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Measles is a highly contagious viral infection caused by the measles virus. It can spread easily through the air when an infected person coughs or sneezes.¹
In South Africa, measles remains a public-health concern because of recent outbreaks linked to reduced vaccination coverage.⁶
Measles typically unfolds in phases — first cold-like symptoms, then the characteristic rash.¹
Initial symptoms:
• High fever (often above 38.5 °C)
• Runny or blocked nose (coryza)
• Sneezing
• Persistent cough
• Red, sore, watery eyes (conjunctivitis)⁵
Spots inside the mouth:
A few days later you may see tiny white spots (Koplik’s spots) inside the cheeks or at the back of the lips.¹
Rash appearance:
• Appears 3–5 days after initial symptoms⁵
• Starts on the face and behind the ears, then spreads to the trunk and limbs.¹
• On lighter skin it appears red or blotchy; on darker skin it may appear dark brown or difficult to distinguish.¹
If you or your child develop these symptoms and you’ve not been vaccinated, contact your healthcare provider promptly.
Diagnosis:
A healthcare provider will evaluate your symptoms and rash. Blood tests or swabs may confirm measles.²
Treatment:
There is no specific antiviral cure for measles. Care is supportive: rest, fluids, controlling fever, monitoring for complications.³
Vitamin A supplementation is sometimes used in children to reduce complication risk.⁷
Urgent help:
Seek immediate medical attention if you or your child:
• Have difficulty breathing or chest pain
• Are very lethargic, not responsive, or have seizures
• Are pregnant and have been exposed to measles³
Measles may lead to:
• Pneumonia (lung infection)
• Encephalitis (brain inflammation)
• Ear infections and hearing loss
• Blindness (especially in malnourished children)¹
In South Africa, low nutrition and reduced vaccination coverage increase risk of complications.⁶
Measles during pregnancy poses serious risks to the mother (pneumonia, hepatitis, death), and for the baby (premature birth, low birth weight, miscarriage, and stillbirth). Vaccination before pregnancy is crucial. Pregnant women should avoid exposure to those with infection and seek immediate care if exposed. The measles vaccine cannot be given during pregnancy but immune globulin treatment may help after exposure.
Vaccination:
Two doses of the measles-containing vaccine is the most effective prevention.¹
In South Africa, the NDoH recommends measles-rubella vaccine at six and 12 months, emphasising closing immunity gaps.⁶
Other prevention tips:
• Ensure all household members are fully vaccinated
• Contact your doctor for post-exposure advice if exposed and not immune
• Practice good hygiene: cough/sneeze into your elbow, wash hands frequently, isolate if infected
• Avoid sharing bedding, utensils, or close contact while infectious
Transmission:
The measles virus is airborne and can linger in a room for up to 2 hours after an infected person leaves.³
You may become infectious around 4 days before the rash appears and remain so for about 4 days after.³
Who is at risk?
Prevention of outbreaks
This brochure is for educational purposes only and is not intended to provide a diagnosis or treatment or replace the advice of your doctor, pharmacist, primary health care nurse or other health care provider. You are advised to discuss any questions or concerns you have with your health care provider.
This referenced content has been reviewed by Dr Helen Sammons, who is a qualified medical doctor with extensive experience in the private healthcare sector of South Africa, particularly in the disciplines of general practice.
