- Alert number:
- Date issued:
- 27 Mar 2019 - (update to Alert issued 26 March 2019)
- Issued by:
- Dr Brett Sutton, Chief Health Officer, Victoria
- Issued to:
- General Practitioners and Hospital Emergency Departments
- There have been additional unrelated cases of measles in persons who may have been infectious whilst attending multiple public areas across metropolitan Melbourne. To date, a total of nine cases of measles have been notified in Victoria for 2019.
- Be alert for measles in patients presenting with a fever at rash onset, particularly if they attended the places below 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 (MMR) vaccine is now available from GPs and some pharmacies for all eligible adults born during or since 1966.
What is the issue?
There have been additional unrelated cases of measles in persons who may have been infectious whilst attending multiple public areas across metropolitan Melbourne. The table below is a summary of all exposure sites for current measles cases in Victoria.
|Date||Time||Location||Onset of symptoms up to|
|Saturday 16 March||Day||Australian Grand Prix - Jones Stand, Gate 2 entrance and food areas at Gate 1||Wednesday 3 April 2019|
|Sunday 17 March||12pm - 1pm||Woolworths Braybrook||Thursday 4 April 2019|
|Sunday 17 March||Day||Australian Grand Prix - Fangio Stand, Gate 2 entrance and food areas at Gate 1||Thursday 4 April 2019|
|Monday 18 March||1pm - 2pm||Woolworths Braybrook||Friday 5 April 2019|
|Tuesday 19 March||3:30pm - 7pm||JQ517 Sydney to Melbourne Airport - Terminals 2 and 4||Sunday 7 April|
|Tuesday 19 March||6:35pm - 11:35pm||Flight VA99 from Melbourne to Christchurch||Sunday 7 April|
|Thursday 21 March||5am - 8am||QF1543 Brisbane to Canberra||Tuesday 9 April|
|Thursday 21 March||8am - 10am||QF809 Melbourne to Canberra||Tuesday 9 April|
|Thursday 21 March||10am - 11am||Melbourne Airport - Terminal 1||Tuesday 9 April|
|Thursday 21 March||10:30am - 11:30am||Skybus Airport Shuttle to Melbourne, Southern Cross Station||Tuesday 9 April|
|Thursday 21 March||11am - 11:30am||Southern Cross Station - Bus Terminal||Tuesday 9 April|
|Thursday 21 March||Day||Nomads All National Hostel - Spencer Street, Melbourne||Tuesday 9 April|
|Friday 22 March||Day||Nomads All National Hostel||Tuesday 9 April|
|Friday 22 March||9:00pm - 9:30pm||7-Eleven, 2 Spencer Street, Melbourne||Tuesday 9 April|
|Saturday 23 March||Day||Nomads All National Hostel||Wednesday 10 April|
|Saturday 23 March||6pm - 7pm||Chemist Warehouse, Paramount Centre, Bourke Street, Melbourne||Wednesday 10 April|
|Sunday 24 March||Day||Nomads All National Hostel||Thursday 11 April|
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 (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. The picture below is typical of rash on the face. This is a rash on day three in a young boy.
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.
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).
Reviewed 26 March 2019