Measles is a highly infectious viral illness, with potentially serious, life-threatening complications. Travel remains an important risk factor for the international spread of measles.
Measles is spread by airborne or droplet (coughing, sneezing, drops from mouth/nose) transmission. Initial symptoms can include fever, runny nose, red, sore eyes (conjunctivitis) and cough. A rash usually then appears after a few days. This starts on the face/head and then spreads over the body, arms and legs in three to four days. People are infectious from the day symptoms first appear to four days after the rash starts. The incubation period (time from exposure to measles virus to symptoms starting) is about ten days but can be between seven and 18 days.
Complications of measles infection can include otitis media (ear infections), diarrhoea, pneumonia and convulsions (fits). Rarely, encephalitis (brain inflammation) or sub-acute sclerosing pan-encephalitis (fatal late onset brain inflammation) can occur. Risk of death from measles complications is age-related and is higher for children younger than one year and adults. Measles can be more severe in immunosuppressed individuals and during pregnancy, and increases the risk of miscarriage, stillbirth, or preterm delivery.
Measles is described as 'endemic' if the disease is commonly reported (continuous transmission) in a defined geographical area for a 12-month period. Measles is endemic in many regions. Damage to health service infrastructure e.g. from conflicts or natural disasters; vaccine hesitancy and interrupted routine immunisation programmes increase risk of significant outbreaks.
Limits in national surveillance and reporting systems, together with measles infected people often not having access to healthcare (so not counted as cases), results in an underestimation of measles cases globally. Many countries worldwide have successfully interrupted measles circulation, but all regions are vulnerable to importing and re-introducing the disease. See the individual Country Information pages under the Vaccination Recommendations 'Some travellers' section for countries where early measles vaccination in infants and children, especially those mixing with local population, should be considered.
NaTHNaC reports some confirmed measles outbreaks worldwide, if they are unexpected or unusual, on the Outbreak Surveillance section, but does not routinely report measles cases.
Travellers with no history of measles infection or who are unvaccinated or incompletely vaccinated may be at risk from measles when visiting countries reporting cases, especially if staying with friends or family and mixing with local people.
Prevention
All UK travellers should make sure they are up to date with the measles, mumps and rubella (MMR) or measles, mumps, rubella and chickenpox (MMRV) vaccines, according to current UK recommendations.
The MMRV vaccine was introduced into the UK routine immunisation schedule in 2026. Children born on or after 1 January 2025 will be given their first MMRV vaccine at 12 months followed by a second dose at 18 months old. Please see MMRV for further details on recommendations for children born between 1 January 2020 and 31 December 2024.
Children and adults born on or before the 31 December 2019 will have followed the previous two dose MMR vaccination schedule at 12 months and 3 years 4 months of age. Anyone born on or before 31 December 2019 who missed out on one or both of their MMR vaccines when they were younger can catch up for free through their GP practice.
Details on measles containing vaccines can be found in Summary of Product Characteristics (SPC), electronic medicines compendium.
Infants from six months of age travelling from the UK to measles reporting countries as indicated on the Country Information pages
Babies born to mothers with immunity to measles before pregnancy (either after natural measles infection or from measles vaccination) receive some protection as they develop in the womb. This immunity is temporary and fades in the first year after birth.
Babies from six months of age travelling to measles endemic areas with a high incidence of measles or with a current outbreak, who are likely to be mixing with local people, should receive an early dose of MMR vaccine. MMRV vaccine may be given from 9 months of age for this purpose if that is the only vaccine product available at the time of the appointment.
Not all children will respond to MMR/MMRV given in the first year of life due to the presence of maternal antibody. When the vaccine has been given before one year of age this dose should be discounted and two further doses of MMR/MMRV should be given at the recommended ages.
Children travelling to a measles endemic area with a high incidence of measles or with a current outbreak who had one dose of MMR/MMRV at the routine age should have the second dose brought forward to at least one month after the first. If the child is given the second dose less than three months after the first dose and at less than 18 months of age, then the routine 18-month dose (which would constitute a third dose in this case) should be given in order to ensure full protection.
Ideally, a four-week minimum interval period should be observed between giving a yellow fever vaccine and MMR/MMRV. Giving these two vaccines together may lead to sub-optimal antibody responses to yellow fever, mumps and rubella antigens. If protection is needed rapidly, then these vaccines should be given at any interval; UKHSA guidance states an additional MMR/MMRV dose should be considered and revaccination with yellow fever can also be considered for those at on-going risk.
UKHSA advice on immunisation against measles is also available for those whose immunisation status is uncertain.
In the UK, measles is a notifiable disease; so any suspected measles cases must be reported to the local Health Protection Team.