Measles is ‘even more serious than people realise’ doctors warn

Measles is even more serious than people realise, doctors have warned.

The highly contagious infection begins with a fever, cough and purple rash, but can  lead to deadly complications.

Three people who suffered hepatitis, viral meningitis and appendicitis after contracting measles were discussed in a report published today.

It comes amid a global outbreak of cases due to declining uptake of the MMR (measles, mumps and rubella) vaccine.

The two-dose jab offers maximum protection against all three infections, but ‘unfounded fears’ about its risks have caused many to refuse it. 

Measles, which begins with a fever, cough and purple rash, is even more serious than people realise, doctors have warned. Three people who contracted measles and later suffered hepatitis, viral meningitis and appendicitis were discussed in a report published today

Writing in the British Medical Journal, doctors at the Mater Dei Hospital said measles can lead to ‘many and varied’ conditions affecting all organs.

About 30 per cent of all reported cases are linked to one or more complications, according to the Centers for Disease Control and Prevention. 

These occur most commonly in children under five years of age and adults above 20 years of age.  

Common complications include diarrhoea and vomiting, eye and ear infections and seizures, according to the NHS. 

Although most people with measles recover in around a week, Dr Thelma Xerri and colleagues highlighted how serious it can become.

Rarer and more serious problems include pneumonia, febrile seizures and encephalomyelitis – inflammation of the brain and spinal cord which causes neurological problems. 

One potential complication is a progressive neurological disorder that causes permanent nervous system damage and leads to a vegetative state, doctors wrote. 

Multi-organ involvement could lead to disability or even cause death, the team said. 


Measles is a highly contagious viral infection that spreads easily from an infected person by coughing, sneezing or even just breathing.

Symptoms develop between six and 19 days after infection, and include a runny nose, cough, sore eyes, a fever and a rash.

The rash appears as red and blotchy marks on the hairline that travel down over several days, turning brown and eventually fading.

Some children complain of disliking bright lights or develop white spots with red backgrounds on their tongue.

In one in 15 cases, measles can cause life-threatening complications including pneumonia, convulsions and encephalitis.

Dr Ava Easton, chief executive of the Encephalitis Society told MailOnline: ‘Measles can be very serious.

‘[It] can cause encephalitis which is inflammation of the brain.

‘Encephalitis can result in death or disability.’

Treatment focuses on staying hydrated, resting and taking painkillers, if necessary.

Measles can be prevented by receiving two vaccinations, the first at 13 months old and the second at three years and four months to five years old.

Source: Great Ormond Street Hospital

They revealed the cases of three unidentified people who were diagnosed with measles complications in hospital in Malta in 2019.  

A 29-year-old man had suffered four days of an intermittent fever with chills and vomiting before going to the doctors. On the second day at hospital, he developed the typical measles rash. 

The man, who had only taken one of two doses of the MMR vaccine, developed hepatitis – inflammation of the liver. 

An 18-year-old British woman who never received the vaccine visited the hospital in Malta while on holiday.

She had a rash over her stomach, face and limbs for three days, as well as a dry cough.

A diagnosis of measles with appendicitis was made, and she stayed in hospital for two weeks recovering.

A middle-aged man saw medics at hospital a week after being diagnosed with measles by his GP. He had been suffering eye irritation and headaches.

He was found to have viral meningitis – an inflammation of the lining of the brain and spinal cord. 

The trio are believed to have suffered severe problems because the measles virus leads to a decline in immune cells. This can last for up to a month, wiping out the body’s ability to fight other illnesses.

All patients in the report recovered fully and were not left with any long-lasting health problems. 

However, full vaccination would have protected all three from the virus. The Daily Mail is campaigning to boost the uptake of childhood MMR immunisations. 

Dr Xerri and colleagues said: ‘Measles, which was once thought to be a disappearing viral infection due to effective vaccination, has been reemerging globally, with increasing cases in adolescents and adults. 

‘This has been attributed to anti-vaccination campaigning in the early 21st century, which has resulted in a drop in overall herd immunity.’

‘Herd immunity’ is when a significant portion of the population are vaccinated against a disease, and those who are not protected are less able to spread the disease between one another.   

For vaccinations to be truly effective, 95 per cent of the population need to be immunised to achieve herd immunity. In England only 86 per cent receive both injections by their fifth birthday.

Even small declines in uptake can have serious consequences for a whole community, which has become apparent in recent years.

Experts have described outbreaks of measles as an ‘unprecedented’ global crisis, causing more than 110,000 deaths globally last year, most of them children under the age of five.

In the first six months of 2019, 10,000 measles cases were reported in Europe.  

The UK used to have a ‘measles-free’ status until a marked increase in the number of cases in 2018.

There were 991 confirmed cases in England  and Wales- treble the number of 284 cases in 2017.   

The hesitance to take children for their jabs has been accelerated by antivaxxer myths about the dangers of the MMR jab which are spread on social media. 

False claims in the early 2000s which linked the MMR vaccine to autism are still rife today. 

The research, led by the disgraced doctor Andrew Wakefield, has since been discredited.  

The authors of the BMJ report wrote: ‘Large outbreaks with fatalities are currently ongoing in European countries which had previously eliminated or interrupted endemic transmission. 

‘Urgent efforts are needed to ensure global coverage with two-dose measles vaccines through education and strengthening of national immunisation systems.’

Dr Mary Ramsay, head of immunisation at Public Health England, said: ‘Measles is very easy to catch and can kill. Fortunately, we have a very safe and effective vaccine that can stop measles from spreading and save lives.

‘But if you’ve not had your two doses of MMR vaccine then you are at risk. If you’re unsure if you are up to date with your two doses of MMR vaccine contact your GP practice. It’s never too late to protect yourself and others.’


Andrew Wakefield's discredited autism research has long been blamed for a drop in measles vaccination rates

Andrew Wakefield’s discredited autism research has long been blamed for a drop in measles vaccination rates

In 1995, gastroenterologist Andrew Wakefield published a study in The Lancet showing children who had been vaccinated against MMR were more likely to have bowel disease and autism.

He speculated that being injected with a ‘dead’ form of the measles virus via vaccination causes disruption to intestinal tissue, leading to both of the disorders.

After a 1998 paper further confirmed this finding, Wakefield said: ‘The risk of this particular syndrome [what Wakefield termed ‘autistic enterocolitis’] developing is related to the combined vaccine, the MMR, rather than the single vaccines.’

At the time, Wakefield had a patent for single measles, mumps and rubella vaccines, and was therefore accused of having a conflict of interest.

Nonetheless, MMR vaccination rates in the US and the UK plummeted, until, in 2004, the editor of The Lancet Dr Richard Horton described Wakefield’s research as ‘fundamentally flawed’, adding he was paid by a group pursuing lawsuits against vaccine manufacturers.

The Lancet formally retracted Wakefield’s research paper in 2010.

Three months later, the General Medical Council banned Wakefield from practising medicine in Britain, stating his research had shown a ‘callous disregard’ for children’s health.

On January 6 2011, The British Medical Journal published a report showing that of the 12 children included in Wakefield’s 1995 study, at most two had autistic symptoms post vaccination, rather than the eight he claimed.

At least two of the children also had developmental delays before they were vaccinated, yet Wakefield’s paper claimed they were all ‘previously normal’.

Further findings revealed none of the children had autism, non-specific colitis or symptoms within days of receiving the MMR vaccine, yet the study claimed six of the participants suffered all three.