Most people recognise a rash as the first sign of measles, but experts say there are multiple other symptoms that can appear days earlier.
But some of these — sneezing, coughing and aches and pains — can be easily mistaken for a cold or flu.
Experts say there’s one red flag that parents should be aware of, that is almost always an indication of measles.
The virus causes small, white spots on the inside of the cheek that appear like ‘grains of sand’, but are often missed, said Helen Bedford, Professor of children’s health at Great Ormond Street Institute of Child Health.
She told MailOnline they are called Koplik spots, and can appear inside the cheeks and on the back of the lips, and tend to be around 1 to 3mm in diameter.
One of the first warning signs that’s often missed are small white spots on the inside of the cheek
Experts are now warning parents about the early warning signs in order to prevent outbreaks of the virus that ‘spread like wildfire’.
Measles can prove fatal, killing roughly three in every 1,000 children who contract it, studies show.
Complications include blindness, deafness and swelling of the brain (encephalitis).
It’s one of the most contagious pathogens known to mankind and can spread through an infected person’s cough and sneezes.
Symptoms include sneezing, coughing, aches and pains as well as the measles rash, but the virus can lead to serious complications including pneumonia and meningitis.
Another tell-tale sign of measles is the rash, it usually starts on the face and behind the ears before spreading to the rest of the body.
The spots that form the rash can be raised and join together to form blotchy patches.
But unlike chickenpox this rash is not usually itchy.
On white skin, the rash appears red or brown. However, it may be harder to see on brown and black skin, according to the NHS.
Cold-like symptoms, such as a fever, cough and a runny or blocked nose, are usually the first signal of measles. A few days later, some people develop small white spots on the inside of their cheeks and the back of their lips. The tell-tale measles rash also develops, usually starting on the face and behind the ears, before spreading to the rest of the body
Earlier this year UK Health Security Agency (UKHSA) revealed measles cases were on the rise.
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The UK saw the biggest measles outbreak in 10 years with cases in February rising higher than the last major out break in 2013.
Analysis shows that if just one child in a classroom is infected, they can pass the virus on to up to nine other unvaccinated children, making it one of the most infectious diseases worldwide and more infectious than Covid.
‘If a child is ill with what you think is measles, it’s better for parents to ring ahead to a doctor rather than rushing them to the GP, because measles is highly infectious, it spreads like wildfire,’ Professor Bedford said.
With no treatment, defence is the best approach in the form of the highly infectious measles, mumps, and rubella (MMR) vaccine.
Two doses of the MMR vaccine — given at one year old, then three years and four months — offers life-long protection.
After both doses, 99 per cent of people are protected from measles.
In January the NHS launched a catch-up campaign, with pop-up clinics at schools and letters sent to millions, in the hopes of increasing jab uptake.
Steve Russell, NHS Director of Vaccinations and Screening: ‘People who are unvaccinated can get catch-up jabs at MMR pop-ups in schools and other convenient places while GPs, teachers and trusted community leaders are encouraging groups that are less likely to get their jab to come forward.’
But it is never to late to get the jab. People who missed their vaccine can schedule a catch up any time by contacting their GP practice.
‘The most important thing is to get children vaccinated. Some people think is their child’s past the age of the recommended vaccination, but it is never too late. You can have the vaccine into adulthood,’ Professor Bedford added.