Measles is a serious and highly infectious illness
Note for Health Professionals:
Some Auckland GPs may have received a fax on 25 June from the Ministry of Health regarding the Waikato measles outbreak “Measles circulating in Waikato, MMR vaccination is free - if in doubt, vaccinate” (dated 16 June), requesting that they recall any patients who have not received two doses of the MMR vaccine. This was sent to some Auckland GPs in error. Our advice remains the same as that issued in our Health Professional Advice dated 9 April 2014.
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:
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 -16 May 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.