Status:
Resolved
Health alert:
190003
Date Issued:
22 Feb 2019 (update to Alert issued 14 February 2019)
Issued by:
Dr Brett Sutton, Acting Chief Health Officer, Victoria
Issued to:
General Practitioners and Hospital Emergency Departments

Key messages

  • There has been an additional unrelated case of measles in a returned overseas traveller who may have been infectious whilst in multiple public areas in the Melbourne Central Business District (CBD) between Tuesday 12 February and Wednesday 20 February 2019.
  • This is in addition to the two (2) previously reported cases of measles in the Point Cook and Southbank areas.  
  • Be alert for measles in patients presenting with a fever at rash onset, particularly if they attended the above places 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?

There has been an additional unrelated case of measles in a returned overseas traveller who may have been infectious whilst in multiple public areas in the Melbourne Central Business District (CBD) between Tuesday 12 February and Wednesday 20 February 2019.

This is in addition to the two (2) previously reported cases of measles who may have been infectious whilst in and around the Point Cook and Southbank areas between Monday 4 February and 7 February inclusive.  

 
Date Time Location Onset of symptoms up to
Monday 4 February to Thursday 7 February 2019 Day 2 Southbank Blvd, Southbank 25 February 2019
Monday 4 February to Wednesday 6 February 2019 Day 42 Balston Street, Southbank  24 February 2019 
Tuesday 5 February 2019 8.00am to 8.30pm 2 Southbank Blvd, Southbank 23 February 2019 
Thursday 7 February 2019 3.00pm to 4.00pm Skybus, Southern Cross Station to Melbourne Airport 25 February 2019 
Thursday 7 February 2019  3.30pm to 6.15pm  Melbourne Tullamarine Airport Terminal 3  25 February 2019 
Thursday 7 February 2019 Departed 5.35pm (Melbourne time) arrived 6.50pm (Perth time) Virgin Australia Flight VA691 (Melbourne-Perth) 25 February 2019
Friday 8 February 2019  6.00 to 7.30pm  Between Two Buns (B2B) burger restaurant, Hoppers Crossing  26 February 2019 
Tuesday 12 February to Wednesday 20 February 2019  Day

RMIT Training Centre and surrounding area, 251 Bourke St, Melbourne

10 March 2019  
Tuesday 12 February to Friday 15 February 2019  Day  Bus and Tram services between Toorak and RMIT Bourke Street  5 March 2019 
Wednesday 13 February to Wednesday 20 February 2019  Day/night  Ibis Hotel and surrounding area, 130 King St, Melbourne  10 March 2019 
Sunday 17 February 2019  Day  Multiple sites around Melbourne Central Shopping Centre including HOYTS Cinema (1.30pm session)  7 March 2019
Monday 18 February 2019  Lunchtime  Emporium Shopping Centre food court  8 March 2019
Tuesday 19 February 2019  Day/night  Multiple sites in the Melbourne CBD area between King and Spencer Streets and Collins and Lonsdale Streets 9 March 2019 
Wednesday 20 February 2019  3.00pm to 5.00pm  255 Bourke Street, Melbourne  10 March 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 picture below is typical of rash on the face. This is a rash on day three in a young boy.

Example of measles rash on the face of a young boy.

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).