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Measles in Northland

An 11 year old visitor from Auckland has been diagnosed with measles, and another 14 month old from Australia suspected to have measles, has presented to the Bay of Islands Hospital over the weekend.

Fortunately, there has been limited public space exposure – but anyone who was at Ngawha Springs Hot Pools on Mon 22 April (i.e. Easter Monday) between 7-8pm, is encouraged to make contact with the Public Health Unit - 0800 600 720.

Medical Officer of Health Dr Virginia McLaughlin said the Public Health Unit "has contacted, or is contacting, more than 49 people" potentially exposed to the disease.

"It was only a matter of time before we saw measles in Northland given our low immunisation rate and with many families travelling over the school holidays the risk of being exposed to measles is far greater,” notes Dr McLaughlin.

Measles is one of the most infectious diseases in humans, and under-immunised people who come within two metres of an infectious person, however briefly, have a 90 percent chance of contracting measles.

People need to be very aware of the symptoms of measles which starts with a fever and cough and runny nose and sore red eyes and then after three or four days a rash appears on the face and then spreads to the body.

You are contagious five days before to five days after rash onset – so in the early stages you may spread the infection without actually knowing you have measles.

“If you are found to be a contact of a case of measles (and not immune) you will need to stay away from work, school or public places for up to 14 days, to help prevent putting other people at risk.”

Note that the Medical Officer of Health will be enforcing these exclusion periods, to ensure that our community is protected, so the best way to avoid this is to get up to date with your immunisations now.

It has been estimated that to prevent recurrent outbreaks of measles, 95 percent of the population must be immune. Presently, this rate is about 86 percent so we are well below target in Northland.

“This is incredibly frustrating as a public health practitioner, practising in a developed country such as New Zealand,” Dr McLaughlin said.

“Our low coverage rate, means that the most vulnerable people (e.g. babies and children too young to be immunised, and those with immunosuppressive disorders) are being placed at unnecessary risk. Make no mistake measles can be a very serious illness, and is easily prevented by vaccination.

“Given our immunisation rates are very low it may be time to start looking at compulsory immunisation.”

Only people who were born before 1969 or have had two MMR vaccinations are considered fully protected.

Those aged between 29 and 50 will only have had one measles vaccination and are not considered immune. Modelling suggests those aged 14 to 37 years of age are most susceptible to contracting measles.

The best protection is for people born after 1969 is to have had two MMR (measles, mumps and rubella) vaccinations. If you are not sure if you have had two doses of the MMR vaccine, check with your usual general practice, or look in your Well Child book, or ask your parents.

All New Zealanders are eligible to two free doses of MMR.

Individuals, or their family members, who have symptoms suggestive of measles should immediately seek advice from a doctor, and avoid contact with young children.

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.

Measles Fact Sheet

• Measles is a highly infectious viral illness spread by contact with respiratory secretions through coughing and sneezing

• Symptoms of measles include:

o A respiratory type of illness with dry cough, runny nose, headache
o
o Temperature over 38.5 C and feeling very unwell
o
o A red blotchy rash starts on day 4-5 of the illness usually on the face and moves to the chest and arms.
o
• People are infectious from five days before the onset of the rash to five days after the rash starts.

Infected persons should stay in isolation – staying home from school or work – during this time.

• The best protection from measles is to have two MMR vaccinations. MMR is available from your general practice and is free to eligible persons.

• People are considered immune if they have received two doses of MMR vaccine, have had a measles illness previously, or were born before 1969.

• Anyone believing they have been exposed to measles or exhibiting symptoms should not go to the ED or after hours’ clinic or general practitioner. Instead call Healthline free on 0800 611 116 for advice and information from a trusted registered nurse, anytime, 24 hours a day, 7 days a week.

How you get it

Measles virus is highly contagious. It is spread through the air by infected droplets or by direct contact with secretions from the nose or throat of infected persons, for example by touching contaminated items or surfaces. It can survive for up to two hours in the air. A person with measles is most contagious from when symptoms start until three to four days after the rash appears.

Anyone who has not received at least one dose of a measles-containing vaccine or who has not already had the disease is at risk of catching measles.

Symptoms and treatment

It usually takes 10-12 days from exposure to the first symptom. The illness begins with fever, cough, runny nose and conjunctivitis (inflammation in the eyes), which lasts for 2-4 days. It may be possible to see small white spots (Koplik spots) inside the mouth. A rash appears 2-4 days after the first symptoms, beginning at the hairline and gradually spreading down the body to the arms and legs. The rash lasts for up to one week.

There is no specific antiviral treatment for measles. Supportive care including rest, good nutrition, vitamin A supplements, painkillers and adequate fluid intake, including hospital care when needed, can help to manage severe complications.

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