Measles alert as vaccine coverage declines

4 minute read

If a patient has the ‘three Cs’ and a rash, suspect the disease until it's confirmed otherwise.

Measles cases are on the rise in Australia, pushed by returning overseas travellers and declining national vaccination rates, an infectious diseases expert warns.

As of 19 February, there have been 14 reported cases of measles nationally, more than half the number recorded for the whole of 2023.  

NSW Health this week reported two new cases of the highly infectious disease in people who had recently returned from Asia, where there have been measles outbreaks in several countries.

Those NSW cases pushed the numbers to five in that state, while there are four in Victoria, three in Queensland, one in South Australia and one in the ACT. No cases have been reported in the Northern Territory, Western Australia or Tasmania this year.  

Last year there were 26 cases of measles nationally, according to the National Notifiable Disease Surveillance System.

Infectious diseases physician and microbiologist Associate Professor Paul Griffin from the University of Queensland said it was difficult to predict how much case numbers would rise this year but warned against complacency particularly with falling vaccine coverage.

“The challenge we’re facing with measles at the moment is that vaccine coverage has declined significantly,” the director of infectious diseases at Mater Health Services told TMR.

“Given it’s perhaps the most infectious virus that we see, the probability of secondary transmission within our country is very significant, particularly if we’re complacent and people don’t pay attention to the public health alerts and we don’t maintain high vaccine coverage.”

Professor Griffin said to watch out for the “three Cs” of measles – cough, coryza, and conjunctivitis – with a rash.

“That really has to be thought of as measles until proven otherwise,” he said.

Professor Griffin also recommended checking with patients whether they were up to date with their measles vaccinations.

“For a lot of people, it may not be that they’re intentionally averse to being vaccinated, but they – particularly those people born after ‘66 but not recently – might not be aware that they may be eligible for a vaccine,” he said.

“Because we’ve seen so few cases in recent times, I think there is a reduced recognition of how people may present and how to test people quickly.”

Professor Griffin urged GPs to be aware of the symptoms of measles, expedite testing and to quickly alert the appropriate relevant authorities when there are positive cases.

He said measles faced the same paradox as other infectious diseases that have effective vaccines.

“When you have such an effective vaccine, you see very little disease that people start to wonder why we need to even worry about that sort of an infection,” he said.

“But what’s really clear is if we get complacent, if our vaccine coverage drops, if people don’t heed the warnings about exposures and getting tested when we do have cases, then we will continue to see significant numbers.

“It is a very serious infection that I think a lot of people underestimate because of that paradox, because of how good the vaccine is and how little severe disease we’ve seen over a very long time.”

Following the latest cases detected in NSW, health authorities this week issued a measles alert with potential exposure sites listed.

South Eastern Sydney Local Health District Director of Public Health Dr Vicky Sheppeard said anyone born during or after 1966 needed to ensure they had received two doses of measles vaccine.

“This is particularly important prior to overseas travel, as measles outbreaks are occurring in several regions of the world at the moment,” she said in the statement.

“Symptoms of measles include fever, runny nose, sore eyes and a cough, usually followed three or four days later by a red, blotchy rash that spreads from the head to the rest of the body.”

In NSW, the measles-mumps-rubella (MMR) vaccine is free for anyone born during or after 1966 who hasn’t already had two doses.

Children aged six to 12 months can have their MMR vaccine schedule adjusted to receive their first dose earlier if they are travelling, NSW Health said.

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