doses of the measles vaccine should be given at 9 months and 15–18 months (often as MMR or MMRV).
The vaccine has been used for over 60 years and is highly cost-effective.
Routine immunization and mass vaccination campaigns are crucial to preventing outbreaks and reducing global deaths.


Dr. Anjan Kumar T M, Consultant Neonatologist & Paediatrician, Apollo Hospitals, Sheshadripuram, Bangalore