Measles is a rash illness resulting from infection with the measles virus. It can affect people of all ages but infants less than one year of age and those who are immunocompromised are at increased risk of complications and death. It's one of the most communicable diseases with one case having the potential to infect another 12 to 18 individuals through airborne transmission and respiratory droplets in susceptible populations.
MMR is the combined vaccine that protects against measles, mumps and rubella and is the most effective strategy for preventing the transmission of measles.
For more information on measles, visit the NHS Choices website.
- Read our guidance for the control of measles and outbreaks in Scotland.
- Visit the Public Health England website for guidance for measles post-exposure prophylaxis.
- Guidance on when to use immunoglobulin can be found on the Public Health England website.
- For more information on measles immunisation, including updates, please refer to the Public Health England (PHE) Green Book, Chapter 21.
For all infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.
Data and surveillance
Before vaccination, measles was a very common childhood disease in Scotland and deaths attributable to measles were substantial. Following the introduction of measles vaccine in 1968 and the subsequent introduction of the MMR vaccine in 1988, the incidence of the disease has decreased dramatically. However, as Figure 1 shows, outbreaks still occur in under immunised populations.
Surveillance update for 2018
As shown in Figure 2, in the last four years, the number of laboratory confirmed measles cases each year has been variable, ranging from no cases in 2015 to 26 in 2016. In 2017, five laboratory confirmed cases were reported all of which were imported or linked to an imported case within or outwith the UK. Two confirmed case of measles were reported to Health Protection Scotland in 2018. These were in unvaccinated individuals with history of travel within and outwith Europe. No further transmission occurred highlighting the success of the MMR vaccination programme and the importance of maintaining high uptake in Scotland.
Throughout 2017, measles outbreaks occurred across Europe and they continued into 2018. The countries most affected between December 2017 and November 2018 have been:
- France with 2,921 cases
- Greece with 2,634 cases
- Italy with 2,548 cases
- Romania with 1,346 cases
- UK with 984 cases
Overall, there has been a decrease in measles activity in Europe including England which experienced increased incidence of measles with a number of outbreaks throughout the country in the spring and summer months. The outbreaks in Europe and England show that the risk of an importation of measles into Scotland remains high.
Age distribution of cases
The age distribution of measles cases has been variable for the past five years but Figure 3 shows the majority of cases are in children and young adults. For 2016, the median case age was 22 years, compared to nine years in 2014 and 15 years in 2013. The median age of the five measles cases in Scotland in 2017 was higher than previous years at age 27 years. The age of the two measles cases in Scotland in 2018 is not shown due to the potential for deductive disclosure of the two cases.
Vaccine Uptake Statistics
Vaccine uptake statistics can be found on the Information Services Division website.