Status:
Resolved
Health alert:
AL180009
Date Issued:
16 May 2018
Issued by:
Dr Brett Sutton, Deputy Chief Health Officer, Victoria
Issued to:
General Practitioners and Hospital Emergency Departments

Key messages

  • There has been one confirmed case of measles who may have been infectious whilst at a number of places across Melbourne between 8 and 13 May 2018:
    • 8 May - Noble Park Aquatic Centre (7am to 4pm), Goodlife Dingley (6.30-7.30pm)
    • 9 May - Noble Park Aquatic Centre (7am to 4pm), Goodlife Chelsea Heights (5-6pm)
    • 10 May - Noble Park Aquatic Centre (7am to 4pm)
    • 11 May - Noble Park Aquatic Centre (7am to 4pm)
    • 12 May - Chez Dré café South Melbourne (10-11am), Westfield Fountain Gate, Narre Warren (1.30-3pm) (including YOMG burger restaurant)
  • The case was acquired in South-East Asia (Thailand or Vietnam).
  • Be alert for measles in patients presenting with a fever at rash onset, particularly if they attended the above places.
  • 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.

What is the issue?

There has been one confirmed case of measles who has spent significant time in a number of places across Melbourne while possibly infectious between 8 and 13 May 2018.

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.

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.

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).