Measles is a highly contagious acute viral respiratory disease
with symptoms appearing 10-12 days after exposure to
the measles virus

  • High fever
  • Cough
  • Running nose (coryza)
  • Red, watery eyes (conjunctivitis)
  • Tiny white spots (Koplik spots) inside the mouth
  • Rash as flat red spots that first appear on the face (3-4 days after the fever) and spreads to the rest of the body

  • Person-to-person through direct contact with infectious droplets or by small particle aerosols that remain suspended in the air for up to 2 h when an infected person breathes, coughs, or sneezes
  • A patient with measles may infect ~12-18 susceptible persons within close contact
  • The infectious period spans from several days before to several days after appearance of rash

  • Measles can be prevented through measles vaccination
  • Measles vaccines are available as combined vaccines with those for rubella (MR), mumps (MMR), or varicella (MMR-V)
  • In India, the following measles vaccination programmes have been implemented:
    • Routine immunization with the first dose of measles containing vaccine (MCV1) for children aged 9 months-12 months was introduced in 1985
    • Routine immunization with the second vaccine dose (MCV2) for children aged 16 months-24 months was introduced in 2011
    • Mass vaccination campaigns or supplemental immunization campaigns were introduced in a phased manner for children aged 9 months-10 years between 2010 to 2013 and for measles and rubella between 2017 to 2019
    • In 2017, the routine immunization schedule with MCV1 and MCV2 was replaced by measles- and rubella-containing vaccine (MRCV)

  • India made considerable progress in its measles and rubella immunization programme resulting in a 62% decrease in the annual incidence of measles - from 10.4 to 4.0 cases per million population - during 2017-2021.
  • Despite the progress made in measles immunization, routine MRCV1 and MRCV2 coverages decreased during the COVID-19 pandemic causing recent outbreaks in some states. Therefore, meeting the measles and rubella elimination goals by 2023 remains a challenge.

  • Moss WJ. Measles. Lancet. 2017;390(10111):2490-2502.
  • Guerra FM, Bolotin S, Lim G, et al. The basic reproduction number (R0) of measles: a systematic review. Lancet Infect Dis. 2017;17(12):e420-e428.
  • Murugan R, VanderEnde K, Dhawan V, et al. Progress toward measles and rubella elimination - India, 2005-2021. MMWR Morb Mortal Wkly Rep. 2022;71(50):1569-1575.
  • Vaidyanathan G. Massive measles outbreak threatens India’s goal to eliminate disease by 2023.