Frequently asked questions

Measles situation in the Philippines

January 2014

What is measles?

Measles is a highly contagious, serious disease caused by a virus of the paramyxovirus family. The measles virus normally grows in the cells that line the back of the throat and lungs. Measles is a human disease and is not known to occur in animals.

Measles remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine.

Accelerated vaccination activities have had a major impact in reducing measles deaths. Since the year 2000, more than one billion children in high risk countries have been vaccinated against measles through mass vaccination campaigns, and global deaths have fallen by over 70%.

How is the virus transmitted?

The virus can be transmitted through cough or sneeze from an infected person to another person with close, direct contact.

The virus remains active and contagious in the air or on infected surfaces for up to two hours. It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts.

Who is at risk?

Unvaccinated young children are at highest risk of measles. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.

People who have had measles are immune for the rest of their lives.

What are the signs and symptoms?

The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage.

After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days).

Severe measles is more likely among poorly-nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.

Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20.

The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care.

Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery.

What is the treatment for measles?

There is no specific treatment for measles and patients generally recover within two to three weeks. All measles patients should stay at home until at least four days after the rash appears to prevent further spread of the virus.

Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhoea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.

All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.

How can people protect themselves or their families from the virus?

Routine measles vaccination for children, combined with mass immunization campaigns in areas with high case and death rates, are key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 40 years. It is safe, effective and inexpensive. It costs less than one US dollar to immunize a child against measles.

What is the measles situation in the Philippines?

The Department of Health announced on 6 January 2014 that there are currently a rising number of measles cases in the National Capital Region (Manila) and other parts of the country.

Why are measles cases on the rise?

For a community to be protected from measles, there has to be at least 95% immunization coverage. Factors contributing to the increasing number of cases include gaps in routine measles vaccination coverage including that less than 50% of eligible children have received a 2nd dose of measles vaccine that reinforces protection against measles infection. Another factor contributing to the spread of the measles virus is increased travel within the country recently, both because of the recent emergencies and also the holiday season.

What is WHO doing to address the rise in measles cases?

WHO is procuring 1 million doses of MR (measles and rubella) vaccine, to supplement current national stocks of several million measles doses and is also procuring logistics materials (2.4 million auto-destruct syringes, 270,000 mixing syringes and 30,000 safety boxes) for the ‘Goodbye measles’ campaign in Metro Manila and seven provinces, taking place from 23 January to 3 February 2014.

WHO is providing surveillance support – on data encoding and management – to the Department of Health, and is also procuring medical supplies for measles case management (including vitamin A and antibiotics). In addition, WHO is procuring blood testing kits and laboratory supplies in order to confirm measles cases, as part of measles surveillance activities.

The organization is supporting monitoring activities for the ‘Goodbye measles’ campaign, including rapid coverage assessments. These are quick surveys of households and children that provide health authorities with a quick impression of how complete the vaccination campaign is.

WHO is also providing cold-chain equipment for the disaster affected areas in the country.

More broadly, WHO provides expert technical assistance – through the WHO Philippines Country Office, the Western Pacific Regional Office and WHO Headquarters, as well as through international partners such as the United States Centers for Disease Control and Prevention (US CDC).

Should people living in the Philippines be concerned about the measles outbreak?

Measles is a serious disease. In the Philippines, children can be vaccinated free of charge at all government health centers. All children should be protected by the measles vaccine which is given at nine months (monovalent measles vaccine) and at 12 months (measles-mumps-rubella/MMR vaccine).

All adults who have had contact with a person infected with the virus should be vaccinated.

Is it safe to travel to the Philippines?

Measles is still common in many countries, including the Philippines. Travel in densely populated areas may favor transmission. Travellers, especially children and young adults who have not been immunized against measles should be vaccinated.