Hong Kong Measles Guide: Symptoms, Treatment & Prevention

Measles (麻疹) is a vaccine-preventable Rubeola virus known to be among the most contagious viruses. The most common trait associated with measles is blotchy red rashes all over an infected person's skin. People who have recovered from measles will develop immunity[1].

Measles Situation in Hong Kong and Internationally

As an endemic disease (a disease inherent to a country), most Western countries consider measles to be eliminated. However, measles cases still occasionally flare up, such as in Hong Kong in 2019[2].

The most common reason for flare-ups is unvaccinated persons entering countries with measles and then importing the virus back.

According to data from the Centres for Disease Control and Prevention (CDC), In the United States, 71% of people infected with measles in 2019 were completely unvaccinated[3]. Similarly, in France, 2500 measles cases were reported in 2018, most of which were children under one who were not fully vaccinated. The French authorities reported 88% of cases were from people who had not had two doses of the measles vaccine [4].

Measles Outlook

Unfortunately, reporting and testing for measles have slowed down due to COVID-19. The pandemic has also weakened many countries' immunisation programs, especially in Europe and North America[5], increasing the risk of a future measles epidemic.

How is Measles Transmitted?

Measles is spread through an infected person's nose and throat mucus, such as sneezing and coughing. It's easy to get infected as you can breathe contaminated air or touch an infected surface and then touch your eyes, nose or mouth. Measles is highly contagious; the virus can survive in the air for up to two hours after an infected person leaves the area.

It is estimated that up to 90% of non-immune people in close contact with an infected person will get the virus[6].

Symptoms of Measles

On average, the first symptoms of measles start appearing 10-12 days after initial exposure to the virus. The first noticeable symptom is a high fever, often exceeding 40°C. Then rash will appear, usually starting around the hairline and spreading down the rest of the body. Other symptoms include coughing, a runny nose and red, watery eyes[7].

How Can I Prevent Measles?

Since measles is highly contagious, prevention is more effective than cure. Getting immunised against measles with an MMR vaccination (measles, mumps and rubella) or MMRV (Varicella) is the best thing you can do.

One dose of the MMR vaccine is 93% effective, and two doses are 97% effective against measles[8].

Measles Vaccinations in Hong Kong

1. All babies 12 months and older should ensure they have had at least one MMR dose.
2. The Centre for Health Protection Hong Kong has recommended that the second vaccination dose be given earlier, at 18 months. This can even be given as early as 28 days after the first dose if travelling to a high-risk region.
3. Foreign domestic helpers unsure of their vaccination status should be tested and vaccinated.
4. For individuals unsure of their status, this can be checked by a simple blood test before vaccination. You can use our vaccine calculator to generate a personalised immunisation schedule for you and your family.

You can use our vaccine calculator to generate a personalised immunisation schedule for you and your family. For more information, consult with the practitioners at OT&P today!

References

1. 1. National Health Service. (2018). 'Measles.' NHS. 14 August 2018. Available at: <https://www.nhs.uk/conditions/measles/>[Accessed 2 October 2021].
   2. Cheung, E. (2019). 'Measles: a highly infectious disease previously brought under control but now appearing to be making a comeback in Hong Kong.' South China Morning Post. 28 March 2019. Available at: <https://www.scmp.com/news/hong-kong/health-environment/article/3003514/measles-highly-infectious-disease-previously>[Accessed 2 October 2021].
   3. Patel M, Lee AD, Redd SB, et al. (2019). 'Increase in Measles Cases — United States, January 1–April 26, 2019.' CDC. 3 May 2019. Available at: <https://www.cdc.gov/mmwr/volumes/68/wr/mm6817e1.htm?s_cid=mm6817e1_w>[Accessed 2 October 2021].
   4. Finnegan, G. (2018). 'France measles outbreak: babies hit hardest'. Vaccines Today. 7 November 2018. Available at: <https://www.vaccinestoday.eu/stories/france-measles-outbreak-babies-hit-hardest>[Accessed 2 October 2021].
   5. Durrheim, D.N., Andrus, J.K., Tabassum, S. et al. (2021). 'A dangerous measles future looms beyond the COVID-19 pandemic'. Nature Medicine. 15 February 2021. Available at: <https://doi.org/10.1038/s41591-021-01237-5> [Accessed 2 October 2021].
   6. Centres for Disease Control and Prevention. (2020). 'How measles spreads'. CDC. 5 November 2020. Available at: <https://www.cdc.gov/measles/transmission.html> [Accessed 2 October 2021].
   7. Centres for Disease Control and Prevention. (2020). '7 – 14 days after a measles infection: first symptoms show'. CDC. 5 November 2020. Available at: <https://www.cdc.gov/measles/symptoms/signs-symptoms.html> [Accessed 2 October 2021].
   8. Centres for Disease Control and Prevention. (2021). 'Who Should Get MMR Vaccine?'. CDC. 26 January 2021. Available at: <https://www.cdc.gov/vaccines/vpd/mmr/public/index.html> [Accessed 2 October 2021].