SA Health has been notified of a case of measles in a person who was a contact of the previous measles case. This is the third measles case in South Australia this year, with three cases reported last year. There are now multiple exposure sites in Adelaide, with these listed below. People in these settings at the specified times may have been exposed.
Measles is a highly contagious viral infection 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 rash classically appears 4 days after prodrome onset. 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 until 4 days after the onset of the rash.
Doctors are encouraged 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 urine in a yellow top container both for measles PCR; and measles serology 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.
- 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 as and up to 30 minutes after the infectious patient has left the rooms as contacts.
- Ensure all household and other contacts are protected against measles (see Australian Immunisation Handbook https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/measles).
- Offer post exposure prophylaxis to non-immune contacts who have been at exposure sites listed above as per Measles CDNA National Guidelines for Public Health Units.
Measles vaccination
- 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. See Australian Immunisation Handbook.
- Most people born in Australia before 1966 will have had measles in childhood and be immune (unless immunosuppressed). In Australia during the late 1960s to mid-1980s only one measles vaccine was routine, hence people born during this time may require an additional vaccine to be immune.
- Vaccination against measles can now be given from 6 months of age in infants travelling to countries where measles is endemic or measles outbreaks are occurring (if given <12 months, 2 subsequent doses will be required).
Further clinical information is available at www.sahealth.sa.gov.au/InfectiousDiseaseControl
