Measles information for South Eastern Sydney General Practitioners

There has been a new case of measles in a resident of Sutherland Shire this week. Secondary cases are possible until 19 November 2018.

During the infectious period the case spent time in healthcare facilities and community settings in South Eastern Sydney between 26 October and 1 November. During this period, they attended:

  • Westfield Miranda on Sunday 28 October, 2pm to 3.30pm and Tuesday 30 October, 2pm to 4pm
  • Sylvania Heights Community Club on Monday 29 October, 10.30am to 11.30am
  • Sutherland Hospital Emergency Department on Wednesday 31 October, 4.30pm to Thursday 1 November, 4.00am
  • Sydney Children’s Hospital Emergency Department on Thursday 1 November, 3.30am to 11am

The public health unit has contacted relevant susceptible contacts to arrange prophylaxis, however other people may have been exposed and not provided with prophylaxis.

Secondary cases are possible until 19 November 2018. Please make sure you have triage measures to identify and isolate suspected measles cases.

Please notify the public health unit immediately of suspected cases – the public health unit can assist in expediting testing and provide advice about isolation.

Who is susceptible to measles

The following groups may be susceptible to measles infection:

  • Infants under 12 months of age
  • People born after 1966 who have not received two doses of measles vaccine
  • Some immunocompromised persons

Many teenagers and young adults in the Pacific Islander community are susceptible to measles due to missing their routine childhood vaccines.

Clinical presentation

Measles symptoms commence 7 – 18 days after exposure to an infectious case. The symptoms are:

  • High fever (usually >38°C)
  • Cough &/or coryza &/or conjunctivitis
  • Koplik’s spots may be visible on the buccal mucosa
  • A rash commences after 3-4 days of symptoms: beginning on the face, spreading to the trunk & then the limbs

Measles infectivity

Measles is highly infectious and is spread via aerosol.

  • Cases are infectious four days before and four days after the appearance of the rash.
  • Suspected cases should not wait in the same room as other patients. Any consulting room used for a suspected case should not be used by others for 30 minutes afterwards

Measles diagnosis

For patients presenting with symptoms of measles please collect:

  • Nasopharyngeal swab (or NP aspirate, if appropriate) and 40 ml urine from suspected cases, and request urgent measles PCR testing. For effective testing the swab must contain cells, thus it is crucial that the swab collect cells from the nose and/or pharynx.
  • If more than 3 days have elapsed since rash onset, please also collect blood for measles serology (use a clotted tube).

Free MMR vaccine is available for adults born after 1966 who have not received two doses of measles vaccine. Please also check that all your staff are immune to measles.