Six subtle symptoms of measles in children – and how to get the vaccine

The early symptoms of measles can appear similar to other illnesses – here’s what to look out for

A measles outbreak is currently sweeping through schools in north-east London, prompting significant concern among parents as the UK Health Security Agency (UKHSA) confirms hospitalisations among affected children.

The highly contagious disease has primarily impacted unvaccinated children under the age of 10, with the UKHSA confirming that some affected children have required hospital treatment.

The UKHSA had previously reported 34 laboratory-confirmed measles cases in Enfield from January 1 to February 9, while more than 60 suspected cases of measles have been reported by seven schools and a nursery in Enfield.

Given that measles is often mistaken for other common illnesses, Dr Henrik Premasundaram, a GP at HCA Healthcare UK, has provided crucial advice on identifying its early, subtle symptoms and knowing when to seek urgent medical attention for worried families.

Here are the early subtle symptoms parents should look out for.

1. Cold-like symptoms

A cough and cold are early symptoms of measles. (Alamy/PA)

“In the early phase, so usually between day one to day four, children with measles tend to have cold-like symptoms such as a cough, fever, runny nose and sore, red, watery eyes,” says Premasundaram.

“Colds are very, very common at this time of year, but children with measles tend to look more unwell, more tired and more miserable than they would with a typical viral infection.”

2. Sensitive to light

“Children who get sore, watery eyes tend to be more sensitive to light, which you wouldn’t typically expect with a simple cold,” says Premasundaram.

3. High fever

A high temperature can be a sign of measles. (Alamy/PA)

“A high fever is a key symptom of measles and tends to keep rising over the first few days,” says Premasundaram.

4. Loss of appetite

“A child with measles might have a reduced appetite or a reduced fluid intake,” says Premasundaram.

5. Rashes

Measles is associated with a blotchy rash. (Alamy/PA)

“Day four to day five is usually when a rash appears,” says Premasundaram. “A lot of the time it starts on the face and behind the ears then spreads down to the body, the trunk, the arms and to the legs.

“The fever often peaks around the time that the rash appears.”

The spots of the measles rash are sometimes raised and join together to form blotchy patches, but are not usually itchy, according to the NHS website.

6. Small white spots inside the mouth

“Some children start to develop small white spots inside their mouth before the full body rashes develop,” says Premasundaram. “These white spots are called ‘Koplik’s spots’ and are very specific to measles.”

These spots may appear inside the cheeks and on the back of the lips and usually last a few days, according to the NHS website.

Is measles contagious?

“Measles is highly contagious and can spread really quickly, from around four days before any rashes have even appeared until four days after,” says Premasundaram.

“If you think your child might have measles I would recommend trying to safely isolate as much as possible. If there are other members of the family who are unvaccinated or at high risk they should try to avoid contact as much as reasonably possible.”

Measles is spread by an infected person’s breathing, coughing or sneezing, so the NHS website recommends opening windows and doors to help reduce the risk, using tissues and binning them immediately, and washing your hands often with soap and warm water.

Can measles lead to any complications?

“Measles can lead to problems with breathing, infections and problems with the brain, so it can be very serious,” says Premasundaram.

Other problems that can be caused by measles include pneumonia, meningitis, blindness and seizures, according to the NHS website.

When should parents seek medical advice?

“If your child starts to feel more unwell, for example, they become more sleepy, more difficult to rouse, experience difficulty breathing, have a persistent wheeze and have a fever that is high and is not improving, that’s when you should really seek medical advice,” recommends Premasundaram.

“In addition, any child that’s unvaccinated or has been in contact with a known case, should also definitely seek medical advice.”

How is measles treated?

“There’s no specific antiviral treatment for measles, so the treatment is mainly supportive,” says Premasundaram. “Once a child has been seen by a GP they will be advised to drink plenty of fluids to try and prevent dehydration, to rest and to take paracetamol and ibuprofen to try and reduce fever.”

Is there any way to prevent your child from getting measles?

The MMR vaccine is the most effective way to protect against measles. (Alamy/PA)

“The most effective prevention is the MMR vaccine which helps prevent measles, mumps and rubella,” says Premasundaram. “Two doses of the MMR vaccine provides really strong protection. The first dose is usually given to children after they turn 12 months old and then they will typically receive the second dose at around three years old as a pre-school booster.

“If they’re not vaccinated already, then you can go and speak to your GP. The vaccine is very effective and is one of the most widely researched vaccines. However, because measles is one of the most infectious viruses, high vaccine uptake is essential.”