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17 May 2018

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Causative agent

It is caused by a virus called Measles virus.

Clinical features

Measles was a common childhood infection prior to the introduction of measles vaccine. Affected persons will present initially with fever, cough, runny nose, red eyes and white spots inside the mouth. This is followed 3 to 7 days later by a red blotchy skin rash, which usually spreads from face to the rest of the body. The rash usually lasts 4 - 7 days, but can persist for up to 3 weeks leaving with brownish staining and sometimes fine skin peeling. In severe cases, lung, gut and brain can get involved and lead to serious consequences or even death.

Mode of transmission

This can be transmitted airborne by droplet spread or by direct contact with nasal or throat secretions of infected persons, and less commonly, by articles soiled with nasal or throat secretions. Measles is one of the most highly communicable infectious diseases. The patient can pass the disease to other persons from 4 days before to 4 days after appearance of the rash.

Incubation period

It usually ranges from 7 - 18 days, but can be up to 21 days.


Affected persons should avoid contact with non-immune persons, especially those with weakened immunity, pregnant women and infants. Although there is no specific treatment, drugs may be prescribed to reduce the symptoms and antibiotics may be used to treat bacterial complications.


1. Maintain good personal hygiene

  • Perform hand hygiene frequently, especially before touching the mouth, nose or eyes, after touching public installations such as handrails or door knobs or when hands are contaminated by respiratory secretion after coughing or sneezing. Wash hands with soap and water for at least 20 seconds, then dry with a disposable paper towel or hand dryer. When hands are not visibly soiled, clean them with 70 - 80% alcohol-based handrub as an effective alternative.
  • Cover your mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissues into a lidded rubbish bin, then wash hands thoroughly.
  • When having respiratory symptoms, wear a surgical mask, refrain from work or school, avoid going to crowded places and seek medical advice promptly.
  • Children with measles should stay at home; keep out of Schools/ Kindergartens/ Kindergartens-cum-Child Care Centres/ Child Care Centres till 4 days from the appearance of rash to prevent spread of the infection to non-immune persons in school.

2. Maintain good environmental hygiene

  • Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing 1 part of 5.25% bleach with 99 parts of water), leave for 15 – 30 minutes, and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.
  • Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing 1 part of 5.25% bleach with 49 parts of water), leave for 15 – 30 minutes and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.
  • Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places.

3. Immunisation

  • Vaccination against measles is the most effective preventive measure. Under the Hong Kong Childhood Immunisation Programme, children are given Measles, Mumps and Rubella (MMR) vaccine at 1 year old and at Primary 1. (Please refer to the Hong Kong Childhood Immunisation Programme).
  • Different places will develop different immunisation programmes in light of their epidemiological profiles.  Parents should arrange their children to receive vaccines according to the local immunisation programme of their place of residence. For instance, children aged under one who frequently travel to or stay in the Mainland should follow the Mainland's schedule of measles immunisation with the first dose of measles containing vaccine at 8 months old, followed by another dose at 18 months.
  • All foreign domestic helpers (FDH) who are non-immune* to measles should receive MMR vaccine, preferably before they arrive in Hong Kong. If this is not possible, they can consult a doctor after they have arrived in Hong Kong. Employment agencies can consider adding the assessment of immune status against measles or MMR vaccination for FDH as additional items in the pre-employment medical check-up package.
  • *In general, people can be considered as non-immune to measles if (i) they did not have measles infection confirmed by laboratory test before, and (ii) they  had not been fully vaccinated against measles or have unknown vaccination status.

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