Measles | Northland DHB

Measles

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Update #11 - 2 July

If you or your child is unimmunised and have been exposed to measles Auckland Regional Public Health Service has developed this handy quarantine calculator. This will help you to work out how long you or your child need to stay at home. Visit: arphs.health.nz/measles-calculator

Your quarantine period needs to start seven days after your first contact with measles. It will finish 14 days after your last contact with measles. For example:

If your friend got their measles rash on 6 October, they will have been infectious from 1 October and will stay infectious until 10 October. If you were at work with them from 4-6 October your first contact was on 4 October and your last contact was on 6 October. You should remain in quarantine from 11 October to 20 October.

Update #10 - 25 June

A tenth case of measles has been confirmed in Northland with six cases currently under investigation. 

Public Health Nurses are offering MMR vaccination to the children and staff at the schools they are currently visiting for Boostrix immunisation, with parents being given a consent form to return to school. Children having B4School Checks are also being offered MMR if they are not up to date. 

"We know that the MMR coverage of our 11-12-year-olds is around 75 percent, and testing for measles immunity suggests that one in five people in Northland aged 13 and 29 are not immune to measles," offered Dr Catherine Jackson, Medical Officer of Health.

"With school holidays coming up it would be a good idea for parents to make an appointment with their general practice for their teenage children to be vaccinated." 

Almost everyone aged 50 or older had measles as a child and are therefore immune.  Teenagers and young adults are least likely to have been immunised as young children.

People aged 15 months to 50 years who have not previously been vaccinated against measles can be protected for free at their general practice.

"I can't emphasise enough the importance of everyone getting their immunisations up to date given the recent cases of measles in our community - now is the time to act."

If you're not sure of your vaccination history, you can check you're Well Child/Tamariki Ora (or Plunket) book, or ask your general practice. 

The community need to be very aware of the symptoms of measles which start 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.

Anyone believing they have been exposed to measles or exhibiting symptoms should not go to the ED, 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, seven days a week.

Update #9 - 10 June

There are now nine confirmed cases of measles in Northland, up three from the end of last week. The new cases range in age from 25 to 58, immunisation status was unknown and all live in Whangarei.

Contact tracing has identified that people had unknowingly visited Whangarei Hospital when they were infectious and before the rash had appeared which highlights the extreme care we all need to be taking.

“We know that measles is circulating in Northland and is well and truly here now so we need everyone in the community to be vigilant around the signs and symptoms and to know what to do if you have been exposed or are exhibiting symptoms of measles,” said Dr. Catherine Jackson, Medical Officer of Health.

“Measles is a serious, highly infectious, potentially life-threatening disease, and immunisation is the only sure way to avoid getting measles,” Dr. Jackson said.

Symptoms of measles start with a high 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. Measles is infectious for 5 days before the rash starts until 5 days after the rash has appeared and spreads very easily.

“It is really important to stay at home until you feel better, and for at least 5 days after the rash appears. If you get a rash then call Healthline on 0800 611 116 for advice and information in the first instance.” Some people get very unwell with measles, if you need to see a doctor please call ahead to your GP or the emergency department so they can prepare for your arrival.

All three new cases have been very unwell with one person being cared for in ICU. And, there are another 30 people and their close contacts in isolation because they are at high risk of getting measles and passing it on.

Update #8 - 6 June

Northland has now had six confirmed cases of measles this year, with three of those cases occurring in the last two weeks.

Be prepared for measles: 

  • Check your Immunisation Register now. Centres will need to know who is not vaccinated or immune if there is a measles case.

  • Make sure that all staff members have documented evidence of immunity from a MMR vaccination, or a previous measles diagnosis. If staff cannot prove immunity and are born after 1 Jan 1969, they should get one MMR vaccination immediately from their doctor.

  • Be aware who is particularly at risk. Pregnant women who are not immune are at risk of complications if they get measles, as are people who have weakened immune systems.
  • Know what to do with a suspected measles case. Northland Public Health Unit will help identify those who have been in contact with a measles case, and advise what action will need to be taken.

  • Include our notice to parents in your newsletter to parents. We have one (attached) which you can put in your newsletter or send to parents. We are advising parents that unvaccinated children may need to be excluded if another child at the centre has measles.

Update #7 - 30 May

What is quarantine?

Protect others: stay at home, don’t have visitors who aren’t immune

Quarantine is for non-immune people who have been close to someone with measles. This is because there is a chance they may get sick too and spread it to others.

What is quarantine?

Quarantine means staying at home, away from other people, until you are cleared of having measles. Being in quarantine means you must not use public transport, or go to:

• Work

• Preschool, school, university, college, technical institutes or any other institution

• Visit neighbours, family and friends (or have them come to visit you if they are not immune)

• Churches or other places of worship

• Social or sports activities (including gyms, shopping malls and movie theatres)

• Supermarkets and food venues, such as restaurants, cafes, takeaways, food markets

Your quarantine period needs to start seven days after your first contact with measles. It will finish 14 days after your last contact with measles. For example:

If your friend got their measles rash on 6 October, they will have been infectious from 1 October and will stay infectious until 10 October. If you were at work with them from 4-6 October your first contact was on 4 October and your last contact was on 6 October. You should remain in quarantine from 11 October to 20 October.

Why do I need to stay in quarantine?

• The measles virus can spread quickly and easily to others by breathing, sneezing and coughing. Just being in the same room as someone with measles can make you sick if you are not immune - as many as 15 people can catch measles from just one person.

• Measles is a serious disease that can make people very sick and lead to hospitalisation, serious complications or, in rare cases, death.

• It is especially dangerous for pregnant women, babies and people with low or no immunity (protection) against the disease.

• You can have measles and spread it to others before you feel sick or show symptoms

How will I know if I have measles?

The symptoms of measles are fever, runny nose, cough and sore, red eyes. A few days later a raised rash starts on the face and neck, and then spreads to the rest of the body. If you have any of these symptoms, you should call us (623 4600), your family doctor or Healthline (0800 611 116).

If it turns out you do not have measles, it is recommended that you arrange to be vaccinated with MMR vaccine by your doctor. This will prevent you from being at risk of the disease again in the future.

Questions?

• Phone Northland DHB Public Health Unit on 0800 600 720.

• If you need to see a doctor, please ring ahead.

When you arrive at the health centre or hospital, stay in the car and call (or send in whoever is with you) to let them know you have arrived.

This will prevent the spread of infection to others in the waiting room.

For more information

• Northland DHB website – www.northlanddhb.org.nz

• Ministry of Health: www.health.govt.nz

• Immunisation Advisory Centre: www.immune.org.nz (0800 IMMUNE – 0800 466 863)

Source Auckland Regional Public Health Service - Last reviewed April 2019

Update #6 - 29 April

A woman with measles was admitted to Whangarei Hospital ICU on Saturday 25 May and is now in a stable condition on the ward.  

After travelling to the Philippines, the woman travelled back to New Zealand in early May and developed signs and symptoms of measles about two weeks later. She presented at Whangarei Hospital last week, was clinically diagnosed with measles and treated as such.

“This is the third case of measles that has originated from outside of Northland, the fourth case in Northland year to date, and, this reinforces that we must be vigilant in protecting Northlanders from this disease,” Medical Officer of Health Dr Virginia McLaughlin said.

“With over 100 contacts being followed up by the Public Health team I want to emphasise that immunisation is the only way to stop a measles outbreak, make no mistake measles can be a very serious illness, and is easily prevented by vaccination.”

There has been limited exposure within public spaces whilst she was infectious, however, there is a low risk for people attending Kensington Stadium on Friday 17 May between about 6.20pm and 8.30pm. 

Anyone who was at the stadium during this time is encouraged to contact the Public Health Unit on 0800 600 720.

The community 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.

“For those people in our community who have made an effort to make sure they are up to date with their vaccinations, we’d like to say thanks for doing the right thing for your community. For those who are still thinking about it - now is the time to act. Don’t delay.”

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.

Almost everyone aged 50 or older had measles as a child and are therefore immune.  Teenagers and young adults are least likely to have been immunised as young children. If you’re not sure of your vaccination history, you can check your Well Child/Tamariki Ora (or Plunket) book, or ask your general practice. 

People aged 15 months to 50 years who have not previously been vaccinated against measles can be vaccinated if their general practice has sufficient supplies of the vaccine.  

Practices may need to defer appointments for catch up immunisations for a few weeks if vaccine stocks are low. 

A person who has been given one dose of the MMR vaccine has a 95 percent chance of being immune to the virus. More than 99 percent of people who receive two MMR doses (given at least four weeks apart, and the first dose given after age 12 months) develop immunity to measles.

It’s important to check you are up to date with your immunisations, especially if you’re travelling overseas.  See the New Zealand Immunisation Schedule for a list of free immunisations and the ages at which they’re recommended.

Go to the DHB website www.northlanddhb.org.nz for more information about the signs and symptoms of measles and what to do if you are concerned.

In 2019 there have been outbreaks of measles in Canterbury (now declared over), Auckland and Bay of Plenty.  Cases have also been reported in the Waikato, Lakes, Capital and Coast, and Southern DHB areas.  In New Zealand there have been 149 confirmed cases reported up to the 22 May, with at least 44 additional cases under investigation.

Update #5 - 29 April 

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: 
    • A respiratory type of illness with dry cough, runny nose, headache
    • Temperature over 38.5 C and feeling very unwell
    • A red blotchy rash starts on day 4-5 of the illness usually on the face and moves to the chest and arms.
  • 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 - for up to 14 days.
  • 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.

Update #4 - 19 March

Auckland Regional Public Health Service (ARPHS) is working with the University of Auckland after measles was confirmed in an 18 year old University student.

It is suspected this student acquired the illness overseas, therefore it is not linked to other cases. There have now been four measles cases in Auckland this year.

The number of confirmed measles cases in Canterbury now stands at 30, with one under investigation.

Northland does not have an outbreak of Measles, and we DO NOT want one.

The best way to prevent measles is to be immunised on time, with two free MMR vaccinations for all children at 15 months and four years. Two doses of MMR vaccine are at least 97 percent effective in preventing measles.

We do not recommend that toddlers under four get their second MMR early unless there is a clear indication for it, such as heading overseas, especially to a high-risk country (Philippines especially).

If you think you have the measles, it’s important to call before visiting your doctor to avoid spreading the virus in the waiting room. If you catch measles you're infectious from 5 days before and until 5 days after the rash appears.

 

Update #3 - 15 March 

We do not currently have an outbreak of Measles in Northland and we DO NOT want one. 

We need to maintain delivery of the MMR vaccination at ages 15 months and 4 years and ensure that children are up to date with all their vaccinations.  The best way to prevent measles is to be immunised on time, with two free MMR vaccinations for all children at 15 months and four years. Two doses of MMR vaccine are at least 97 percent effective in preventing measles.

We do not recommend that toddlers under four get their second MMR early unless there is a clear indication for it, such as heading overseas, especially to a high-risk country (Philippines especially).

If you think you have the measles, it’s important to call before visiting your doctor to avoid spreading the virus in the waiting room. If you catch measles you're infectious from 5 days before and until 5 days after the rash appears.

 

Update #2 - 14 March 2019 - Ministry of Health

There have now been 28 cases of measles confirmed in Canterbury, two cases in Dunedin and two isolated cases in Auckland. There has also been a recent outbreak in the Waikato this year and Dr Caroline McElnay, Director of Public Health at the Ministry of Health, warns there are also a number of international outbreaks. More cases of measles are therefore likely.

Update #1 - 14 March 2019

At least 27 people in the Canterbury region have already contracted measles, with a further 20 suspected cases being checked.

There are currently three confirmed cases of measles in Auckland, so measles is circulating in New Zealand, meaning it is only a matter of time before it arrives in Northland.

 

Measles is a highly infectious viral illness, that can be very serious. It is prevented by the measles, mumps, and rubella (MMR) vaccination.

Measles is caused by a virus and is easily spread from person to person. Both children and adults can get measles, and it can be very serious. A third of people with measles get ear infections, pneumonia (an infection in the lungs), or diarrhoea (loose, watery poo). Very bad cases of measles need treatment in hospital and some people can die from measles.

Your family/whānau’s best protection against measles is to be immunised against it. Protection from measles is part of the free MMR vaccinations given to children at 15 months and four years of age. If you think you or your child may not have had these vaccinations, see your doctor.

If you are concerned about measles call Healthline on 0800 611 116 or see your doctor or practice nurse.

 

Vaccines: Cameron Case Study

https://www.youtube.com/watch?v=6t3g29erg9I

Page information source: Auckland Regional Public Health Service

 

 

Measles: a quick guide Q&A

 

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