Measles in air traveller triggers alert
14 December 2007
Measles in air traveller triggers alert
An international passenger arriving in Auckland aboard flight Air New Zealand, NZ734 from Brisbane on 28 November 2007 has been diagnosed with English measles (morbilli).
Dr Craig Thornley, medical officer of health, Auckland Regional Public Health Service (ARPHS), says “measles is a highly infectious disease that makes children, and sometimes adults, quite unwell for a week to ten days. Now, due to immunisation, measles infection is rare in Auckland but could spread rapidly in unimmunised groups”.
In the past, measles infection was very common in childhood. It is a highly infectious illness that can sometimes have serious consequences such as pneumonia and encephalitis (inflammation of the brain). Typical symptoms of measles are initial fever, tiredness, runny nose, cough and sore red eyes. These symptoms usually last for a few days before a red blotchy rash appears. People are infectious for 5 days before they develop the rash. The rash starts on the face over 1-2 days and spreads down to the body. The rash will last for 4-7 days. Almost all cases will make a complete recovery. Up to a third of children may develop complications such as middle ear infection and diarrhoea. From being exposed to developing symptoms usually takes 8-12 days. New Zealand children are immunised against measles at 15 months and four years of age. More information is available at http://www.moh.govt.nz/
The Auckland Regional Public Health Service (ARPHS) advises anyone travelling on flight NZ734 and who has symptoms suggestive of measles should immediately seek advice from a doctor (call ahead to alert your doctor about the possibility of measles before visiting to allow them to make arrangements to assess you safely and without infecting others), avoid contact with young children and also alert their local public health service.
Communicable Disease Factsheet: Measles
Measles is a serious disease that is easily spread through the air. Immunisation is effective in preventing the disease.
What is measles?
Measles is an acute viral disease that may have serious complications. In the past, measles infection was very common in childhood. Now, due to immunisation, measles infection is rare in Auckland.
What are the symptoms?
* The first symptoms of infection with measles are fever, tiredness, runny nose, cough and sore red eyes. These symptoms usually last for a few days before a red blotchy rash appears. The rash starts on the face over 1-2 days and spreads down to the body. Sometimes the rash peels. The rash will last for 4-7 days.
* Up to a third of people infected with measles will experience a complication. Complications are more common in young children than in adults. Complications include ear infections, diarrhoea and pneumonia, and may require hospitalisation. About one in every 1000 people with measles develops encephalitis (swelling of the brain).
How is it spread?
* Measles is usually spread when a person breathes in the measles virus that has been coughed or sneezed into the air by an infectious person. Measles is one of the most easily spread of all human infections. Just being in the same room as someone with measles for as little as an hour can result in infection.
* People with measles are usually infectious from just before the symptoms begin until four days after the rash appears. The time from exposure to becoming sick is usually about 10 days. The rash usually appears around 14 days after exposure.
Who is at risk?
* Anyone who comes in contact with measles during the infectious phase and has not been infected with measles in the past or has not received two doses of vaccine is at risk of measles infection.
* If it is less than three days since you came into contact with measles, immunisation with MMR can prevent infection.
* Infants under one year of age can receive an injection called immunoglobulin to prevent infection, if six days or less have passed since contact with measles. MMR vaccination is not recommended for this age group.
How is it prevented?
* While a person is infectious with measles (i.e., up to 5 days before and 4 days after the onset of the rash) it is important that they remain at home to reduce the possibility of spread to other people.
* The best protection against measles is through immunisation with a vaccine called MMR (measles, mumps and rubella vaccine). This vaccine provides protection against infection with measles, as well as against mumps and rubella.
* MMR vaccine should be given to children at age 15 months and a second dose at age four years. These two doses of MMR provide protection against measles to over 95% of those immunised.
* MMR vaccine is a safe and effective vaccine that has been used worldwide for many years. It is safe to have the vaccine even in those who have had previous measles or vaccination.
* While many older adults are immune to measles, because they were infected as children, young adults may have not either had measles or received measles immunisation.
* Unimmunised children who have come into contact with measles and who do not receive MMR or immunoglobulin should not attend school until 14 days after the rash appeared in the person with measles. It is recommended that susceptible adults also do not attend work during this period. This is because non-immune people can unknowingly spread the infection to others.
How is it diagnosed?
* Measles can be difficult to diagnose early in the illness because there are many other viruses that cause similar illnesses with fever and a rash. Sometimes the presence of white spots inside the mouth, called Koplik spots, the timing of the fever and the rash, and the characteristics of the rash can help a doctor to make the diagnosis.
* Whenever measles is suspected, a blood test or samples from the nose, throat or urine can be collected to confirm the diagnosis. Confirming the diagnosis is important so that other people who may be at risk of measles can be identified.
How is it treated?
* There is no specific treatment for measles. The treatment includes rest, plenty of fluids, and paracetamol for fever.
* While a person is infectious with measles it is important that he or she remains at home to reduce the possibility of spreading it to other people.
What is the public health response?
* Doctors, hospitals and laboratories must notify cases of measles to the local public health unit. Public health unit staff will interview the doctor or patient (or carers) to find out how the infection occurred, identify other people at risk of infection, implement control measures (such as immunisation and restrictions on attending school or work) and provide other advice.
* Contact the Auckland Regional Public Health Service on 09 623 4600 for advice regarding the need for immunisation, immunoglobulin and exclusions from work and school in the case of exposure to measles.