One of the confirmed Victorians to have measles travelled interstate to Brisbane while infected
A fifth case of measles has been confirmed by the Victorian Department of Health. The person is a relative of one of the four cases already known.
Of the four initial cases, three were reportedly in the Melbourne CBD area during the Queen’s birthday weekend, making it the likely place and time of transmission, says Bram Alexander, spokesperson for the Victorian Department of Health and Human Services.
“It’s not unexpected that we received this latest notification, and we fully expect more cases to come,” says Alexander.
None of the cases have travelled internationally and all are likely to have acquired measles within Victoria, says Victoria’s acting Chief Health Officer, Dr Finn Romanes.
However, some of the infected individuals travelled around Melbourne and regional Victoria while infectious.
“There are many other areas across metropolitan Melbourne where infections may have been acquired, and individuals have attended a range of public settings across Melbourne and in regional Victoria whilst infectious, including Shepparton,” says Dr Romanes.
One of the infected individuals also travelled to Brisbane from the 25 to 28 June while infectious.
The Queensland Department of Health has subsequently put out their own measles alert encouraging people who are unsure of their immunity status to speak with their GP.
““Public health staff have already been contacting people known to have been in close contact with the case,” says Metro South Health (MSH) Public Health Physician Dr Bhakti Vasant.
“But given the number of people potentially exposed, further measles cases could present in Brisbane or elsewhere over the next few weeks,” says Dr Vasant.
The flight and travel details of the infectious person were:
- Jetstar flight JQ 574, Melbourne to Brisbane, departing at 12:30pm Sat 25 June
- Brisbane Domestic Airport Sat 25 June early afternoon and Tue 28 June late morning and early afternoon
- Beenleigh Train (from Brisbane Airport to Beenleigh Station) Sat 25 June afternoon
- Beaudesert Fair Shopping Centre on Mon 27 June afternoon
- Jetstar flight JQ 569, Brisbane to Melbourne, departing at 12:45pm Tue 28 June
All health staff have been asked to be on alert for new measles cases, and have a high index of suspicion for patients presenting with a febrile rash.
Clinical features of measles include prodromal fever, a severe cough, conjunctivitis and coryza. Individuals, especially children, are typically unwell.
The most important clinical predictors are the following features:
- generalised, maculopapular rash, usually lasting three or more days, AND
- fever (at least 38°C, if measured) present at the time of rash onset, AND
- cough, coryza or conjunctivitis.
Measles is transmitted by airborne droplets and direct contact with discharges from respiratory mucous membranes of infected persons and less commonly, by articles freshly soiled with nose and throat secretions.
It is highly infectious and can persist in the environment for up to two hours, says Dr Romanes.
The incubation period can last up to 18 days, from exposure to the onset of fever, with an average of 14 days from exposure to the onset of rash. The infectious period of patients with measles is roughly five days before, to four days after, the appearance of the rash.
The Victorian Department of Health urges health workers to notify suspected cases immediately to the Communicable Disease Prevention and Control Section via telephone on 1300 651 160 (24 hours).
To minimise the risk of measles transmission within your department/practice:
- avoid keeping patients with a febrile rash illness in shared waiting areas
- give the suspected case a single use mask and isolate them, until a measles diagnosis can be excluded
- leave vacant all consultation rooms used in the assessment of patients with suspected measles for at least 30 minutes after the consultation.
Image: Wellcome Images