Measles Alert
Information for NSW General Practitioners
Please distribute to all medical and nursing staff
Measles situation
• Of the 10 cases this year, 6 were acquired overseas. The remaining 4 acquired measles in NSW
following contact with known cases.
• There are large outbreaks currently in South-East Asia particularly Vietnam and Indonesia.
• Measles transmission is increasing globally, including in countries where measles has been
eliminated such as the United States, Canada, and the United Kingdom.
• There is continued risk of measles in NSW due to international travel. Have a high index of
suspicion for measles in anyone with clinically compatible symptoms who arrived in Australia
from overseas within 18 days of first symptom onset, even if they report measles vaccination.
How does measles present?
• A 2-4 day prodromal illness with fever, cough, coryza, and conjunctivitis.
• A maculopapular rash typically begins on the face and neck and then spreads down the body.
• Measles in previously vaccinated people may present atypically, with milder symptoms and a
slower, or altered progression of the rash.
• Cases are usually infectious from the day before the prodrome to 4 days after rash onset.
How to manage suspected cases
• Isolate: measles is a highly contagious illness. Have the patient wear a mask and move them
away from the waiting room and staff.
• Notify: inform your Public Health Unit (PHU) immediately by calling 1300 066 055 (don’t wait
for test results before calling).
• Test: collect a nose and throat swab, and a first pass urine sample for nucleic acid testing
(PCR) and blood for measles serology (IgM and IgG). Ensure airborne precautions are in place.
Mark the tests requested as URGENT and note the travel history on the request form. Your
PHU can assist in expediting testing.
Opportunistic measles vaccination
• Consultations prior to overseas travel are opportunities to provide measles vaccination for
any patients with an uncertain measles vaccination history.
• Children aged from 6 months to under 12 months can have an MMR vaccination early if
travelling overseas. Children who do receive an earlier dose should receive their usual MMR
vaccine at 12 months of age or 4 weeks after the 1st early dose, whichever is later. They
should receive their final dose of MMRV at 18 months of age as routinely recommended.
• Measles containing vaccines (MMR) are free in NSW for those born during or after 1966 who
do not have two documented doses.
For further information, please see www.health.nsw.gov.au/Infectious/measles