Measles Alert

Information for NSW General Practitioners.

1. Four cases of measles have been detected in Sydney in the past two weeks.
2. More cases could present in the coming weeks.
3. Isolate suspected cases immediately and call the public health unit.

Measles in NSW

• Four cases of measles have been reported in Sydney in the past two weeks.
• Whilst infectious, the cases spent time in:
  • Hostels in Cairns and Magnetic Island
  • Flights from Cairns to Sydney: Virgin Airlines on 28 March and Tiger Airlines on 29 March.
  • Royal North Shore Hospital Emergency Department on 29 March
  • A flight from Delhi, India arriving in Sydney on 30 March
  • Mount Druitt Emergency Department
  • A medical centre in Blacktown on 2 April.
• Be aware that those who are too young to be vaccinated (<12 months), and those who have not received two doses of measles containing vaccine are at risk of infection.
• Be alert to travellers who may have been exposed in youth hostels – this population is likely highly mobile. However, suspect measles in people with fever and rash irrespective of travel history.

How does measles present?

• Two to four days of prodromal illness with fever, cough, coryza, and conjunctivitis.
• While febrile a maculo-papular rash then typically begins on the face and neck and becomes generalised.
• Measles cases are infectious from the day before the prodrome illness to 4 days after the onset of rash.

How to manage suspected cases

• Isolate – arrange to see suspected cases in their homes or at the end of the day.
• Notify – inform your public health unit (PHU) immediately – don’t wait for test results before calling. The earlier a PHU knows about a suspected case the more effective containment interventions can be.
• Test – Collect a nose and throat specimen, and a first pass urine sample for nucleic acid testing and blood for measles serology. Your PHU can assist in expediting testing, if indicated.
• Continue to display travel posters and measles posters and be on the look out for new imports following holiday travel:
  http://www.health.nsw.gov.au/Infectious/diseases/Pages/MERS-travel-poster.aspx and
  http://www.health.nsw.gov.au/Infectious/Pages/Measles.aspx

Advocate for immunisation

• The best way for people to protect themselves and others is to get vaccinated.
• Remember to vaccinate children at 12 and 18 months of age.
• Discuss vaccination with your patients – opportunistic vaccination is important, overseas travel is an opportunity to encourage vaccination.
• Health care workers are at increased risk – ensure that you and your staff are vaccinated.
• Measles containing vaccines (MMR) are safe and available free in NSW for those born during or after 1966 who have not previously had two documented doses.

Further Information

• Contact your local public health unit on 1300 066 055.
• NSW Measles control guidelines:
  http://www.health.nsw.gov.au/Infectious/controlguideline/Pages/measles.aspx

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