Measles Advice

MEASLES ALERT - information for NSW General Practitioners

Key points for EDs

1. Watchout for measles in susceptible patients

2. Isolate suspected cases

3. Ring the public health unit and arrange urgent tests

Seventeen cases of measles have been notified in the Sydney metropolitan region this year. It is likely that more cases will soon emerge in unimmunised or under-immunised children and young adults.

Who is at greatest risk of measles?

Infants less than 12 months of age
Children over 12 months of age who have not been fully vaccinated against measles.
Adults born during or since 1966 who have never had measles and have not had 2 MMR doses.
People who travelled overseas.

How does measles present?

2-4 days of prodromal illness with fever, cough, coryza and conjunctivitis.
A maculopapular rash typically begins on face and neck and becomes generalised. It lasts between 4 to 7 days.
Koplik spots (white spots on an erythematous base) are sometimes seen on the buccal mucosa opposite the molars.
Acute otitis media and bronchopneumonia are common complications

How should I manage suspected measles cases?

Prevent other patients from exposure by isolating suspected cases. Don't put suspected cases in the waiting room, either at the surgery, ED or at the pathology collection centre.
Notify your local public health unit by telephone. Don't wait for test results.
Arrange urgent tests including measles serology, nose and throat specimen on a viral transport swab and a first pass urine sample (~50mL) for measles immunofluorescence and culture.
If suspected cases are well enough to be cared for at home, they should remain isolated there until 4 days after the onset of the rash (when they are no longer infectious).

Immunisation is safe and effective prevention against measles

Routinely immunise infants at 12 months and children at 4 years with MMR.
Opportunistically immunise those born during or since 1966 who have had neither measles nor 2 doses of MMR (many in this age group have received none or only 1 MMR dose).
Opportunistic immunisation is especially important for people planning overseas travel
Health care workers are at increased risk. Ensure that you and your staff are immune to measles.

For more information, please call your local public health unit

Camperdown	02 9515 9420	Wollongong	02 4221 6700	Tamworth	02 6767 8630
Gosford	02 4349 4845	Goulburn	02 4824 1837	Bathurst	02 6339 5601
Hornsby	02 9477 9400	Albury	02 6080 8900	Broken Hill	08 8080 1499
Parramatta	02 9840 3603	Lismore	02 6620 7500	Dubbo	02 6841 5569
Randwick	02 9382 8333	Port Macquarie	02 6588 2750
Penrith	02 4734 2022	Newcastle	02 4924 6477

Please visit our website: www.health.nsw.gov.au/infect/diseases.htm