Measles
Also called: rubeola
Measles is a very catching viral illness that causes fever, cough, runny nose, red eyes and a blotchy rash. It can lead to pneumonia, diarrhoea and brain swelling, and can kill, especially in young and malnourished children. The measles vaccine prevents it.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Measles is an infection caused by the measles virus. It is extremely catching. One person with measles can pass it to 15 to 20 people who are not protected. The virus spreads through coughs and sneezes, close contact, and contact with fluid from the nose and throat. A person can spread measles from 4 days before the rash appears until 4 full days after it appears.
The illness starts like a bad cold, with fever, runny nose, cough and red, watery eyes. A few days later a blotchy rash appears on the face and spreads down the body. Most people get better, but measles can cause serious problems in the lungs, gut and brain, even in children who were healthy before. Babies, young children, pregnant women, adults and people with a weak immune system are most at risk.
There is no medicine that kills the measles virus. Care is mainly rest, fluids and fever control, with hospital care for complications. The best protection is the measles vaccine, which is very effective. In Pakistan it is given through the routine childhood vaccination programme (EPI). Measles keeps returning where many children miss their vaccines.
In Pakistan
In 2022 Pakistan was one of ten countries that together held over half of the world's children who missed their first measles vaccine dose. During the 2013 epidemic, two in three children admitted with measles to Mayo Hospital, Lahore had never been vaccinated, about seven in ten were underweight, and pneumonia was the most common complication.
Symptoms
- Fever, which often becomes high
- Runny nose, like a cold
- Cough
- Red, watery eyes that may be sensitive to light
- Small white spots inside the cheeks and lips
- A blotchy red rash that usually appears 2 to 3 days after the fever starts, beginning on the face and spreading down to the body, arms and legs
- On dark skin the rash can be harder to see and may look purple or darker than the skin around it
Causes and risk factors
Causes
- Infection with the measles virus
- Breathing in droplets when an infected person coughs or sneezes
- Close contact with an infected person, or touching fluid from their nose or throat; about 15 minutes of close contact can be enough
- Contact with someone in the infectious period, which starts 4 days before their rash appears, often before anyone knows it is measles
What makes it more likely
- Not having had the measles vaccine, or missing doses
- Living in or visiting a community where many children are unvaccinated or where there is an outbreak
- Babies under 1 year old and children under 5 years (higher risk of complications)
- Adults (higher risk of complications)
- Pregnancy
- A weak immune system, for example from illness or strong medicines
- Malnutrition (being underweight or wasted) and anaemia, which were linked to death in a large Pakistani hospital study
Complications
Common complications include ear infection (otitis media), pneumonia (lung infection), croup (swelling of the windpipe and voice box) and diarrhoea. In a Karachi emergency department, gastroenteritis (a stomach and bowel infection) and pneumonia were the most common complications in children with measles. Germs such as bacteria can also infect the body while it is weak from measles. Measles can affect the brain, causing fits (seizures), meningitis or encephalitis (brain swelling), which happens in about 1 in 1,000 infections. Eye problems can also occur, and lack of vitamin A makes eye damage worse. In pregnancy, measles raises the risk of hospital care, early birth and losing the baby. Measles can kill, especially in young, unvaccinated and malnourished children.
When to see a doctor
- Difficulty breathing or fast breathing, which may mean pneumonia
- A fit (seizure), unusual drowsiness, confusion or being hard to wake: this is an emergency
- A baby under 1 year, a pregnant woman or a person with a weak immune system who has measles or has been in contact with it: contact a doctor straight away
- Diarrhoea that will not settle, or a child who is not drinking
- Eye pain or any change in eyesight
- Phone the clinic or hospital before you go, so they can keep others safe from the infection
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Diagnosis
Doctors first suspect measles from the pattern of illness: fever, cough, runny nose and red eyes, followed by a blotchy rash that starts on the face. They also think about other illnesses that cause fever and rash, such as some serious bacterial infections and Kawasaki disease, and rule them out. A suspected case should be kept apart from other patients straight away, without waiting for test results.
Tests confirm the diagnosis, which is important for tracking outbreaks. The main test is a PCR test (a test that finds the virus's genetic material) on a swab from the mouth or throat, ideally taken close to when the rash starts. A blood test for measles antibodies (IgM) can also be used. Suspected cases are reported to the local health authorities so that contacts can be traced and protected.
Treatment
- Phone ahead before visiting a clinic or hospital, and stay at home away from others until at least 4 days after the rash appeared
- Rest and drink plenty of fluids; paracetamol or ibuprofen can ease fever and aches. Children should not be given aspirin
- There is no medicine that kills the measles virus, so treatment supports the body while it fights the infection
- Antibiotics are not used for measles itself; your doctor may give them only if a bacterial complication such as an ear or chest infection develops
- Babies, pregnant women, people with a weak immune system and anyone with pneumonia or brain problems need urgent medical care and may need hospital treatment, where specialists decide on any extra treatment
- Doctors may give vitamin A to children with measles, especially where vitamin A deficiency is common; do not give it yourself, as too much is harmful and high doses must be avoided in pregnancy
- People who have been in contact with measles and are not protected should see a doctor quickly: the vaccine or an immunoglobulin injection given soon after contact can prevent or soften the illness
Medicines in Pakistan
Medicines a doctor may use, by group. Read the role: some are only for special cases. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Pain and fever relievers | ease fever, aches and discomfort; they do not treat the virus itself; children should not be given aspirin; ask your pharmacist or doctor about the right dose | Paracetamol (350 brands), Ibuprofen (378 brands) |
| Antibiotics | not used for measles itself; given only when a bacterial complication such as an ear infection or pneumonia develops; your doctor chooses the medicine and the dose | Chosen by your specialist |
| Measles-containing vaccines | prevention; the most effective way to prevent measles and its complications; can also be used soon after contact with measles for some people who are not protected; it is a live vaccine and is not given in pregnancy or to people with a severely weak immune system | Measles + Mumps + Rubella live attenuated vaccine (1 brand) |
| Immunoglobulins (ready-made antibodies) | given soon after contact with measles to people who cannot have the vaccine, such as young babies, pregnant women and people with a severely weak immune system; arranged by a doctor or health team | Human normal immunoglobulin (IgG) (5 brands) |
| Antivirals | not routinely used and not approved for measles; clear evidence of benefit is lacking; specialists may consider one only in some severe hospital cases | Ribavirin (206 brands) |
Also used (not yet in our price list): Vitamin A (retinol), given by a doctor to some children with measles
Self-care and prevention
Self-care
- Rest and drink plenty of fluids
- Use paracetamol or ibuprofen for fever and aches, following your pharmacist's or doctor's advice
- Do not give aspirin to children
- Stay off school, college or work for at least 4 days after the rash first appears
- Keep away from babies, pregnant women and anyone with a weak immune system while you are infectious
- Phone your doctor or clinic before going in, so they can prepare and protect other patients
- Do not give vitamin A at home unless a doctor tells you to
Prevention
- Make sure every child gets all the measles vaccine doses offered by the EPI programme; ask your nearest EPI vaccination centre or health facility
- Check your child's vaccination card, and ask a health worker if any measles dose was missed; older children and adults who missed vaccination can ask too
- High vaccine coverage in a community also protects babies and others who cannot be vaccinated
- If someone who is not protected has been near a person with measles, see a doctor quickly about the vaccine or immunoglobulin
- Keep people with measles at home and away from others during the infectious period
- Vitamin A does not prevent measles and is not a substitute for the vaccine
Common questions
Is measles a serious illness?
Yes, it can be. Many children recover, but measles can cause pneumonia, diarrhoea, ear infections, eye problems and brain swelling, and it can kill. In a Lahore hospital study during the 2013 epidemic, almost 9 in every 100 admitted children died, most of them unvaccinated.
How long is a person with measles infectious?
A person can spread measles from 4 days before the rash appears until 4 full days after it appears. This is why measles spreads before people realise they have it. Stay away from school, work and other people for at least 4 days after the rash starts.
Does the measles vaccine cause autism?
No. The 1998 study that suggested a link was withdrawn because its methods were unethical and inaccurate. Large studies since then have found no link between the measles, mumps and rubella vaccine and autism. The most common side effects are a sore arm, fever and sometimes a mild rash.
Can vitamin A prevent or cure measles?
Vitamin A does not prevent measles and does not replace the vaccine. Doctors may give it to children with measles, because it has lowered deaths in places where vitamin A deficiency is common. Too much vitamin A is harmful, and high doses must be avoided in pregnancy, so only give it if a doctor advises.
Can a pregnant woman have the measles vaccine?
No. The vaccine contains a weakened live virus, so it is not given in pregnancy. A pregnant woman who is not protected and has been near someone with measles should contact her doctor or midwife straight away, as an immunoglobulin injection may be offered.
Sources
- CDC. Measles Prevention and Treatment Overview: Information for Healthcare Providers (n.d.).
- NHS England. Measles guidance for healthcare services (n.d.).
- NHS Lancashire and South Cumbria Integrated Care Board. LSC Integrated Care Board :: Measles (n.d.).
- StatPearls (NCBI Bookshelf). MMR Vaccine - StatPearls (n.d.).
- CDC (newsroom, with WHO data). Global measles threat continues to grow as another year passes with millions of children unvaccinated (2023).
- Annals of King Edward Medical University. Morbidity and Mortality Pattern of Hospitalized Children with Measles at Mayo Hospital, Lahore (Epidemic 2013) (2014).
- Aga Khan University (eCommons, symposium poster). Disease severity and presentation in children with recent measles epidemic: Karachi, Pakistan (2014).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.