What is the issue?
There has been a new case of measles in a person who was infectious whilst returning from overseas travel in the Philippines. The table below is a summary of all public exposure sites for the current measles case in Victoria
||Onset of symptoms up to
|Saturday 20 July
||4pm – 6.30pm
||Cebu Pacific flight 5J49, Manila to Melbourne, Melbourne Airport - Terminal 2
||Wednesday 7 August 2019
In 2019 there have now been 27 cases of confirmed measles notified in Victoria. Almost all cases are in people who are not fully immunised against measles, who have either travelled overseas or been in contact with travellers from overseas in Victoria. Many cases are people born since 1966 who believed they were fully immunised but who had not had two doses of MMR vaccine.
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 visited any of the areas listed 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. These pictures are typical of a measles rash.
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.
The Australian Immunisation
The Blue Book - Guidelines for the control of infectious diseases
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).