Measles: Post exposure prophylaxis protocol for urgent care and GPs

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Post exposure prophylaxis (PEP) can consist of MMR vaccine or normal human immunoglobulin (NHIG) depending on the patient's personal risk factors and time since exposure. PEP type will be guided by the local public health unit (PHU).

Asymptomatic contacts do not need to isolate unless advised by the local PHU.

Notify the local PHU immediately for all suspected measles presentations on 1300 066 055.

​Purpose

  • This document outlines actions for clinicians in assessing and administering post exposure prophylaxis (PEP) for eligible contacts of a confirmed measles case as advised by the local PHU.
  • The document also covers expected actions for providers in the event of a new suspected measles case and potential exposure within the facility.
  • Access HealthPathways​ in your jurisdiction or see NSW Health Measles information for healthcare professionals for more information.

Measles PEP

  • The PHU will determine who is considered a contact of a measles case and will assess which form of PEP is most appropriate.
  • If a patient presents asking for measles PEP without PHU referral, please contact the local PHU to discuss their exposure.
  • If a contact presents and is symptomatic, please test, isolate and contact the PHU for advice.
  • The Australian Immunisation Handbook -Man​aging contacts of measles cases​ and the following table outlines measles PEP options depending on individual risk and time since exposure to the case.
​MMR Vaccine​              Normal Human Immunoglobulin (NHIG)
  • ​Should be given within first 72 hours of first exposure
  • Contains live attenuated virus
  • Is an intramuscular injection (IMI)
  • Can be given to eligible contacts:
    • 6 months and older
    • Individuals with unknown immunity as they can receive additional doses safely
  • Children aged 6-11 months who receive MMR vaccine will still need two further doses after turning 12 months of age as per the national immunisation schedule.
  • MMR cannot be given to
    • Children under 6 months
    • Pregnant women
    • Individuals who are immunocompromised
​
  • Can be given to eligible contacts at high risk from measles within 144hrs (6 days):
    • Children under 6 months
    • Pregnant women
    • Individuals who are immunocompromised
  • Can be given between 73-144 hours of first exposure to:
    • 6 months and older
    • Individuals with unknown immunity
  • Consult with local PHU, who will order NHIG from the National Blood Author​ity​
  • Is an IMI

 Suspected measles cases

 

If a symptomatic person needs referral to hospital, please telephone the hospital prior to their arrival so infection control can be in place upon their arrival.

  • Consider measles in anyone with fever, cough, coryza, conjunctivitis and maculopapular rash. Previously vaccinated individuals may present atypically with milder symptoms. Take a travel history.
  • Have a high degree of suspicion if the individual is a contact of a known measles case or has visited measles public exposure locations in NSW

 Measles diagram.tif

Suggested actions for suspected measles  

  • Isolate suspected measles patients in a single room with airborne precautions​. Keep the room vacant for 30min after the patient has departed. If unable to isolate, ensure patient is not in a crowded waiting room and away from other patients.
  • Contact the local PHU to notify them of the suspected measles case. Public health officers are available to provide advice after hours.
  • Collect a nasopharyngeal swab and first-pass urine for measles PCR. If testing for other respiratory pathogens, please ensure a separate swab is sent for testing, so the measles PCR is not delayed.
  • Collect blood for measles serology (IgM & IgG).
  • Mark all tests as “urgent" and note any travel history or measles exposure (e.g. contact of a known case) on the request form. Request that the local laboratory sends measles PCR specimens to ICPMR for processing on the pathology form. The PHU can assist to expedite testing.

  • If the patient is clinically well, advise them to isolate at home until test results are available.

Managing measles exposure

 

If a confirmed case of measles or a patient highly likely to have measles has attended the facility, the risk of transmission to susceptible contacts at the facility is high.

  • Urgently identify individuals (staff, patients, and accompanying people) in the waiting room from the time case/suspected case entered the facility to 30 minutes after their departure.
  • Rapidly compile a spreadsheet of these exposed individuals, including their contact information and date of birth. Where possible, flag any exposed individuals known to be pregnant or immunocompromised.
  • The PHU will assess the listed contacts for their eligibility to receive MMR or NHIG.
  • The PHU will coordinate MMR or NHIG for contacts. The PHU may ask some or all contacts to attend the facility to receive PEP. The PHU will arrange the supply and delivery of MMR and/or NHIG.

Feedback to PHU

  • Primary care providers must record MMR administration in the Australian Immunisat​ion Register​ under legislative requirements.
  • Any adverse events following immunisation are to be managed in accordance with the NSW Health adverse event following immunisation control guideline.
  • A record of MMR, NHIG administration and any adverse events following immunisation must be forwarded to the referring local PHU.
  • Patient refusal to accept PEP or PEP administration failure must be conveyed to referring PHU.

Information for contacts

  • Asymptomatic contacts do not need to isolate unless advised by the local PHU.
  • The Measles: Information for Contacts form contains useful information for clinicians to provide to measles contacts, following assessment and/or provision of PEP.

More information

For further information please call your local Public Health Unit on 1300 066 055

Current as at: Friday 19 December 2025
Contact page owner: Vaccine Preventable and Respiratory Diseases