Status:
Resolved
Health alert:
AL19005
Date Issued:
16 May 2019 (update to Alert issued 8 May 2019)
Issued by:
Dr Angie Bone, Acting Chief Health Officer, Victoria
Issued to:
General Practitioners and Hospital Emergency Departments

Key messages

  • An additional case of measles has been confirmed in an overseas traveller.
  • This is in addition to the four cases of measles confirmed in Victorian residents who travelled overseas recently but do not appear to be linked. These five cases may have been infectious whilst attending multiple public areas.  
  • To date, a total of 14 confirmed cases of measles have been notified for Victoria year-to-date. 
  • Be alert for measles in patients presenting with a fever at rash onset, particularly if they attended the places below in the 7-18 days prior to onset of illness.
  • Isolate suspected cases to minimise the risk of transmission within your department/practice.
  • Notify the Communicable Disease Prevention and Control Section at the Department of Health and Human Services on 1300 651 160 of suspected cases immediately.
  • Take blood for measles serology in all suspected cases.
  • Discuss whether to take nose and throat swabs for PCR with the department if your suspicion for measles is high. Approval is required prior to PCR testing at the reference laboratory. PCR testing for measles does not attract a Medicare rebate.
  • Free measles-mumps-rubella (MMR) vaccine is now available from GPs and some pharmacies for all eligible adults born during or since 1966.

What is the issue?

A new case of measles has been confirmed in an overseas traveller who visited Victoria while infectious. This is in addition to the four cases of measles confirmed in Victorian residents recently. This includes people who may have been infectious whilst attending multiple public areas. The table below is a summary of all exposure sites in Victoria.

Date Time Location Onset of symptoms up to
Tuesday 23 April 7am – 5.30pm St. Andrews Avenue, Bendigo CBD Saturday 11 May 2019
Wednesday 24 April    10am – 10.30am
Strathfieldsaye Primary Health  Saturday 11 May 2019 
Wednesday 24 April     11.30am – 12.30pm  Axedale Tavern, Axedale Sunday 12 May 2019
Wednesday 24 April  12.15pm – 1.15pm  Toolleen Hotel, Tooleen Sunday 12 May 2019
Wednesday 24 April  12.45pm – 2.20pm   High Street, Heathcote  Sunday 12 May 2019
Wednesday 24 April  Late afternoon  IGA, Heathcote  Sunday 12 May 2019
Saturday 27 April  Morning  Heathcote Pharmacy, Heathcote Wednesday 15 May 2019 
Saturday 27 April  Morning  BP, Heathcote  Wednesday 15 May 2019 
Monday 29 April  11.30am – 3pm Holiday and Cruise Centre, Sturt Street, Ballarat  Friday 17 May 2019 

Monday 29 April
Tuesday 30 April
Wednesday 1 May
Thursday 2 May
Friday 3 May 

8.30am – 9am each day  Munch & Lunch On Mair, Ballarat 

Friday 17 May 2019
Saturday 18 May 2019
Sunday 19 May 2019
Monday 20 May 2019
Tuesday 21 May 2019 

Thursday 2 May  9am – 10.30am  Bridge Mall, Ballarat  Monday 20 May 2019 
Thursday 2 May  3.30pm – 5.30pm   Melbourne Airport, Terminal 2,
Cebu Pacific flight 5J49
 
Monday 20 May 2019 

Thursday 2 May
Friday 3 May 

5pm – 6pm
6am – 7am  

Holiday Inn Melbourne Airport, reception  Tuesday 21 May 2019 
Friday 3 May  6am – 8.40am  Melbourne Airport, Terminal 1, QF2051  Tuesday 21 May 2019 
Friday 3 May   Day  The Mornington Hotel, Mornington  Tuesday 21 May 2019  
Friday 3 May   8.30pm – 11.00pm  Counting House Bar and Grill, Mornington  Tuesday 21 May 2019  
Saturday 4 May   Morning – 2.00pm  The Mornington Hotel, Mornington  Wednesday 22 May 2019 
Saturday 4 May  1.30pm – 3pm  Coltman Plaza-Lucas Shopping Centre,
Lucas (City of Ballarat)
 
Wednesday 22 May 2019 
Sunday 5 May  Morning – 10.00am  The Mornington Hotel, Mornington  Thursday 23 May 2019 
Sunday 5 May  2.00pm - Midnight  Quest Services Apartments, St Kilda  Thursday 23 May 2019 
Monday 6 May  Morning – 10.30am  Quest Services Apartments, St Kilda  Friday 24 May 2019 
Monday 6 May  4.00pm – 5.00pm  Priceline Pharmacy, Williamston,
Douglas Parade Williamston
 
Friday 24 May 2019 
Tuesday 7 May  8.30am – 11.00am   Melbourne Airport, Terminal 2
Vietnam Airlines flight VN780
 
Saturday 25 May 2019 

Anyone who presents with signs and symptoms compatible with measles should be tested and notified to the department. There should be an especially high index of suspicion if they have attended any of the areas stated above and are unvaccinated or partially vaccinated for measles.

This is a timely reminder for individuals to check their vaccination records. Free measles-mumps-rubella (MMR) vaccine is now available for adults born during or since 1966 who do not have documented evidence of receiving two doses of a measles-containing vaccine or do not have documented evidence of immunity.

Who is at risk?

Children or adults born during or since 1966 who do not have documented evidence of receiving two doses of a measles-containing vaccine or do not have documented evidence of immunity are considered to be susceptible to measles. People who are immunocompromised are also at risk.

Symptoms and transmission

Clinical features of measles include prodromal fever, a severe cough, conjunctivitis and coryza, followed by a maculopapular rash starting on the face. Individuals, especially children, are typically unwell. The infectious period of patients with measles is roughly five days before, to four days after, the appearance of the rash.

Measles is highly infectious and can persist in the environment for up to two hours. The pictures below are typical of measles rash. 

Example of measles rash on the face of a young boy.  Example of measles rash on the face and neck of a man.

Summary of recommendations

  • Be alert for new measles cases – ensure all staff, especially triage nurses, have a high index of suspicion for patients presenting with a febrile rash.
  • Notify suspected cases immediately to the Communicable Disease Prevention and Control Section via telephone on 1300 651 160 (24 hours).
  • Take blood for serological confirmation.
  • Call the department to discuss the need for nose and throat swabs for PCR diagnosis. PCR testing for measles does not attract a Medicare rebate.
  • To minimise the risk of measles transmission within your department/practice:
    • avoid keeping patients with a febrile rash illness in shared waiting areas
    • give the suspected case a single-use mask and isolate them, until a measles diagnosis can be excluded
    • leave vacant all consultation rooms used in the assessment of patients with suspected measles for at least 30 minutes after the consultation.
  • Identify patients who are susceptible to measles, especially those planning travel overseas, and offer free measles-mumps-rubella (MMR) vaccine.

More information

Clinical information

The Australian Immunisation Handbook

The Blue Book - Guidelines for the control of infectious diseases

Consumer information

Better Health Channel

Contacts

For further information please contact the Communicable Disease Prevention and Control section at the Department of Health and Human Services on 1300 651 160 (24 hours).