The symptoms of measles that every parent must know - from a runny nose to the tell-tale rash (and how to tell it apart from other illnesses)

A national incident has been declared by the authorities after measles outbreaksThe surge has been blamed on vaccination uptake, which are at a decade low

Measles will take off across the UK unless more people get vaccinated, health chiefs have warned.

A national incident has been declared by the authorities after outbreaks in the West Midlands and London have sickened hundreds.

The surge in illness has been blamed on a slump in vaccination rates, which are at their lowest level in a decade. Just 84.5 per cent of five-year-olds in England have had both MMR jabs, compared to the 95 per cent needed to prevent the virus from spreading. 

The NHS today launched a catch-up campaign, with pop-up clinics at schools and letters sent to millions, in the hopes of increasing jab uptake.

Measles, which can be caught at any age and prove fatal, is highly infectious.

Cold-like symptoms, such as a fever, cough and a runny or blocked nose, are usually the first signal of measles. A few days later, some people develop small white spots on the inside of their cheeks and the back of their lips. The tell-tale measles rash also develops, usually starting on the face and behind the ears, before spreading to the rest of the body

Latest UK Health Security Agency (UKHSA) data shows there were 1,603 suspected measles cases in England and Wales in 2023. The figure is more than twice as high as the 735 logged in 2022 and an almost five-fold rise compared to the 360 cases reported in 2021

Cold-like symptoms

Measles, one of the most contagious pathogens known to mankind, is spread through an infected person’s coughs and sneezes.

The virus then makes its way into other people’s lungs and then spreads through the bloodstream to infect cells in almost every organ.

Symptoms usually appear 10 to 12 days after getting infected.

A fever, runny or blocked nose, sneezing, a cough and red, sore and watery eyes are the first signs of the respiratory illness. These can last for a few days.

It means that, in its earliest stages, measles can be mistaken for Covid, flu or even a common cold.

Rash in mouth

According to the NHS, small white spots may then start to appear in the mouth.

Known as Koplik spots, they typically appear inside the cheeks and on the back of the lips.

The lumps tend to be around 1 to 3mm in diameter and last for a few days.

Rash

A rash is the tell-tale sign of measles that can help distinguish it from other viruses.

It usually starts on the face and behind the ears before spreading to the rest of the body.

The spots that form the rash can be raised and join together to form blotchy patches. They’re not usually itchy.

On white skin, the rash appears red or brown. However, it may be harder to see on brown and black skin.

A person who has caught measles is infectious from five days before their rash appears to around four days afterwards, according to the European Centre for Disease Prevention and Control.

The rash is caused by the body’s immune system releasing chemicals to destroy the virus, which trigger swelling and damage to its own cells.

How serious is measles?

Measles can be caught at any age and prove fatal. Complications include blindness, deafness and swelling of the brain (encephalitis).

One in five children who catch it will need to be admitted to hospital for treatment, according to estimates.

Analysis shows that if just one child in a classroom is infected, they can pass the virus on to up to nine other unvaccinated children, making it one of the most infectious diseases worldwide and more infectious than Covid.

If pregnant women become infected, the virus can cause stillbirth, miscarriage and a baby to have a low birth weight.

However, two doses to the measles, mumps, and rubella (MMR) vaccine — given at one year old, then three years and four months — offers life-long protection.

After both doses, 99 per cent of people are protected from measles.

People who missed the jabs as part of the childhood vaccination schedule can catch up at any time by contacting their GP practice, which can also inform them if they have had both jabs already.

Rashes in babies and children – how to tell them apart

Slapped cheek syndrome: A rash on cheeks with high temperature

Slapped cheek syndrome

A fever, runny nose, sore throat and headache are usually the first signs of slapped cheek syndrome.

A red rash on one or both cheeks then appears. However, it may be less obvious on brown and black skin. In adults, the rash doesn’t usually develop.

A few days later, a spotty rash may appear on the chest, arms and legs. The rash can be raised and itchy. It can also be harder to see on brown and black skin.

Slapped cheek syndrome usually gets better on its own within three weeks.

It can usually be treated at home with rest, plenty of fluids, medicine to ease symptoms and an antihistamine to ease itchy skin.

The illness is caused by a virus (parvovirus B19) and is spread through coughs and sneezes.

Hand, foot and mouth disease: Blisters on hands and feet plus mouth ulcers

Hand, foot and mouth disease

Hand, foot and mouth disease is a common childhood illness that can also affect adults. It usually gets better on its own in 7 to 10 days.

A sore throat, fever and lack of appetite are usually the first signs of the illness.

Within days, painful mouth ulcers appear, along with a raised rash of spots on the hands and feet and sometimes the thighs and bottom.

The rash of spots can look pink, red or darker than the surrounding skin. They can turn into blisters, which might be grey or lighter than surrounding skin.

Hand, foot and mouth disease is easily passed on to other people. It’s spread in coughs, sneezes, poo and the fluid in the blisters. You can get it more than once.

Scarlet fever: Rash on the face and body

Scarlet fever

A rash of small, raised bumps that feels rough, like sandpaper, could be scarlet fever.

The contagious infection mostly affects young children. It is treated with antibiotics.

Flu-like symptoms, such as a high temperature, a sore throat and swollen neck glands are the first signs.

A rash appears 12 to 48 hours later and looks likely small, raised bumps. It starts on the chest and tummy before spreading.

A white coating will appear on the tongue, which peels off and leaves the tongue red, swollen and covered in little bumps (called ‘strawberry tongue’).

The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin.

Measles: A rash that appears on the head or neck and spreads over the body

Measles

Measles, one of the most contagious pathogens known to mankind, is spread through an infected person’s coughs and sneezes.

A fever, runny or blocked nose, sneezing, a cough and red, sore and watery eyes are the first signs of the respiratory illness. These can last for a few days.

Small white spots may then start to appear in the mouth. Known as Koplik spots, they typically appear inside the cheeks and on the back of the lips.

A rash is the tell-tale sign of measles that can help distinguish it from other viruses.

It usually starts on the face and behind the ears before spreading to the rest of the body.

The spots that form the rash can be raised and join together to form blotchy patches. They’re not usually itchy.

On white skin, the rash appears red or brown. However, it may be harder to see on brown and black skin.

Prickly heat: A rash of small, raised spots that feels itchy or prickly

Prickly heat

Heat rash is uncomfortable, but usually harmless. It usually gets better on its own after a few days.

Symptoms include small, raised spots, an itchy, prickly feeling and mild swelling.

It can appear anywhere on the body and spread but can’t be passed to others.

Prickly heat is usually caused by excessive sweating, which sees the sweat glands blocked, leading to a rash.

It usually gets better on its own after a few days.

Atopic eczema: Scaly or cracked skin

Atopic eczema

Atopic eczema causes the skin to become itchy, dry, cracked and sore.

Some people only have small patches of dry skin but others may have inflamed skin all over their body.

It can affect any part of the body but most often affects the hands in adults, while it most commonly affects the inside of the elbows, backs of the knees and the face and scalp of children.

People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe.

The exact cause is unknown but it’s clear it is not down to one single thing. It often occurs in people who get allergies.

Sufferers are advised to go to their GP. Treatments include moisturising and topical corticosteroids to reduce swelling, redness and itching.

Hives: Raised, itchy spots or patches

Hives

Raised itchy patches or spots could be caused by an allergic reaction (hives).

Hives can usually be treated at home. But the NHS says to call 999 if there’s swelling around a child’s mouth or they’re struggling to breathe.

Hives is triggered by something causing high levels of histamine and other chemicals to be released in the skin, such as food, contact with certain chemicals or cold water or wind.

The rash can be raised bumps or patches of different shapes and sizes, be anywhere on the body, feel itchy and sting or burn and look pink or red.

Pharmacists can give advice about antihistamine treatment to help a hives rash.

Ringworm: Itchy round rash

Ringworm

Ringworm is a common fungal infection.

It is transmitted through close contact with an infected person or animal or infected objects — such as bedsheets, combs or towels.

Signs include an itchy, dry, ring-shaped patch of skin, which may look red, pink, silver, or darker than surrounding skin.

Ringworm can appear anywhere, including the scalp and groin.

A pharmacist can recommend the best antifungal medicine, which may be needed for up to four weeks.

Chickenpox: Small spots and blisters

Chickenpox

Chickenpox is a contagious infection that causes an itchy, spotty rash.

Small spots appear anywhere on the body, which become very itchy fluid-filled blisters, which then form scabs and flake.

Other symptoms can include a fever, aches and pains and loss of appetite.

It most commonly affects children but can be caught at any age.

It usually gets better within two weeks without seeing a GP.

Impetigo: Itchy sores or blisters

Impetigo

Impetigo is a very contagious skin infection.

Red sores or blisters are the first signs of the condition, which burst and leave golden-brown patches that can look like cornflakes stuck to the skin. They can be itchy and painful.

A GP will prescribe hydrogen peroxide cream to speed up recovery or antibiotic cream or tablets if the infection is very bad.

It often gets better in 7 to 10 days with treatment. Anyone can get impetigo but it’s more common in young children.

Scabies: Small and very itchy spots

Scabies

Scabies is an itchy rash caused by mites.

It is spread through close skin contact with an infected person and must be treated quickly to stop it spreading further.

Symptoms include intense itching, especially at night, and a raised rash or spots.

The rash usually spreads over the entire body, apart from the head and neck. It often appears between fingers, around the wrists, under the arms and around the waist, groin and bottom.

It must be treated and won’t go away on its own.

A pharmacist can recommend a cream or lotion, which quickly kills the mites. However, itching can last until weeks later.

Milia: Tiny spots on a baby’s face 

Milia

Very small spots often appear on a baby’s face when they’re just days old.

These spots, called milia, might look white or yellow, depending on a baby’s skin colour.

They usually go away within a few weeks and do not need treatment.

Erythema toxicum: Red, yellow and white spots in babies

Erythema toxicum

Raised red, yellow and white spots can appear on babies when they’re born.

Erythema toxicum usually appear on the face, body, upper arms and thighs.

The rash can disappear and reappear. It should get better in a few weeks without treatment.

Molluscum contagiosum: Skin-coloured or pink spots

Molluscum contagiosum

Spots that appear on the skin and look dome-shaped with a shiny white dimple in the middle may be molluscum contagiosum.

The spots are 2 to 5mm wide and tends to affect the folds of the skin, such as the groin, behind the knees and armpits.

The infection is contagious and is usually passed on by skin to skin contact. However, there is only a small chance of passing it on during normal activities.

It’s usually harmless and clears up in 18 months without treatment.

However, if spots become infected, GPs may prescribe antibiotics or a steroid cream.

Nappy rash: Red patches on a baby’s bottom

Nappy rash

Nappy rash is caused by a baby’s skin being in contact with pee or poo for a long time, not changing a nappy often enough or the nappy rubbing against the skin.

It’s normal for babies to suffer from the reaction sometimes.

Symptoms include red or raw patches on a baby’s bottom, skin that looks sore and feels hot to touch, scaly and dry skin and an itchy and painful bottom.

It can be treated and prevented by regularly changing nappies, keeping the skin clean and dry and bathing a baby daily.

A pharmacist can recommend a nappy rash cream.

Acne

Acne: Pimples on the cheeks, nose and forehead 

Spots that appear on a baby’s cheeks, nose or forehead within a month after birth could be baby acne.

Baby acne does not need to be treated.

It usually gets better after a few weeks or months.

Cradle cap: Yellow, scaly patches on the scalp 

Cradle cap

Cradle cap is a harmless skin condition that’s common in babies.

It causes patches of greasy, scaly skin that are found on the scalp and face but sometimes affects the nappy area.

It can look like patches of white or yellow greasy scales that form a crust, which might flake off. In the nappy area, it looks like small, dry flakes of skin.

It is not itchy or painful and usually goes away on its own in 6 to 12 months.

The cause is not known but it can’t be caught from other babies.