Status:
Resolved
Health alert:
190001
Date Issued:
16 Jan 2019 (update to alert issued 14 January 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 confirmed case of measles who may have been infectious whilst in and around Inner East and North East Melbourne between Wednesday 9 January and Friday 11 January 2019: 
    • Wednesday 9 January: Hooking Restaurant, Kew East (7.00pm to 8.30pm) and Laird Hotel, Abbotsford (9.00pm and 12.30am)
    • Thursday 10 January: Metro train Hurstbridge line, Collingwood to Ivanhoe (12.20am to 1.00am), and Blackhearts and Sparrows, North Fitzroy (4.00pm to 4.35pm) and Colonel Tans Restaurant, Prahran (7.30pm to 9.30pm)
    • Friday 11 January: Prahran Aquatic Centre, Prahran (1.00pm to 4.00pm)
  • This follows a previously reported case who may have been infectious whilst at Box Hill Hospital between Thursday 10 January and Sunday 13 January.  
  • 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 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 case of measles who has spent time in and around Inner East and North East Melbourne while possibly infectious between Wednesday 9 January and Friday 11 January inclusive. 

This follows a previously reported case of measles who may have been infectious whilst at Box Hill Hospital between Thursday 10 January and Sunday 13 January inclusive:

Date Time Location Onset of symptoms up to
9 January 2019 7.00pm to 8.30pm Hooking Restaurant, Kew East 27 January 2019
9 January 2019 9.00pm to 12.30am Laird Hotel, Abbotsford 27 January 2019
10 January 2019  12.20am to 1.00am Metro Train (Hurstbridge line) between Collingwood and Ivanhoe 28 January 2019
10 January 2019 8.00am to 9.30pm Box Hill Hospital including lunch in the onsite café, Zouki Cafeteria 28 January 2019
10 January 2019 4.00pm to 4.35pm Blackhearts and Sparrows, North Fitzroy 28 January 2019
10 January 2019 7.30pm to 9.30pm Colonel Tans Restaurant, Prahran 28 January 2019
11 January 2019 8.00am to 6.30pm Box Hill Hospital including lunch in the onsite café, Zouki Cafeteria 29 January 2019
11 January 2019 1.00pm to 4.00pm Prahran Aquatic Centre, Prahran 29 January 2019
12 January 2019 8.00am to 9.30pm Box Hill Hospital including lunch in the onsite café, Zouki Cafeteria 30 January 2019
13 January 2019 8.00am to 10.00am Box Hill Hospital 31 January 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 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.
Picture courtesy of U.S. Centers for Disease Control and Prevention

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 vaccine.

More information

Clinical information

The Australian Immunisation Handbook; 10th edition, 2013

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).

Find out more about the Chief Health Officer.