Health alert
- Status:
- Active
- Alert number:
- 230218
- Date issued:
- 17 Feb 2023
- Issued by:
- Associate Professor Deborah Friedman, Deputy Chief Health Officer (Communicable Disease)
- Issued to:
- Health professionals and the Victorian community
Key messages
- A new case of measles has been identified in a returned overseas traveller.
- The case was infectious at a number of premises between 16 and 17 February 2023.
- People who attended the listed exposure sites during the specified dates and times are advised to monitor for symptoms of measles. Symptoms can develop 7 to 18 days after exposure.
- Unvaccinated or immunocompromised people who attended the listed exposure sites should seek medical assessment for post-exposure prophylaxis as soon as possible.
- In this case, MMR vaccine can be administered within 72 hours of initial measles exposure, or immunoglobulin within 6 days of exposure (for selected people).
- Anyone who develops symptoms of measles should seek medical care. Wear a mask and call ahead to make sure you can be isolated from others.
- Healthcare professionals should be alert for measles in patients presenting with fever and rash, particularly if they were overseas or attended a listed exposure site during the specified period. People with compatible illness should be tested, advised to isolate, and notified to the Department of Health.
- Offer free measles-mumps-rubella (MMR) vaccine to all people born during or since 1966 who do not have documentation that they have received two doses of measles containing vaccines. Vaccinate all individuals who are unsure of their vaccination history, regardless of Medicare status.
- There is no need to check serology prior to vaccination.
- Anyone planning overseas travel should ensure they have received vaccinations appropriate for travel.
- Be aware that the initial symptoms of measles are similar to that of COVID-19 and influenza. If a patient has a negative COVID-19 test, but develops a rash, consider measles.
What is the issue?
A case of measles has been identified in an overseas traveller. There have now been 8 cases of measles reported in Victoria since 1 January 2022. Any overseas travel could lead to exposure to measles at the current time. Outbreaks of measles have been recently reported in Asia, Africa, Europe, and the USA.
The table below is a summary of public exposure sites for the current measles case in Victoria.
Date | Time | Location | Monitor for onset of symptoms up to |
Thursday, 16 February 2023 | 6:00 pm to 7:30 pm | Hikaru Sushi M-City - | Monday, 6 March 2023 |
Thursday, 16 February 2023 | 7:00 pm to 10:00 pm | Village Cinemas – cinema number 6 M-City Monash Shopping Centre | Monday, 6 March 2023 |
Friday, 17 February 2023 | 4.45 pm to 5.30 pm | Chemist Warehouse Clayton 403/407 Clayton Rd, Clayton VIC 3168 | Tuesday, 7 March 2023 |
Anyone who presents with signs and symptoms compatible with measles should be tested and notified to the Department of Health. There should be an especially high level of suspicion if they have travelled overseas or visited any of the areas listed above and are unvaccinated or partially vaccinated for measles.
Who is at risk?
Any person born during or since 1966 and who does not have documented evidence of receiving two doses of a measles-containing vaccine or does not have documented evidence of immunity, is at risk.
Unvaccinated infants are at particularly high risk of contracting measles. Infants as young as six months of age can receive MMR vaccine prior to travel overseas to countries where measles is endemic, or where measles outbreaks are occurring. The first dose of MMR vaccine is usually given at 12 months of age as part of the National Immunisation Program Schedule (NIP). If an infant receives an early dose of MMR vaccine (e.g. at 8 months) prior to travelling overseas, they are still required to receive their routine 12 month and 18 months doses in line with the NIP schedule. MMR vaccine is free for infants aged 6 to 12 months travelling to measles affected areas.
Symptoms and transmission
Clinical features of measles include prodromal fever, a severe cough, conjunctivitis and coryza, followed by a maculopapular rash usually starting on the face. It is important to be mindful that initial symptoms of measles may be similar to those of COVID-19 and influenza. If a symptomatic patient has a negative COVID-19 and/ or influenza test, they should continue to isolate and be tested for measles if they develop a rash.
People with measles are potentially infectious from around 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.
Recommendations
For the general public
People who attended the listed exposure sites during the specified dates and times may have been exposed to measles and should monitor for symptoms.
Anyone who develops symptoms of measles should seek medical care. Ensure to call the health service beforehand and wear a mask.
It is important to stay up to date with your vaccinations. Anyone planning overseas travel should receive vaccination appropriate for travel.
For health professionals
Free measles-mumps-rubella (MMR) vaccine is available for people susceptible to measles. People who are not Medicare eligible can also receive the free MMR vaccine. Serology is not required before vaccinating.
A person is potentially susceptible, if they were born after 1966 and do not have documented evidence of receiving two doses of a measles-containing vaccine or do not have documented evidence of immunity. Anyone planning overseas travel should ensure they have received vaccinations appropriate for that travel.
General practices and emergency departments are recommended to:
- Be alert for measles infection – ensure all staff, especially triage nurses, have a high index of suspicion for measles in patients presenting with a febrile rash.
- Notify suspected cases immediately to the Department of Health via telephone on 1300 651 160 Discuss the need for nose and throat swabs for PCR diagnosis with the department. PCR testing for measles does not attract a Medicare rebate.
- Take blood for measles serology in all suspected cases.
- 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 face 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.
Reviewed 18 February 2023