Metropolitan measles alert

A case of measles has been identified in a returned overseas traveller.

Several countries around the world are experiencing measles outbreaks. People travelling to these countries are at risk if they do not have immunity to the measles virus.

Exposure locations

Be vigilant for symptoms if you visited the following locations on the days/times listed.

Anyone who presents with signs and symptoms of measles should be tested and the Department of Health notified. They should be especially vigilant if they have travelled overseas or visited any of the areas listed above and are not immune to measles (i.e., are not fully vaccinated against measles and have not had measles previously).

Who is at risk?

Anyone born in or since 1966 and who does not have documented evidence of receiving two doses of a measles-containing vaccine or documented evidence of immunity, is at risk of contracting measles.

Unvaccinated babies are at particularly high risk of contracting measles. Babies as young as six months can receive a free measles, mumps, rubella (MMR) vaccine prior to travel overseas to countries where measles is prevalent, or where measles outbreaks are occurring.

The first dose of MMR vaccine is usually given at 12 months as part of the National Immunisation Program (NIP) schedule. If a baby receives an early dose of MMR vaccine (e.g. at eight months) prior to travelling overseas, they must still receive their routine 12-month and 18-months doses in line with the NIP schedule.

Those at risk of severe illness from measles include immunocompromised people, young children and pregnant women.

Symptoms and transmission

The first symptoms of measles are:

• Fever
• Tiredness
• Runny nose
• Cough
• Sore red eyes.

These symptoms usually last for a few days before a red blotchy rash appears. The rash normally starts on the face before spreading down to the body and usually lasts for four to seven days.

Some measles cases involve complications such as pneumonia and encephalitis and many people with measles end up in hospital.

Measles is highly infectious and can spread via airborne droplets to people close by (e.g. in waiting rooms). It can last in the environment for up to two hours.

People with measles are usually infectious from one day before their symptoms start and for four days after their rash appears.

Recommendations

General public

If you attended the exposure sites during the listed dates and times you may have been exposed to measles and should monitor for symptoms.

People with measles typically develop symptoms around 10 days after being exposed to the virus, but this can vary from seven to 18 days. The rash usually appears four to five days after symptoms start to show.

Anyone who develops symptoms of measles should put on a mask and seek medical care. Before visiting a general practice clinic or emergency department, it is important to call ahead to let them know you may have measles, so they can provide instruction on where to go and isolate you when you arrive to prevent spread to other patients or staff.

If you are concerned you may have measles and require medical advice after hours contact healthdirect on 1800 022 222.

It is important to stay up to date with your vaccinations. People born after 1965 should make sure they have had two documented doses of a measles-containing vaccine at some stage in their life.

Anyone planning overseas travel should see their general practitioner or a travel doctor to discuss appropriate vaccinations prior to travel.

Health professionals

Health professionals should be alert for measles, particularly among returned overseas travellers – ensure all staff have a high index of suspicion for measles in patients presenting with a febrile rash.

General practices and emergency departments should:

• Ask about recent travel when assessing acute illness.
• Identify people with measles-compatible illness at reception or triage, provide a mask and isolate immediately – consultation rooms used in the assessment of patients with suspected measles should be left vacant for at least 30 minutes after the consultation.
• Consider testing patients presenting with fever and rash for measles – the recommended laboratory tests for diagnosis of acute measles include: a throat swab (or nasopharyngeal aspirate); first catch urine; serum samples for serology +/- PCR (SST and EDTA tubes, respectively)
• Notify suspected cases immediately to your local Public Health Unit by telephone (8am to 5pm Mon-Fri excluding public holidays) or to the Department of Health on call duty officer (after hours).

Free MMR vaccines are available to people susceptible to measles, even if they are not eligible for Medicare. Serology is not required before vaccinating.

Anyone planning overseas travel should ensure they are up to date with all routine vaccinations and consider receiving additional travel vaccinations.