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  » Immunization Schedules  »  Measles, mumps and rubella (German Measles)

Measles, mumps and rubella

Measles, mumps and rubella (German measles) are all serious viral diseases. A combined measles-mumps-rubella (MMR) vaccine is used to protect children against these diseases.

Measles

Measles is a serious, highly contagious viral illness which causes fever, rash, runny nose, cough and conjunctivitis. Complications following measles can be very dangerous, and pneumonia occurs in 4% of cases. Approximately one child in every 2,000 who contracts measles will develop inflammation of the brain (encephalitis). For every 10 children who contract measles encephalitis, one will die and up to four will have permanent brain damage. Measles has caused more deaths in Australia in the past 15 years than diphtheria, whooping cough and rubella combined. A very serious but rare illness called subacute sclerosing panencephalitis (SSPE) can occur in children several years after a measles infection. SSPE is a disease which rapidly destroys the brain and always results in death. SSPE develops in about one in 25,000 cases of measles.

Young adults between the ages of 18 and 30 years have also been identified as an 'at-risk' group for measles. The reasons for this group having a higher susceptibility to measles is because:

  • they are too old to have been recipients of the two-dose MMR vaccination program that was introduced in 1994, and some will not have received a single dose; and
  • previous measles control initiatives, including the Measles Control Campaign, and the two-dose MMR policy, appear to have raised levels of immunity in younger age groups to a point where sustained transmission of measles is unlikely to occur, thereby increasing the age of those infected during an outbreak.

It is anticipated that free MMR vaccine will be available between March and June 2001 for young adults.

Mumps

Mumps is a viral disease which causes fever, headache and inflammation of the salivary glands. Occasionally it causes an infection of the membranes covering the brain (meningitis) but permanent effects are rare. In as many as five per 1,000 patients it can cause inflammation of the brain (encephalitis). Mumps can also cause permanent deafness. About one in five adolescent or adult males who contracts mumps develops painful inflammation and swelling of the testicles. While the person with this condition usually recovers completely, on rare occasions it may cause infertility.

Rubella

Rubella, which used to be called German measles, is usually a mild disease of childhood but it can also affect teenagers and adults. The usual symptoms of rubella are a slight fever, swollen glands, joint pain and a rash which appears on the face and neck and lasts for two or three days. Recovery from rubella is almost always speedy and complete. The most dangerous form if rubella infection is congenital rubella, where infection during the first 20 weeks of pregnancy can result in devastating abnormalities in the newborn baby. Deafness, blindness, heart defects and mental retardation can occur. Rubella is highly contagious. The best way to protect expectant mothers and their babies from rubella is to make sure that all women have been immunised before they become pregnant, and to immunise all children to stop the spread of infection.

Measles-mumps-rubella (MMR) immunisation

Children should be first immunised against measles, mumps and rubella at 12 months of age. The vaccine can also be given to older children and adults, and is very effective. The combination measles-mumps-rubella (MMR) vaccine protects children against all three diseases. Children should receive a second dose of MMR vaccine at 4 years of age. Women of child bearing age, and especially those considering pregnancy, should have a blood test for rubella, as the immunisation they received as a teenager may have worn off. If rubella antibody levels are low, these women should receive MMR vaccine. Women should not receive the vaccine if they are pregnant or might become pregnant within two months. The MMR vaccine contains small amounts of reduced strength live measles, mumps and rubella viruses, and a small amount of an antibiotic (neomycin).

Possible side effects of MMR immunisation

Reactions to MMR immunisation are much less frequent than the complications of natural measles. The most common reaction is feeling unwell and having a low grade fever, possibly with a rash, occurring 5 to 12 days after immunisation. Children who develop the rash during this time are not infectious to others. The fever can be reduced with appropriate doses of paracetamol. Occasionally children will develop a mild swelling of the salivary glands about three weeks after the immunisation because of the mumps component of the vaccine. More serious reactions are rare. About one in 30,500 children develops thrombocytopenia (bruising or bleeding). If encephalitis (inflammation of the brain) occurs at all following MMR immunisation, it is very rare - probably at a rate of one in a million doses or less. Subacute sclerosing panencephalitis (SSPE) is prevented by immunisation. The risks of serious complications after catching measles, mumps or rubella, are much greater than the very small risks of the MMR immunisation.

If every child in a school of 500 children had not been immunised and an outbreak of measles occurred, nearly every student would come down with measles. Pneumonia would occur in 20 children. There is a 25% chance that one child in the school would develop encephalitis (inflammation of the brain) as a result of measles. If every child in the school was immunised correctly with MMR vaccine, on average there would be one case of encephalitis every 2000 years caused by the immunisation.