Public health in overdrive managing measles outbreak

Public health in overdrive managing measles outbreak

Auckland Regional Public Health Service (ARPHS) are working hard to contain a measles outbreak with 48 people currently in quarantine, four confirmed cases of the disease and more cases being investigated following a public health alert last week when a person ignored quarantine instructions.

"Some staff are working extra shifts and the phone is constantly ringing. The laboratories have an unusually heavy workload as they visit people’s homes to obtain blood samples and process blood tests so we can quarantine people who are not immune. Our number one priority is public safety and that means stopping the disease spreading as quickly as possible," says Medical Officer of Health Dr Richard Hoskins.

During this phase of the outbreak the ARPHS team is working quickly and efficiently to minimise public risk. ARPHS is focused on extensive tracking of individuals exposed to the disease, establishing each person’s immunity, isolating those who are infectious and managing quarantine.

"There can be a delay of up to 14 days until the first symptoms appear, so we’ll know by the end of this week if anyone from Skycity Casino or Sugar Tree apartments has been infected" says Dr Hoskins.

People who are at risk are those who visited:

1) Skycity Casino 9th February 9.45pm - 12.00am: level 2, level 3 and public areas

2) Sugar Tree apartments 9 - 13th February in the lifts and common areas.

Three of the measles cases stem from an infected passenger on China Southern Airlines flight CZ305 arriving at Auckland airport on 30th January. A public health alert was raised after one person ignored quarantine potentially exposing hundreds to the disease.

"I’m disappointed with this individual who disobeyed medical instructions for quarantine. They have let the public down and created a major upheaval for those involved. My plea to the people of Auckland is to always follow medical instructions and ensure you are vaccinated so you are protected against measles," says Dr Hoskins.

The fourth case is unrelated to the China Southern Airlines flight and this person became ill after an overseas holiday. ARPHS will not be issuing a public health alert for the fourth case as the exposure was contained to medical waiting rooms. Patient lists have been provided and ARPHS is in the process of tracking people down to establish immunity.

Measles at a glance: Q &A with Dr Richard Hoskins

Is it easy to catch measles? Yes measles is one of the most contagious diseases in the world. The virus from an infected person can stay in the air for more than an hour after they have left the room. This means if you don’t have immunity you can contract the disease by simply walking past someone with measles. In a recent case one child infected 25 others at school within 48 hours.

Is it possible to have measles without realising?

Yes. If you have measles there could be a delay of up to 14 days until the first symptoms appear. People can be infectious with no symptoms while spreading the disease to other people who are not immune. This is why the Medical Officer of Health instructs people who are at risk to go into quarantine.

How serious is measles?

For many it is a moderate illness but for some it can be very serious. In New Zealand 20% of cases require hospitalisation. There are a number of complications such as acute encephalitis which is a rare condition occurring in 1 out of 1000 cases and can lead to death or permanent brain damage.

Are enough people vaccinated against measles? No. According to research there are a number of people who are unvaccinated especially in the 10-30 age groups. If you are not immunised you have the potential to catch and transmit the disease which means you are risking your health and those around you. Everyone needs to check their vaccination records but this is particularly important for those aged 10-30.

Why are there people in the 10-30 age groups who are not immune to measles?

The reasons are complex, some in this cohort may have had a single MMR (measles, mumps, and rubella) vaccination at 12 months which we now know to be insufficient protection. For others they have simply not been vaccinated. New Zealand’s immunisation programme has improved over time.

How do I know if I am immune to measles?

First ring your doctor to check your vaccination records. If you are unable to locate your vaccination history or if you are unsure of your immunity you can get a blood test and discuss with your doctor whether you are immune to the disease. Some people will have their Well Child or Plunket baby book which contains vaccine records.

Does vaccination mean I am immune?

The disease is so infectious that you need two doses of the vaccine for the best chance of immunity. If you have only had one dose then your second dose is free using the MMR vaccine. If your vaccination history is unclear we recommend you either get a blood test to check your immunity or have two doses of the MMR vaccine with a month in-between.

If I contract measles how can it be treated?

There is no treatment to cure measles or stop the illness once you have contracted the disease. The only way to protect yourself is to become vaccinated so you don’t catch it in the first instance. A high dose of vitamin A can reduce some complications and is recommended for hospitalised children in New Zealand.

What are the symptoms of measles?

The first symptoms are a fever, and one or more of a runny nose, cough and sore red eyes. After a few days a red blotchy rash starts on the face and spreads to the rest of the body.

Where can I get information more on measles?

Phone Healthline for advice on 0800-611-116 or ARPHS on 09-623-4600 or visit the Auckland Regional Public Health Service website for a fact sheet on measles: http://tinyurl.com/arphsmeaslesfactsheet

ENDS

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