Measles - what you need to know
Dr Carla Morley is a Consultant Paediatrician at Leading Steps Paediatric Clinic with special interest in infectious diseases.
In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.
New Zealand is experiencing an ongoing epidemic with its worst outbreak in decades. In 2019 there were 2161 cases reported, with children under five, people aged 15-29 and Pacific peoples the most affected. At least 74 cases of measles in Australia and the epidemic in Samoa have been linked with the New Zealand outbreak.
A state of emergency in Samoa was declared late 2019 after 5600 confirmed cases and 81 deaths. Schools were closed, a curfew was imposed and christmas celebrations and public gatherings were cancelled. All unvaccinated families were ordered to display a red flag or cloth in front of their homes to warn others and to aid mass vaccination efforts. 61 out of the first 70 deaths were aged four and under and all but seven were aged under 15.
Thailand and the Philippines are in the top 10 countries in the world for number of measles cases.
Anyone who is not fully vaccinated against measles is at risk of becoming infected when traveling overseas. They may also risk exposing others to this highly infectious, serious illness either while travelling, or on return to Australia.
WHAT SHOULD I DO TO PROTECT MY CHILD?
The best protection for very young children is to ensure that parents and other people around them are vaccinated. Babies born to mums who are immune will have some of this protection passed on during the early months.
However it is important to know the vaccination is contraindicated during pregnancy.
Immunisation protects the individual and also the wider community (those that cannot be immunized due to specific health conditions) by herd immunity. Herd immunity needs to be maintained around 92-94% to prevent broad transmission of measles.
Check that you and your family are up to date with immunizations before traveling overseas.
WHAT AGE WILL BE MY CHILD BE PROTECTED FROM MEASLES?
The standard national immunization program includes measles vaccination at 12 and 18 months.
For infants travelling overseas public health authorities recommend vaccination from 6 months of age. The standard two course immunisations at 12 and 18 months is still recommended after this.
Catch up immunizations are available for children that have not been vaccinated. You can speak to your GP or paediatrician about this.
WHY ARE PEOPLE BORN BETWEEN 1966 AND 1994 AT RISK?
To be protected from measles two doses of the MMR vaccine are needed. People born between 1966 and 1994 are most likely to have only one dose of MMR vaccine. While the measles vaccination has been in Australia since 1968 the two dose program was only introduced in 1992. That means most people in this age group will not have received the two doses of measles vaccine needed for optimal immunity.
WHAT ARE THE SYMPTOMS OF MEASLES?
Cough, runny nose, sore red eyes, fever, rash
Other complications can include diarrhoea and vomiting, pneumonia and other respiratory complications, problems for pregnant women and swelling of the brain and even death.
Some complications can also (rarely) occur many years after exposure.
WHAT IF YOU ARE NOT PROTECTED?
Measles is highly contagious and approximately 90% of susceptible people will develop measles if exposed.
Unfortunately there is no treatment for measles. Being protected via vaccination is the best defense against this serious disease.
IS AUSTRALIA AT RISK OF A MEASLES EPIDEMIC?
Australia currently has an all time high vaccine coverage with 94.5% of five year old children fully immunised at the end of 2017.
This level of coverage creates the herd immunity needed to prevent measles spreading to others, including those who cannot be vaccinated, which is good news for all Australians.
However there is low coverage in the nearby Asia Pacific and measles has resurfaced in countries due to falls in vaccine coverage from unfounded safety concerns. The World Health Organisation has listed vaccine hesitancy in the top 10 threats to global health.
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