Measles alert

28 March 2019

 

Key information
  • Cases of measles continue to be imported into NSW from overseas
  • Locally-acquired cases have begun to occur and more are likely in the coming weeks.
  • Suspect measles in those presenting with fever and rash irrespective of travel history.
  • Isolate suspected cases immediately and call the public health unit.

Since December 2018, 23 cases of measles have been notified in NSW. Several cases have spent time in busy public places such as hospitals, shopping centres, and backpacker hostels while infectious. At highest risk are those who are too young to be vaccinated (<12 months), and those who have not received two doses of measles containing vaccine. Suspect measles in people with fever and rash irrespective of travel history.

NSW Health, and health authorities in Victoria and New Zealand have issued warnings for passengers on two international and two Australian domestic flights to be alert for signs and symptoms of measles after a passenger travelling from Phuket to Christchurch via Sydney and Melbourne was diagnosed with the illness. The flights and areas of the airport that the passenger spent time in are provided here.

How does measles present?
  • Two to four days of non-specific illness with fever, cough, coryza, and conjunctivitis.
  • A maculo-papular rash then typically begins on the face and neck and becomes generalised.
  • Cases have occurred in people reporting prior vaccination – these tend to present atypically, with short or absent prodrome, milder fever and less rash – maintain a high index of suspicion for measles in vaccinated patients if exposure to earlier cases is possible.
  • Measles cases are infectious from the day before the onset of non-specific symptoms to 4 days after the onset of rash.
How to manage suspected cases
  • Isolate - arrange to see suspected cases in their homes or at the end of the day.
  • Notify - call your local public health unit (PHU) on 1300 066 055 immediately – don’t wait for test results before calling. The earlier a PHU knows about a suspected case the more effective containment intervention can be.
  • Test - collect a nose and throat viral swab and a first pass urine sample for nucleic acid testing, and blood for measles IgG and IgM. Mark specimens as URGENT. Your PHU can assist in expediting testing.
  • Continue to display travel posters and measles posters and be on the look-out for new imports following holiday travel, and potentially locally acquired cases.
Advocate for immunisation
  • Vaccinate children on-time at 12 and 18 months of age.
  • Infants travelling overseas can be vaccinated as early as 9 months of age – if vaccinated prior to 11 months of age two additional doses will be required to ensure long-term protection.
  • Measles-mumps-rubella vaccine (MMR) is safe and available free in NSW for those born during or after 1966 who have not previously had two documented doses.
  • Discuss vaccination with your adult patients – overseas travel is an opportunity to catch-up MMR.
  • Ensure that you and your staff are vaccinated.
Further Information

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