FOR hundreds of years, measles has been one of the most contagious and lethal viruses known to humans. It poses a significant risk to individuals, especially children under five years of age who lack vaccination, as their immune systems and organ systems are still developing.
Measles disease, caused by the measles virus, is highly infectious. Despite the availability of a safe and affordable vaccination, measles kills more children than any other vaccine-preventable disease in Nigeria each year.
One person afflicted with measles can spread the virus to up to 18 unprotected others, making it ‘extremely infectious’. The virus is easily spread through respiratory droplets or contact with contaminated surfaces and remains viable for up to two hours.
Dr Foluso Balogun, a consultant paediatrician at University College Hospital, Ibadan, and team leader for the Oyo State Immunization Champions, said measles, like rubella, is a viral disease that can be prevented through vaccination.
She spoke at an advocacy meeting by the Paediatric Association of Nigeria in collaboration with the International Paediatric Association to create awareness of the integrated measles-rubella vaccine among traditional birth attendants.
Nigeria is also introducing a new combined measles-rubella vaccine to replace the measles-only vaccine. It is part of Nigeria’s integrated vaccination campaign, aiming to reach about 109 million children aged 9 months to 14 years with vaccines against measles-rubella (MR), human papillomavirus, which protects against cervical cancer (HPV), polio, and other routine immunisations.
The campaign is being implemented in two phases: phase one covers 20 high-risk northern states and Oyo state in the southwest; phase 2 begins in January 2026 and will be expanded to the remaining southern states.
The initiative responds to persistent outbreaks of circulating variant poliovirus type 2 (cVDPV2) as well as measles and rubella outbreaks in Nigeria and across the Lake Chad Basin.
Dr Balogun declared that with two doses of the measles-rubella (MR) vaccine, the first dose at 9 months and the second dose at between 15 and 18 months, one is protected for life against these infections.
‘Once the vaccine is in good condition, it has not expired, it has been given through the right route, it has not been exposed to the wrong temperature or environment, and two doses have been taken, it might confer immunity for life,’ she said.
She said the impression by mothers that a child could repeatedly have measles is wrong if the child has already had a full dose of measles vaccine or a past measles infection.
Dr Balogun declared many times that a skin rash and high body temperature in children are misinterpreted as measles by many mothers.
She stated, ‘The mistake is because of the similarities in some symptoms of measles with some other conditions like rubella, Roseola Infantum, and Rocky Mountain spotted fever. All these conditions also cause similar rashes and increased body temperature in children.’
Common early symptoms of measles-fever, cough, runny nose-are similar to other viral infections such as colds or flu. A few days into the illness, painless, tiny white spots in the mouth (called Koplik spots) appear. But they’re easy to miss and are absent in many cases. A day or two later, a distinctive skin rash develops.
However, Dr Balogun said there are subtle differences between measles, rubella and other diseases like Roseola infantum, and Rocky Mountain spotted fever.
The maculopapular rash, in the case of measles, usually starts from the face, spreading to the back of the ear, and then the body. But rashes due to rubella don’t follow that particular pattern.
Rashes due to rubella usually last for three days, and after three days they disappear, and it doesn’t peel. But rashes due to measles last longer than that, and then they peel off. Also, body temperature is higher in measles, unlike in rubella.
Dr Balogun also discouraged practices like applying palm oil mixed with bitter leaf extract on rashes in children as a treatment, saying rashes can be caused by different conditions and necessitate that such children be taken to the hospital for appropriate diagnoses and treatment.
‘I’ve seen cases where they mix up chicken pox and measles. The layman would call everything measles. Not every rash is measles. Measles rash has characteristics, and there’s some history and tests to know whether it’s measles or not.
‘We use calamine lotion in treating measles because the rash is itchy. And it’s to reduce the itching so that the child will be calm. But they are not supposed to use it on their own,’ she added.
Dr Balogun, however, said that with immunization, the spread of measles and rubella in the community can be stemmed once herd immunity is attained.
According to her, ‘This measles-rubella vaccine is safe and effective to protect from the disabilities and mortality that can come from measles and rubella; this vaccine can prevent congenital rubella syndrome so that we will not have such in our midst again.’
The measles vaccine has been in use since the 1960s. It is safe, effective and inexpensive. The best thing is to prevent it from occurring. And any life lost cannot be brought back. So, it’s better for us to make sure we prevent it from occurring.