Measles Update, Measles Outbreak Auckland News

By: Eastmed  05-Apr-2012

Outbreak Status

The Auckland Regional Public Health Service(ARPHS) has now confirmed 39 cases of measles in what is the largest outbreak in Auckland this year.

Four cases have required hospitalisation. ARPHS is continuing to take appropriate steps to trace people who have been exposed and treating them.

ARPHS is also encouraging children aged between 15-months and 3 years of age who have had one MMR over a month ago to have their second MMR early ( this will then not need to be repeated at 4 years of age).

Measles - what to look for?

  • Measles is a viral infection and is highly infectious. It is spread by coughing and sneezing or by direct contact with secretions.
  • Signs of infection include:
    • Prodrome: Fever (usually the first sign, lasts 4‐7 days), malaise, anorexia, cough,
  • coryza, conjunctivitis
    • Exanthem: Koplik spots are pathognomonic for measles. These are small white spots inside the cheeks and present near the end of the prodrome, usually prior to the eruption of rash. Their absence does not exclude diagnosis
    • Exanthem: The measles rash is an erythematous maculopapular rash (usually 14 days post initial exposure, 3‐5 days post onset of prodrome). It begins on the face and upper neck and spreads to the trunk and extremities.
  • Complications:
    • Includes otitis media, diarrhoea, pneumonia and in severe cases, encephalitis.
  • Incubation period:
    • From exposure to onset of symptoms ranges from 8‐12 days.
  • Infectivity:
    • Cases are contagious from 5 days before the onset of rash to 4 days after (a total of 10 days).

Immunisation Update

  • Measles can be prevented by the combination MMR (measles, mumps, and rubella) vaccine.
  • The only effective mechanism of preventing measles infection is achieving high levels of immunisation in the population. Because the virus is highly contagious, a 5 percent susceptible population is enough to sustain sporadic outbreaks in otherwise highly vaccinated populations. A single dose of the MMR vaccine (in children older than 12 months) can induce immunity in 90 percent of recipients. A second dose of MMR vaccine increases protection rates by 5‐7 percent.
  • Primary care practices need to achieve high levels of MMR coverage within their enrolled populations and timeliness is important for children.
  • While measles infection confers life‐long immunity, ARPHS recommends all measles cases to be offered an MMR vaccine to ensure they are subsequently protected from mumps and rubella.

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