Measles Q&A: How do I know if I have measles, and what should I do if I have it?

Plans are being made for an urgent catch-up vaccination programme for young adults against measles after the Health Service Executive (HSE) warned the probability of an outbreak in Ireland was high.

Minister for Health Stephen Donnelly briefed Cabinet on Tuesday that a significant increase of measles cases notified in Europe this winter, coupled with falling rates of MMR (measles, mumps, rubella) vaccine uptake in Ireland, has raised concerns about wide transmission of the disease in Ireland in 2024.

What are the symptoms of measles and how will I know if I have it?

The early symptoms of measles are similar to those of other common viruses. These include a stuffy, runny nose, sneezing, sore throat, cough, a temperature over 38 degrees and general tiredness, lack of energy and irritability.

Small greyish-white spots in the mouth are often the identifying symptom of measles which are noticeable before the body rash appears two to four days later. The rash – which starts on the head and spreads down the trunk and limbs – has small red-brown flat or slightly raised spots which may come together into larger blotchy patches.

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“If you have two doses of the measles, mumps and rubella [MMR] vaccine, it is exceedingly unlikely that you have measles even if you develop a temperature and a rash,” explains Dr Scott Walkin, clinical lead for infectious diseases at the Irish College of General Practitioners.

However, he adds: “If you have a high temperature, red eyes, aren’t vaccinated against measles and have travelled from an area with an outbreak of measles, I should suspect measles.”

A saliva test carried out by your GP and sent to the National Viral Reference Laboratory (NVRL) will confirm diagnosis. Anyone who suspects they may have measles should contact their GP before turning up so arrangements can be made to reduce the possible spread of infection. If you have measles, you will be infectious before the rash appears.

What should I do if measles is confirmed for me or my child?

You will need to look after yourself or your child and avoid contact with vulnerable individuals (see next answer).

“There is no specific antiviral treatment for measles but the usual medicines to control temperature and relieve aches and pains are recommended,” says Dr Walkin, who is a GP in Co Mayo.

About 30 per cent of people who get measles will have complications and 25 per cent will require hospitalisation for these complications.

“Complications of measles range from ear infections on the mild end to pneumonia to encephalitis on the extreme end,” explains Dr Walkin. “People have forgotten how severe illnesses like measles can be because we don’t see the deafness, blindness and pneumonia that was more common before MMR vaccines were introduced in Ireland [in the 1980s]. Ireland was declared measles free by the World Health Organisation in 2017. Yet in 2000, three children died in an outbreak of measles in north Dublin.”

What are the wider concerns about someone having measles?

Measles is a highly contagious disease that can spread very easily in unvaccinated populations. “Flu and Covid is transmitted to two people on average but measles is spread to 12-18 people in unvaccinated populations,” says Dr Walkin.

For this reason, containment of measles is a high priority if any cases are identified in Ireland. Children under a year old (the MMR can only be administered to babies over 6 months and is usually given at 12 months) and anyone with a weakened immune system are particularly at risk of serious complications such as meningitis or hearing loss if they catch measles. Complications in pregnancy include miscarriage, premature or stillbirth or a low birth weight baby.

Due to recent outbreaks of measles in the UK and Europe, GPs in Ireland are now obliged to notify the Health Protection Surveillance Centre (HPSC) if a case of measles is identified. The HPSC recommends that anyone with measles stay at home until four days after the rash appears. Only those who are protected against the measles (ie if they have two doses of the MMR vaccine) should visit your home.

Should family members or others sharing a house with someone with measles get the MMR vaccine urgently?

“Close contacts who are not vaccinated or immune from previous infection (you can only have measles once in your lifetime and anyone born before 1978 is very likely to have had it) are offered preventive MMR vaccines within 72 hours of a suspected or confirmed case,” says Dr Walkin. Pregnant women who are close contacts are given human normal immunoglobulin within three to six days to protect them as the MMR vaccine isn’t given during pregnancy.

How can I help prevent measles spreading in Ireland if there is an outbreak?

Ensuring you and everyone in your household is up to date on their MMR vaccines is the best way to prevent the spread of measles. The first dose of the MMR vaccine is given to children at one year old and the second dose is given in junior infants. Vaccination of children in junior infant classes was moved to the first term this academic year due to fears of an outbreak of measles here.

The Government is now planning to offer free catch-up MMR vaccine to any young adults who didn’t get the two doses of MMR vaccine as young children. The HSE currently doesn’t pay GPs for administering the MMR vaccines to adults but patients can request it and pay for it themselves.

The uptake rates of the MMR in Ireland are currently below the rates recommended by the World Health Organisation to prevent measles from spreading, according to the HPSC. There are particular concerns that a large outbreak of measles in England and further outbreaks across Europe could easily spread into Ireland.

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