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Measles timeline revealed – all the symptoms of ‘world’s most infectious disease’ as child dies at UK hospital 

BRITS are being urged to look out for symptoms of measles after a child with the highly contagious disease died at a UK hospital.

Most people associate measles with a flat, red rash that appears on the face and starts to form blotchy patches.

a poster showing the measles symptoms timeline
Measles symptoms can take several days to appear and sufferers may experience consequences even after recovering from the illness (Source: CDC)

But this symptom typically doesn’t appear for a good few days after the infection has taken hold.

Official data released earlier this year revealed that cases of the lethal Victorian disease have surged to their highest level since 1997 in Europe and central Asia, and rates have doubled in the past year alone.

This includes the UK, where a child with measles and other health problems died in intensive care at Alder Hey Children’s Hospital in Liverpool.

Around 16 other children have been treated at the hospital – which is in the grip of an outbreak – after becoming severely unwell.

Health officials warn that low uptake of the measles, mumps and rubella (MMR) jab threatens further spread of what is one of the world’s most infectious diseases.

Professor Matt Ashton, director of public health for Liverpool, said: “I’m extremely worried that the potential is there for measles to really grab hold in our community.

“My concern is the unprotected population and it spreading like wildfire.

“It’s really important that people understand the seriousness of this.”

Speaking on BBC Radio 4, Dr Mary Ramsay, from the UK Health and Security Agency, added: “Measles is always serious.

“Most children will have a mild illness, but it spreads so quickly that it’s very difficult to keep on top of it; it is such an infectious disease.


“Even one or two cases poses a threat to everyone in that community who hasn’t been protected by vaccination because just passing someone in the street or very casual contact is enough to spread the infection.”

In 2024, over 127,350 measles cases were reported across the WHO’s European region, which covers 53 countries.

This marks a dramatic jump from just 4,400 cases in 2016.

Measles is highly contagious, and a person remains infectious for up to 10 days and can spread the virus to 15 people. 

Measles is not a minor illness. Up to one in five children will get complications


Dr Sarah JarvisGP

Experts stress that giving your kids the MMR vaccine is by far the best way to stop them from getting the illness (providing about 97 per cent protection) – and any side effects that could appear later down the line.

But rates are falling. The MMR vaccine rate in Liverpool for children by the age of five is 73 per cent, the lowest outside of London.

It is also lower than an 86 per cent average across the northwest and 84 per cent across the the whole of England.

To ensure herd immunity, where enough people are protected to prevent the virus spreading, vaccination rates must hit 95 per cent.

Here, we break down the timeline of measles symptoms and what to expect if you or your child fall ill.

Day 1: Infection

Measles has been dubbed the world’s most contagious diseases as up to 90 per cent of people who come into close contact with an infectious person will get it if they aren’t protected, according to the Centers for Disease Control and Prevention (CDC).

The virus lives in the nose and throat mucus of an infected person and spreads to others when they cough or sneeze.

Breathing contaminated air or touching an infected surface and bringing your hand to your eyes, nose or mouth can be enough for you to catch measles if you aren’t vaccinated.

Day 7: First symptoms appear

It will typically take a week to 14 days for the first measles symptoms to appear.

These many not seem serious at first as they’ll often resemble a cold, according to NHS guidance.

The first signs of measles include:

  • A high temperature
  • A runny or blocked nose
  • Sneezing
  • A cough
  • Red, sore, watery eyes

Days 9-10: Koplik spots

Two to three days after you start to experience cold-like symptoms, you might notice tiny white spots in your mouth.

These are sometimes referred to as Koplik spots, the CDC says.

They tend to pop up inside the cheeks and on the back of the lips and should disappear within a few days.

Days 10-12: Rash and fever

It’s not until three to five days after the cold-like symptoms appear that you’ll see the beginnings of the telltale measles rash.

It usually starts as flat red spots on the face and the hairline before spreading downward to the neck, torso, arms, legs, and feet.

You may get small raised bumps on top of the flat spots and the blotches may join together as the rash spreads across the body.

The rash is sometimes accompanied by a spike in your temperature, sometimes exceeding 40C.

Person's back covered in measles rash.
Getty

Measles causes a blotchy rash that starts on the face before spreading to the rest of the body[/caption]

After day 10: Possible complications

Measles is not a mild illness and even the healthiest of children may suffer complications like diarrhoea, vomiting, eye infections, ear infections and laryngitis.

The high fever can sometimes trigger fits.

Less common complications of measles are meningitis and pneumonia, which affects one in 20 children.

These problems are rare, but babies and people with weakened immune systems are most at risk.

Other nasty side effects include hepatitis and, rarely, encephalitis – inflammation of the brain, which can cause convulsions, blindness, deafness and other long-term damage.

These complications may lead to death.

Illustration of multinucleated giant cells infected with measles virus.
Getty

Measles can cause life-threatening brain inflammation, experts warn[/caption]

Dr Sarah Jarvis, GP and clinical consultant to Patient.info, told Sun Health: “Measles is not a minor illness – at best, your child is likely to be really poorly for about five days, and off school for up to two weeks.

“Up to one in five children with measles will get complications.”

About one in 16 children will get pneumonia from the illness and one in 12 develop ear infections.

Dr Jarvis added: “Even worse, one in 1,000 to 2,000 will get inflammation of the brain, which can be fatal.

“And there’s a rare form of brain inflammation which can develop years after the infection, which is usually deadly.”

Measles can also be dangerous if you’re pregnant, as it can cause miscarriage, stillbirth or premature birth.

In other cases, your baby might be born with a low birth weight.

Years down the line

The complications don’t end there.

Gemma Larkman-Jones, from Brixton, South London, shared how her little boy Samuel passed away aged six from a rare and slow-progressing form of brain inflammation called subacute sclerosing panencephalitis (SSPE).

SSPE strikes sufferers years after they were first infected with measles.

Gemma believes Samuel wouldn’t have died if he’d received the MMR vaccine.

According to the National Institute of Health, just four to 11 per 100,000 measles cases result in SSPE, though this number jumps to 18 per 100,000 if the child was under five when infected.

It can take years for this deadly form of brain inflammation to develop, typically around seven to 10 years after a person has measles – even if the person seems to have fully recovered.

Expert answers MMR questions

TO help deal with parental concerns, Professor Helen Bedford, a specialist in child public health at University College London, tells you all you need to know about the MMR vaccine.

When is the vaccine given?

The MMR vaccine is part of the NHS Routine Childhood Immunisation ­Programme.

It’s typically given via a single shot into the muscle of the thigh or the upper arm.

The first dose is offered to children at the age of one (babies younger than this may have some protection from antibodies passed on from their mother, which start to wear off at about 12 months.)

The second dose is then offered to children aged three years and four months before they start school.

To check to see if you or your child have had the recommended two doses of MMR, you can look at their/your Personal Child Health Record, also known as the red book.

If you can’t find the red book, call your GP and ask them for your vaccine records.

You are never too old to catch up with your MMR vaccine.

If you see from your vaccination records that you did not receive two doses as a child, you can book a vaccination appointment.

Is the vaccine safe?

The MMR vaccine is safe and effective at preventing measles, mumps and rubella.

In the UK, we started using the jab in 1988, so we have decades of ­experience using it.

The jab is made from much-weakened live versions of the three viruses.

This triggers the immune system to produce antibodies that are protective in the face of future exposure.

It takes up to three weeks after having the ­vaccine to be fully protected.

Like any vaccine, the MMR jab can cause side-effects, which are usually mild and go away very quickly.

This includes rash, high temperature, loss of appetite and a general feeling of being unwell for about two or three days.

There is also a very small chance children can have a severe allergic reaction.

But compared to the complications of measles, there is no contest that vaccination is by far the safest and most effective route to take.

Why was it linked with autism?

In 1998, Andrew Wakefield and his colleagues published a now-discredited paper in medical journal The Lancet.

The paper suggested that the MMR vaccine might be associated with autism and a form of bowel disease.

It led to a sharp decline in vaccination rates.

Even at the time, the research was considered poor.

The Lancet retracted the story in 2010 after ­Wakefield’s article was found “dishonest” by the General Medical Council.

He was later struck off and subsequently, in 2011, the British Medical Journal declared the story fraudulent.

Does it contain ingredients from pigs?

There are two types of MMR jabs: One with gelatin (animal/pig collagen), and one without it.

For some religious groups, the inclusion of pig products is not ­acceptable.

Those people should ask for the vaccine without gelatin.

What to do if you come down with measles

You should ask for an urgent GP appointment or get help via NHS 111 if you think you or child have measles.

Bear in mind that it’s highly unlikely that you’ll have measles if you’ve received both doses of the MMR vaccine.

After speaking to a GP, the best thing to do is:

  • Rest and drink plenty fluids, such as water, to avoid dehydration
  • Take paracetamol or ibuprofen to relieve a high temperature – do not give aspirin to children under 16
  • Use cotton wool soaked in warm water to gently remove any crusts from your or your child’s eyes

Unvaccinated children who come into contact with the disease are currently being advised to stay at home for 21 days.

How can I best protect my child from measles?

Kids are offered their first dose of the vaccine aged one and their second at three years at four months, just before they start school.

However, anyone who has missed shots can catch up at any time through their GP surgery.

To keep measles at bay, 95 per cent of children must be vaccinated.

But Latest NHS Digital shows that up to three in 10 children (56 per cent) in parts of England haven’t had both MMR jabs by the time they turn five.

Urgent, “concerted action” is needed to tackle the virus to stop its spread, according to the UK Health Security Agency (UKHSA).

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