Measles Situation Update: March 10, 2015
ARPHS can confirm a single case of measles was carried into New Zealand on an international flight from India on 25 February. The individual has fully recovered and as of March 6 is no longer infectious.
In response to this case, ARPHS is currently contacting approximately 200 people who have been in contact with the infected individual. This includes 110 passengers on board who were seated within 11 rows of the infected passenger. Of these passengers, ARPHS is contacting 78 people in the Auckland region, while Public Health units around the country are attempting to contact the other 32 passengers. ARPHS is also working to contact anyone who was exposed to the infected individual after the flight.
We would expect any infected passengers to show symptoms this week. People develop measles 8-18 days after they were infected. Individuals are infectious from one day before symptoms show until approximately four days after a rash develops. Anyone in contact with the child before 6 March could still be incubating the disease and they could start to show symptoms from eight to 18 days after contact.
If you or a family member are exhibiting symptoms, we urge you to phone your GP or call Healthline on 0800 611 116 before visiting your doctor. Measles is a highly infectious airborne disease, and people with measles can easily infect others in doctors’ waiting rooms. A list of symptoms can be found here.
The usual immunisation process in New Zealand is to vaccinate children at 15 months and at four years. Two vaccinations are required. If travelling with an infant younger than 15 months to a country where measles is prevalent, you should consider vaccinating the child early, however you should still vaccinate again at 15 months and four years. If you are unsure of your vaccination status you should check with your GP.
Recent communications: Confirmed case of Measles in Auckland
Other information: Measles Fact Sheets
. Information for Schools and ECEC Services
. Measles Surveillance Data
. Ministry of Health Posters
What is Measles?
Measles is a very infectious viral disease that starts with a high fever and respiratory symptoms (one or more of the following: runny nose, cough, red eyes and small white spots inside the mouth).
Three or four days after catching measles a red blotchy rash appears, starting on the neck and face, then spreading over the entire body. The rash is not itchy and fades during the first week. A person with measles looks and feels unwell and about 10% need admission to hospital.
Measles is more serious in young infants and in older adults, as well as people with low immunity. Measles is also more serious in children who are malnourished, especially in those who are low in vitamin A.
VIDEO: Measles like 'flu on crack' student says
Source: Ministry of Health. Read more about Felicity's experience here
About one in three people with Measles will experience: ear infections, pneumonia, croup, bronchitis or diarrhea. Measles in malnourished children, especially in those who are low in vitamin A, may result in blindness.
Serious nervous system complications also occur, but are very rare. These include acute encephalitis (inflammation of the brain) and Subacute Sclerosing Panencephalitis (SSPE).
How is Measles spread?
Spread of measles can occur from coughing and sneezing or through contact with nose or throat mucus. It is important to always cover your mouth with coughing or sneezing and to use a tissue that you throw away after use. Good cleaning and hand washing practice will also help stop the spread of measles.
When will symptoms appear?
It will usually take about 10 days (range 7 to 18 days) for symptoms to start showing after someone has caught measles, and the rash usually appears about day 14.
Someone with measles can pass the illness onto others for about 10 days, starting from 5 days before the rash until about 4 days after the start of the rash.
ARPHS recommends that anyone with measles stay away from work, school, childcare, and places where large groups of people gather, so that they do not spread measles. Talk to your doctor about exact dates to be kept way from work or school.
The only way to prevent infection with measles is to vaccinate with MMR vaccine. A single dose of MMR vaccine given at 12-15 months will provide immunity to over 90% of recipients. A second dose will increase the immunity level to about 99%. Two doses of the measles vaccine is all you need to protect yourself, your family and your community. Check with your GP if you or your child should be vaccinated – vaccination is free for children and adults who are not immune to measles.
The high amount of measles worldwide means increased risk of bringing measles into New Zealand.
The recent measles outbreak in Auckland (489 cases) was started with an unimmunised child, who became infected on a family trip to England, then developed measles when back in Auckland.
Worldwide, there has been a resurgence of measles. In Europe (a common destination for New Zealanders) over 30,000 cases were notified in both 2010 and 2011 while in Australia (also a common travel destination) there have been 89 cases of measles confirmed from January to August 2012, 71 of them in New South Wales.
Anyone travelling overseas, whether a child, teenager or adult should know their immunisation status before they leave. Where there is any doubt, immunisation with MMR vaccine is recommended prior to travel.
The Ministry of Health has developed posters for primary care, after hours clinics and emergency departments.
Download them here:
After more than three months with no new confirmed cases, Auckland’s measles outbreak is officially over.
The final figures are:
- 112 confirmed measles cases notified since January 2014
- 12 cases imported from overseas, three of these in babies too young to be immunised
- 18 sporadic cases (cases in the community not linked to other cases)
- 26 cases required hospital treatment
- 3113 contacts traced by ARPHS, many of whom had to be quarantined – missing school, work and other important events
ARPHS wishes to thank all those affected by measles for their cooperation, and to the region's health professionals for their help in limiting the spread of measles.
GRAPH: Number of measles cases in the Auckland region by week
This data has been broken down by other factors including age, ethnicity, and immunisation status. Download it here (PDF, 177 KB).
Black dots represent imported cases (brought into NZ), blue dots represent 'EpiLinked' cases, which means public health have been able to link this case to another known Auckland case, and red dots represent 'sporadic' cases, which means the disease was locally acquired but public health has been unable to trace its origin.
The video shows each of these cases appearing on the date of onset rash symptoms, and each case remains on the map for 10 days (the infectious period) before disappearing. If more than one case subsequently appears at one location (ie. a household) the dot size increases.
VIDEO: Confirmed measles cases in Auckland, New Zealand 2014
An animated map of Auckland showing the location of confirmed measles cases across the region from 1 January -30 June 2014.
Auckland map via Open Street Map project, measles cases from EpiSurv (the national notifiable disease surveillance system) and enhanced with data from NDCMS (APRHS' notifiable case management system).
The Auckland Regional Public Health Service can confirm that the outbreak officially ended 24 July 2012:
- 489 confirmed or probable cases of measles in Auckland (out of a nationwide total of 12)
- 82 of those cases have required hospitalisation
- Statistical information about this measles outbreak (PDF, 145.51KB)
These figures are from 25 May, 2011 until 24 July 2012 when the outbreak in the Auckland region ended.