Measles for health professionals

Measles is a serious viral illness. It is a nationally notifiable disease. We monitor and report on national case numbers and epidemiological trends. We publish case definitions and national guidelines to support health professionals and health authorities respond to measles cases.

For health professionals For everyone

Disease

  • The measles virus is a member of the genus Morbillivirus (a paramyxovirus).

  • Measles typically starts with a prodrome that last 2 to 4 days and includes:

    A non-itchy, maculopapular rash appears 2 to 7 days after onset of symptoms. It usually starts on the face or upper neck and spreads to become generalised. The rash typically lasts for 4 to 7 days.

    Measles is often severe. People who have received 1 or 2 doses of measles vaccine may have attenuated infection with mild symptoms.

    Complications of measles can affect most organ systems and include:

    Read more about diagnosing measles.

Public health importance

  • Measles is one of the most highly infectious communicable diseases. Up to 9 out of 10 non-immune people who are exposed to an infectious case will become infected themselves.

    Measles has a high rate of complications. It can cause severe disease, complications and death, especially in young children and other groups at greater risk of severe disease.

    Endemic measles has been eliminated from Australia through measles vaccination. But national surveillance is essential to inform public health response measures to maintain measles elimination. 

    The highly infectious nature of measles and its severe consequences highlights the importance of:

  • The incidence of measles in Australia is low. Since 2020, fewer than 100 cases per year have been notified in Australia. 

    Most measles infections notified in Australia are either acquired overseas or linked to cases whose infections were acquired overseas.

    Despite the widespread availability of safe and cost-effective vaccines, an estimated 107,500 people worldwide died from measles in 2023. Most of these deaths occurred in unvaccinated and under-vaccinated children aged less than 5 years.

    For the latest information on cases of measles in Australia see our data visualisation tool.

Spread of infection

  • Measles spreads when respiratory droplets and aerosols containing the virus are inhaled or come into contact with a person’s mucous membranes. 

    The virus can transmit through the airborne route, such as when someone is in the same room as an infected person.

    The measles virus can survive for up to 2 hours in air or on objects and surfaces. Sunlight, heat and extremes of pH quickly inactivate the virus.

  • The incubation period ranges from 7 to 18 days.  

  • Cases are likely infectious from 24 hours before the onset of symptoms until 4 days after the onset of rash.

Priority populations

  • People at greater risk of severe disease and complications from measles include:

    • people who are immunocompromised
    • children aged less than 5 years 
    • adults aged 20 years or older
    • pregnant people.

    Read more about measures people can take to protect themselves.

  • People may be at greater risk of exposure to measles if they travel overseas or work in a setting at increased risk of spread.

    People who are unvaccinated or have received fewer than 2 doses of measles-containing vaccine are at risk of getting measles if exposed. 

    See what measures people can take to protect themselves.

  • Measles can spread quickly in households and crowded places, including: 

    • early childhood care centres 
    • schools
    • residential care facilities
    • healthcare facilities
    • correctional and detention facilities. 

    These settings should take extra precautions, including by:

    A measles case in any of these setting requires a public health response.

Prevention

  • Two doses of measles-containing vaccine are recommended for all people born during or after 1966, from 12 months of age. About 99% of people are immune to measles after receiving 2 vaccine doses. 

    People born before 1966 are generally considered immune to measles, unless a blood test has shown otherwise. This is because the virus was prevalent in the community at that time, and most people were exposed to measles. 

    Infants aged 6 to 12 months who are travelling to countries where measles is endemic, or where there is an outbreak, may receive measles-containing vaccine, after an individual risk assessment. 

    These infants still need an additional 2 doses of measles-containing vaccine from 12 months of age to be considered immune to measles.

    Measles-containing vaccines contain live attenuated viruses and should not be given to:

    • pregnant people
    • people who are immunocompromised.

    See the Australian Immunisation Handbook for more information, and who is eligible for free measles vaccination under the National Immunisation Program.

  • Control of measles relies on effective surveillance and outbreak response activities. 

  • People in certain groups who were born during or after 1966 should check their immunity status. This includes people who are:

    • healthcare workers 
    • childhood educators and carers
    • working in long-term care facilities
    • working in correctional facilities
    • pregnant or planning pregnancy
    • travelling overseas.

    Those who do not have immunity against measles are recommended to discuss vaccination with their healthcare professional.

    See the Australian Immunisation Handbook for more information.

Diagnosis and clinical management

  • Measles is usually diagnosed through laboratory testing. Measles serology requires a blood sample. Nucleic acid testing requires urine (first catch) and respiratory (nasopharyngeal or throat) specimens. 

    Read more about measles diagnosis.

  • Read more about laboratory testing and the laboratory case definition.

  • There is no specific therapy for treatment of measles. But symptoms and complications can be managed through supportive therapy. 

    Read more about the clinical management of measles. 

Notification and reporting

Public health response

  • The CDNA national guidelines for public health units inform the public health response to measles.

  • Public health units urgently investigate all suspected, probable and confirmed measles cases. Case management focuses on: 

    • identifying the likely source of infection
    • identifying any contacts 
    • preventing transmission. 

    Public health messaging recommends that people who are infectious with measles should: 

    • isolate at home 
    • avoid interaction with susceptible people 
    • not attend work, school, childcare and other high-risk settings.

    Hospitalised measles cases are kept in respiratory isolation with airborne precautions applied. The person should use a mask when being transported. See the Australian guidelines for the prevention and control of infection in healthcare for more information.

    See the CDNA national guidelines for public health units for detailed guidance on how public health units respond to measles cases.

  • Public health units undertake contact tracing to: 

    • identify all potential contacts 
    • assess the susceptibility of contacts to infection
    • provide advice and public health education
    • offer post-exposure prophylaxis, where appropriate.

    Susceptible contacts may be considered for post-exposure prophylaxis with either:

    • measles-containing vaccine
    • normal human immunoglobulin – only in some circumstances.

    Eligibility criteria for post-exposure prophylaxis include:

    • time elapsed since exposure to an infectious case
    • age
    • previous vaccination history
    • for infants aged less than 6 months, their mother’s history of measles infection or vaccination before the most recent pregnancy
    • immune competence.

    Susceptible and immunocompromised contacts should be excluded from childcare, primary schools and certain work settings, for their own safety and to reduce the risk to others. 

    See the CDNA national guidelines for public health units for detailed guidance on how public health units manage contacts of measles cases.

  • Control measures used during outbreaks include:

    • early diagnosis and notification of cases
    • isolation of infectious cases
    • infection prevention and control measures
    • timely identification and management of contacts
    • post-exposure prophylaxis for susceptible contacts – either as a measles-containing vaccine or normal human immunoglobulin.

    Infection prevention and control measures should be used when people with suspected measles are seen in healthcare settings. These include:

    • providing a mask to the person with suspected measles
    • escorting them to a separate room (away from waiting areas)
    • applying airborne precautions.

    For more information, see the:

  • Special situations and high-risk settings, such as childcare, schools or healthcare facilities, might require extra infection prevention and control actions and public health activities if there is a measles case. These may include:

    • holding a vaccination clinic at the facility
    • monitoring for additional cases in the facility
    • undertaking public health education for staff, attendees and carers.

    For more information, see the:

Resources

We are adding new content to this website and expanding these pages, including a suite of disease-related information. In the meantime, information about diseases in Australia is available on the Department of Health and Aged Care’s website. 

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