Be alert for measles cases in South Australia
4 December 2019
SA Health has been advised by the Victorian Department of Health and Human Services of a number of recent cases of measles in the Mildura area in workers from the Pacific Islands. There are likely to be further cases, some of which may present to GPs and hospitals in South Australia.
There have been 261 measles cases reported in Australia this year, but only four cases in South Australian residents to date. This year there have been over 2100 cases of measles in New Zealand, with outbreaks in Tonga, Fiji, and in particular in Samoa, where over 50 deaths have been recorded, mostly in children under 5 years of age. Measles cases continue to be reported from other countries to which Australians travel and return.
Measles is transmitted via respiratory aerosols that remain a risk to others for up to 30 minutes after the person has left the area. The incubation period is about 10 days (range 7 to 18 days) to the onset of prodromal symptoms and about 14 days to rash appearance. The illness is characterised by cough, coryza, conjunctivitis, a descending morbilliform rash, and fever present at the time of rash onset. The infectious period is from 24 hours prior to onset of the prodrome (or 4 days prior to onset of rash) until 4 days after the onset of the rash.
Doctors with patients suspected of having measles are asked to:
- Notify urgently any patient with suspected measles to the CDCB on 1300 232 272 (24 hours/7 days). Do not wait for laboratory confirmation.
- At the time of consultation, take a throat swab in viral transport media (preferred specimen) and if possible, urine in a yellow top container for measles PCR, and arrange urgent laboratory testing through SA Pathology. To reduce the risk of measles transmission, do not send the patient to a laboratory collection centre.
- Isolate suspected and confirmed measles cases and exclude from child-care/ school/ workplace for 4 days after rash appearance.
- Ensure all household and other contacts are protected against measles (see Australian Immunisation Handbook https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/measles )
- Minimise transmission of measles:
- Examine patients suspected of having measles in their own homes wherever possible.
- Ensure the patient is only seen by practice staff with confirmed immunity to measles.
- Ensure suspected cases do not use the waiting room, and conduct the consultation in a room that can be left vacant for at least 30 minutes afterwards.
- Treat all people who attend the rooms at the same time, and up to 30 minutes after the infectious patient has left the rooms, as contacts.
- Two doses of a measles containing vaccine are highly effective at preventing measles. Offer measles vaccine (unless contraindicated, for example in pregnant women or immunosuppression) to all potentially susceptible persons who attend your practice.
- While most people born in Australia before 1966 will have had measles in childhood, those born in the late 1960s to mid-1980s may have only received one measles vaccine.
- Vaccination against measles can now be given from 6 months of age in infants travelling to countries where measles is endemic or a measles outbreaks are occurring (if given <12 months of age, 2 subsequent doses from 12 months of age are still required).
Further clinical information is available at www.sahealth.sa.gov.au/InfectiousDiseaseControl
For all enquires please contact the CDCB on 1300 232 272 (24 hours/7 days)
Dr Louise Flood – Director,
Communicable Disease Control Branch